Treatment of metastatic transitional cell carcinoma following renal transplantation
David P. Wood, MD
Andrew C. Novick, MDAddress reprint requests to A.C.N., Department of Urology, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Douglas E. Johnson, MD
Stevan B. Streem, MD
Donald Steinmuller, MD
Renal transplantation was performed in a patient with a history of surgical excision for localized transitional cell carcinoma. The graft functioned well; however, metastatic transitional cell carcinoma developed following transplantation. The patient was treated sequentially with CISCA (cisplatin, Cytoxan [cyclophosphamide], and Adriamycin [doxorubicin hydrochloride]) and M-VAC (methotrexate, vinblastine, Adriamycin, and cisplatin) with no alteration in maintenance immunosuppression. Full-dose chemotherapy was well tolerated, with no impairment of renal function, and a demonstrable reduction in tumor burden was achieved. The patient ultimately died of metastatic disease but enjoyed an excellent quality of life throughout the post-transplant period.