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Br Med J. 1979 December 8; 2(6203): 1461–1466.
PMCID: PMC1597175

Collaborative United Kingdom-Australasian study of cancer in patients treated with immunosuppressive drugs.


A collaborative study including centres in the United Kingdom, Australia, and New Zealand was instituted in 1970 to determine the incidence of cancer in patients treated for at least three months with azathioprine, cyclophosphamide, or chlorambucil. Follow-up of 3823 renal transplant recipients showed an almost 60-fold increase of non-Hodgkin's lymphoma together with an excess of squamous-cell skin cancer and mesenchymal tumours. A series of 1349 patients without transplants showed an excess of the same tumours, though to a less extent. These preliminary findings provide no clear evidence that immunosuppressive drugs produce the increased risk of most of the common cancers that might be expected from the simplest interpretation of impaired "immunosurveillance."

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • BURNET M. SOMATIC MUTATION AND CHRONIC DISEASE. Br Med J. 1965 Feb 6;1(5431):338–342. [PMC free article] [PubMed]
  • Penn I, Hammond W, Brettschneider L, Starzl TE. Malignant lymphomas in transplantation patients. Transplant Proc. 1969 Mar;1(1):106–112. [PMC free article] [PubMed]
  • Doll R, Kinlen L. Immunosurveillance and cancer: epidemiological evidence. Br Med J. 1970 Nov 14;4(5732):420–422. [PMC free article] [PubMed]
  • Doak PB, Montgomerie JZ, North JD, Smith F. Reticulum cell sarcoma after renal homotransplantation and azathioprine and prednisone therapy. Br Med J. 1968 Dec 21;4(5633):746–748. [PMC free article] [PubMed]
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  • Gregory MC, Hughes JT. Intracranial reticulum cell sarcoma associated with immunoglobulin A deficiency. J Neurol Neurosurg Psychiatry. 1973 Oct;36(5):769–776. [PMC free article] [PubMed]
  • Isomäki HA, Hakulinen T, Joutsenlahti U. Excess risk of lymphomas, leukemia and myeloma in patients with rheumatoid arthritis. J Chronic Dis. 1978;31(11):691–696. [PubMed]
  • Lipsmeyer EA. Development of malignant cerebral lymphoma in a patient with systemic lupus erythematosus treated with immunosuppression. Arthritis Rheum. 1972 Mar-Apr;15(2):183–186. [PubMed]
  • Ulrich J, Wüthrich R. Multiple sclerosis: reticulum cell sarcoma of the nervous system in a patient treated with immunosuppressive drugs. Eur Neurol. 1974;12(2):65–78. [PubMed]
  • Walder BK, Robertson MR, Jeremy D. Skin cancer and immunosuppression. Lancet. 1971 Dec 11;2(7737):1282–1283. [PubMed]
  • Wall RL, Clausen KP. Carcinoma of the urinary bladder in patients receiving cyclophosphamide. N Engl J Med. 1975 Aug 7;293(6):271–273. [PubMed]

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