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Fatal Melanoma Transferred in a Donated Kidney 16 years after Melanoma Surgery, NEJM 2003 • A woman received a renal transplant (and was immune suppressed) May 1998 and developed melanoma in breast and kidney in 1999. Immune suppression was stopped, and she was given IFN. She died in March 2000. Primary melanoma was not found. • A man received a renal transplant in May 1998 and developed melanoma in the kidney in May 2000. Immune suppression was stopped, and IFN was given. He rejected the kidney and the melanoma and is cancer free. • Both patients received a kidney from the same donor. This donor was found to have a primary melanoma in 1982 that was removed, with no residual tumor. She was followed in melanoma clinic for 15 years and was discharged, apparently tumor free, in 1997. The donor died of a brain aneurysm (unrelated to melanoma diagnosis 16 years earlier). • Previous studies: 13 reports documenting organs from melanoma patients were given to 26 recipients, 21 of whom developed melanoma, 11 of whom died. Organs were transplanted 6 months to 8 years after the donor had undergone melanoma surgery.
Melanoma complicating treatment with natalizumab for multiple sclerosis, NEJM 2008 • Natalizumab is a humanized monoclonal antibody against alpha-4 integrins, which are important for lymphocyte homing during immune responses • It is given to patients with MS to prevent autoimmune attack on myelin sheath • This NEJM 2008 case report describes the rapid development of melanoma in 2 patients receiving this treatment. Both patients developed the melanoma from atypical moles.
Page 1 and 2: Tumor Immunology Jack Bui, MD, PhD
Page 4 and 5: Tumor immunology = the study of wha
Page 6 and 7: Immune cells function to eliminate
Page 8 and 9: Figure 15.12d The Biology of Cancer
Page 10 and 11: The birth of tumor immunosurveillan
Page 12: Paradigm shift : Cancers are opport
Page 15: Shankaran et al., Nature 2001 Mice
Page 18 and 19: The presence of tumor specific T ce
Page 20 and 21: Evidence for tumor immunosurveillan
Page 22 and 23: Shown is survival in ovarian cancer
Page 24: Endogenous T Cell Responses to Anti
Page 28 and 29: Goals 1. Present evidence that the
Page 30 and 31: Shankaran et al., Nature 2001 WT tu
Page 32 and 33: Cancer immunoediting: regressor tum
Page 35: Evidence for equilibrium • Human
Page 39 and 40: Implications of equilibrium state
Page 41 and 42: Inflammation and Cancer: “Cancers
Page 43 and 44: Evidence for inflammation induced c
Page 45 and 46: Deletion of the NF-kB activator IKK
Page 47 and 48: Goals 1. Present evidence that the
Page 49 and 50: Evidence for Cancer Immunoediting:
Page 51 and 52: Normal cell Not recognized Induced-
Page 53 and 54: Gasser et al., DNA damage induces N
Page 55 and 56: Evidence for p53’s role in activa
Page 57 and 58: Corollary to Cancer Immunoediting:
Page 59 and 60: Passenger mutations leading to neo-
Page 61 and 62: Oncogene-driven models of cancer ca
Page 63 and 64: Goals for this hour 1. Present evid
Page 65 and 66: What cells/molecules promote vs inh
Page 67 and 68: Immune therapy of melanoma • IL-2
Page 69: Peripheral blood mononuclear cells
Page 74 and 75: An example of immunotherapy
Page 76 and 77: The presence of tumor specific T ce
Page 78: Can we remove immune suppression?
Page 81 and 82: Cancer immunoediting describes the
Page 83: Some major unanswered questions •

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