Transplantation Tumors And Immunologically Privileged Sites

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Abstract
To the Editor.— The recent article by Hume's group (219:1593, 1972) relating the high incidence of reticulum cell sarcomas in immunosuppressed renal transplant recipients again emphasizes an increasingly frequent problem. That a relatively large number of malignancies should occur in such patients is not unexpected considering the accumulating evidence of a similarly increased malignancy rate associated with other immunodepressed states.1What is surprising, and currently unexplained, however, is the predilection for such tumors to occur in the brain. Penn2has collected and analyzed 37 cases of malignant tumors arising de novo in transplant recipients at some time after the start of immunosuppressive therapy and subsequent renal transplantation. Twenty-one of these cases comprised a rather heterogeneous group of epithelial tumors while 12 cases were reticulum cell sarcomas; six of these (50%) occurred primarily or exclusively in the brain. Although the vast majority of reticulum cell sarcomas involve primarily hemopoietic