Allergic disease, corticosteroid use, and risk of Hodgkin lymphoma: A United Kingdom nationwide case-control study

Abstract

Risk of Hodgkin's Lymphoma in allergic disease Hodgkin's Lymphoma Immune suppression Corticosteroids Eczema Asthma Allergic rhinitis 1.4 x 95%CI(1.2-1.6) p<0.001 6.1 x 95%CI(3.0-12.3) p<0.001 1.9 x 95%CI(1.3-2.7) P<0.001 1.1 x 95%CI(0.9-1.3) P=0.56 1.2 x 95%CI(1.0-1.5) P=0.016 1.4 x 95%CI(1.2-1.7) p<0.001 Infectious mononucleosis Background: Immunodeficiency syndromes (acquired/ congenital/iatrogenic) are known to increase Hodgkin lymphoma (HL) risk, but the effects of allergic immune dysregulation and corticosteroids are poorly understood. Objective: We sought to assess the risk of HL associated with allergic disease (asthma, eczema, and allergic rhinitis) and corticosteroid use. Methods: We conducted a case-control study using the United Kingdom Clinical Practice Research Datalink (CPRD) linked to hospital data. Multivariable logistic regression investigated associations between allergic diseases and HL after adjusting for established risk factors. Potential confounding or effect modification by steroid treatment were examined. Results: One thousand two hundred thirty-six patients with HL were matched to 7416 control subjects. Immunosuppression was associated with 6-fold greater odds of HL (adjusted odds ratio [aOR], 6.18; 95% CI, 3.04-12.57), with minimal change after adjusting for steroids. Any prior allergic disease or eczema alone was associated with 1.4-fold increased odds of HL (aOR, 1.

Immunologic dysfunction and Hodgkin lymphoma: Insight to better therapy?

“…3 The article in this issue by Rafiq and co-authors from the UK confirms previously accepted associations between development of HL and steroids or immunosuppression and suggests an extension of the relationship between HL and immunologic dysregulation by recognizing an association between asthma or eczema and HL. 4 This finding adds allergic conditions to the previously acknowledged immunologic anomalies of autoimmune, infection, and immunosuppression. The authors are to be commended for using ''big data'' to uncover this small but potentially valuable finding.…”

Narrative review on the management of moderate-severe atopic dermatitis in pediatric age of the Italian Society of Pediatric Allergology and Immunology (SIAIP), of the Italian Society of Pediatric Dermatology (SIDerP) and of the Italian Society of Pediatrics (SIP)

“…Therefore, for both drugs, there is no support for the initial hypothesis that they increase the risk of long-term cancer in children with AD [ 55 , 56 ]. A further and recent study has also highlighted a relationship between allergic diseases, use of corticosteroids and Hodgkin's lymphoma, reporting how immunosuppression was associated with a 6 times greater probability of lymphoma, with minimal change after adjustment for the use of corticosteroids [ 57 ]. Furthermore, it has recently been shown that there is no relationship between the risk of keratinocyte tumors and the use of TCIs [ 58 ].…”

Hodgkin Lymphoma: Biology and Differential Diagnostic Problem

“…The risk of CHL development is associated with socioeconomic status, especially among AYAs [ 4 , 9 ]. High socioeconomic status and lack of exposure to microorganisms during childhood have been suggested to increase the risk of NSCHL development [ 10 , 11 ]. Conversely, MCCHL in the AYA age group—which corresponds with a high prevalence of EBV infection—is predominant in developing countries, and its morbidity decreases with economic development [ 12 ].…”