Bk polyoma virus and malignancy: Cause or co-incidence?
Prashar R, Shah A, Stewart D, Williamson SR, Patel A. Bk polyoma virus and malignancy: Cause or co-incidence?. Am J Transplant 2017; 17:483.
Am J Transplant
Background The WHO agency for cancer research has classified BKV as “possibly carcinogenic”. The etiological role of BKV in human cancer, however,remains controversial.We present 5 cases of malignancies in Solid Organ Transplant recipients in association with BKV Methods The clinical characteristics and histology/immunohistochemistry(IHC) of tumors was studied by a chart review of 5 SOTR with renourinary tract tumors and +SV40 IHC and/or BK viremia Results(Table presented) All patients were male with mean age of 56.6 years and 2 were dual organ transplants.3 SOTRs received induction with ATG. The mean time to diagnosis of cancer from transplant was 11.8 years. All Renal transplant recipients had BKV for a mean duration of 4.3 years prior to diagnosis of cancer.4 tumors had positive SV40, it is still pending in one case(5).The occurrence of urothelial cancer in transplant ureter along with bladder cancer in this patient, with tumor genotype revealing recipient tissue rather than donor, in the presence of BKV, points towards the possibility of + SV40 in the tissue.Other interesting findings are SV40+ in a lymph node metastasis(4) and the SV40+ tumor in allograft nephrectomy tissue 2 years after the allograft failed(3) Conclusion While the potential oncogenic role of BKV is unclear, the increasing no. of reported renourinary tract tumors in patients with BKV, and the long latent period after transplant, warrant increased vigilance for early detection of cancers in patients with persistent BKV particularly in highly immunocompromised patients (dual organ transplants , ATG induction).