Clinicopathological features, MCPyV status and outcomes of Merkel cell carcinoma in solid-organ transplant recipients: a retrospective, multicentre cohort study

C. Ferrandiz-Pulido*, A. Gomez-Tomas, B. Llombart, D. Mendoza, J. Marcoval, S. Piaserico, C. Baykal, J. N. Bouwes-Bavinck, E. Racz, J. Kanitakis, C. A. Harwood, P. Cetkovska, A. Geusau, Veronique Del Marmol, E. Masferrer, C. Orte Cano, J. Ricar, W. R. de Oliveira, R. Salido-Vallejo, E. DucrouxM. A. Gkini, J. A. Lopez-Guerrero, H. Kutzner, W. Kempf, D. Seckin

*Corresponding author for this work

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    Background The proportion of Merkel cell carcinomas (MCCs) in solid-organ transplant recipients (SOTR) harbouring Merkel cell polyomavirus (MCPyV) is unknown, as are factors affecting their outcomes. Objective To describe clinicopathological features of MCC in SOTR, investigate the tumoral MCPyV-status and identify factors associated with tumour outcomes. Methods Retrospective, international, cohort-study. MCPyV-status was investigated by immunohistochemistry and polymerase chain reaction. Results A total of 30 SOTR and 44 consecutive immunocompetent patients with MCC were enrolled. SOTR were younger at diagnosis (69 vs. 78 years, P < 0.001). Thirty-three percent of SOTR MCCs were MCPyV-positive vs. 91% of immunocompetent MCCs (P = 0.001). Solid-organ transplantation was associated with an increased cumulative incidence of progression (SHR: 3.35 [1.57-7.14], P = 0.002), MCC-specific mortality (SHR: 2.55 [1.07-6.06], P = 0.034) and overall mortality (HR: 3.26 [1.54-6.9], P = 0.002). MCPyV-positivity and switching to an mTOR inhibitor (mTORi) after MCC diagnosis were associated with an increased incidence of progression (SHR: 4.3 [1.5-13], P = 0.008 and SHR: 3.6 [1.1-12], P = 0.032 respectively) in SOTR. Limitations Retrospective design and heterogeneity of SOTR cohort. Conclusions MCPyV appears to play a less prominent role in the aetiopathogenesis of MCC in SOTR. SOTR have a worse prognosis than their immunocompetent counterparts and switching to an mTORi after the diagnosis of MCC does not improve progression.

    Original languageEnglish
    Pages (from-to)1991-2001
    Number of pages11
    JournalJournal of the European Academy of Dermatology and Venereology
    Issue number11
    Early online date24-May-2022
    Publication statusPublished - Nov-2022


    • CANCER
    • TUMOR
    • LIVER
    • HEART

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