Expression of APRIL in Diffuse Large B Cell Lymphomas from Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis

Löfström, Björn; Backlin, Carin; Pettersson, Tom; Lundberg, Ingrid E.; Baecklund, Eva

doi:10.3899/jrheum.101190

Cited by 35 publications

(28 citation statements)

References 36 publications

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“…Compared to other lymphoma subtypes, DLBCL cells have higher APRIL expression. 19 Furthermore, a high concentration of APRIL has been reported to be associated with both RA and SLE development. 20 However, the elevated odds ratio for high expression of APRIL has only been observed in SLE, but not RA, patients.…”

Section: Discussionmentioning

confidence: 99%

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Clinical features and outcome of lymphoma patients with pre‐existing autoimmune diseases

et al. 2017

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Aims: Previous epidemiological studies have shown that autoimmune diseases increase the risk of lymphoma development. However, whether autoimmune diseases deteriorate the outcomes for lymphoma patients remains unclear. This study aimed to identify the clinical features of lymphoma patients with pre-existing autoimmune diseases. Whether pre-existing autoimmune diseases impacted progression-free survival (PFS) and overall survival (OS) in lymphoma patients was further investigated. Methods:We retrospectively reviewed medical records of 913 newly diagnosed lymphoma patients from January 2008 to November 2016. Thirty-four lymphoma patients with pre-existing autoimmune disorders were identified. Six of these 34 patients were lost to follow-up; their data was used to examine baseline clinical characteristics but not survival. Therefore, 28 lymphoma patients with autoimmune diseases were included in the autoimmune disease group for comparing the remission rate, PFS and OS to lymphoma patients without autoimmune diseases (control group; n = 56).Results: Diffuse large B-cell lymphoma was the most common histological subtype (18/34; 52.94%). Complete remission rates in the autoimmune disease and control groups were 72.0% and 83.3%, respectively (P = 0.178). Patients with and without autoimmune diseases had similar PFS (45.4 AE 59.9 months vs. 51.5 AE 42.8 months; P = 0.398) and OS (46.4 AE 52.6 months vs. 50.1 AE 47.3 months; P = 0.352). By univariate analysis, pre-existing autoimmune diseases were not associated with inferior PFS (P = 0.326) or OS (P = 0.627).Conclusions: Lymphoma patients with and without autoimmune disorders had comparable outcomes. Autoimmune diseases are not an obstacle to lymphoma treatment.

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Section: Discussionmentioning

confidence: 99%

“…20 However, the elevated odds ratio for high expression of APRIL has only been observed in SLE, but not RA, patients. 19 Further studies are required to clarify the underlying pathogenesis for the association between DLBCL and RA.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcome of lymphoma patients with pre‐existing autoimmune diseases

et al. 2017

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“…The increased expression of APRIL in DLBCL lymphoma in some patients may indicate that APRIL may be mediating lymphoma development in SLE. 11 Furthermore, DLBCL lesions found in SLE patients seem to strongly express APRIL (a proliferation inducing ligand), which is essential for B-cell survival and development. 11 The mechanisms by which APRIL facilitate the development of lymphoma has not been elucidated.…”

Section: Discussionmentioning

confidence: 99%

“…11 Furthermore, DLBCL lesions found in SLE patients seem to strongly express APRIL (a proliferation inducing ligand), which is essential for B-cell survival and development. 11 The mechanisms by which APRIL facilitate the development of lymphoma has not been elucidated. However, it seems to play a role in allowing NHL B-cells to overcome apoptosis.…”

Section: Discussionmentioning

confidence: 99%

Burkitt’s Lymphoma in a patient with systemic lupus erythematosus

Oak

Patil

Goyle

2016

IJRCI

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Recent literature evidence has demonstrated a small but definite increase in the risk of malignancies in SLE patients when compared to general population. The present case study reports a rare occurrence of Burkitt's lymphoma in a 32-year-old female patient who had been diagnosed with SLE around 3 years ago. The study also discusses the possible pathophysiological links between Burkitt's lymphoma and SLE.

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“…After staining for APRIL expression in lymphoma biopsies from individuals with RA, SLE and control cases, Lofstrom et al . were able to demonstrate a high expression of APRIL only in SLE-associated lymphoma cases (OR 23.6, 95% CI 2.4–231.2) [62*]. In addition, Epstein-Barr virus (EBV) in the lymphoma tissue was significantly associated with elevated APRIL expression [62*].…”

Section: Inflammation-induced Cancer: the Example Of Slementioning

confidence: 99%

Cancer and autoimmunity: Harnessing longitudinal cohorts to probe the link

Egiziano

Bernatsky

Shah

2016

Best Practice & Research Clinical Rheumatology

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In many autoimmune rheumatic diseases, there is an increased risk of cancer compared to the general population. While reasons for this increased risk have not been elucidated, it has been hypothesized that the link between cancer and autoimmunity may be bidirectional. For instance, chronic inflammation and damage from the rheumatic disease or its therapies may trigger malignant transformation; conversely, anti-tumor immune responses targeting cancers may become cross-reactive resulting in autoimmunity. In rare rheumatic diseases, longitudinal observational studies can play a critical role in studying these complex relationships, enabling investigators to quantify the extent of cancer risk, identify unique clinical phenotypes that associate with cancer, investigate the biological link between these conditions, and define optimal strategies to screen for and treat underlying cancer. In this review, we discuss recent data on cancer in the rheumatic diseases, and suggest a research agenda to address the many gaps in our current knowledge base.

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Expression of APRIL in Diffuse Large B Cell Lymphomas from Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis

Abstract: The high expression of APRIL in DLBCL in SLE and in an RA subset might indicate an association between APRIL and lymphoma in these subsets of rheumatic diseases, but could also reflect a dysregulation of APRIL per se in these patient groups.

Cited by 35 publications

References 36 publications

Clinical features and outcome of lymphoma patients with pre‐existing autoimmune diseases

Clinical features and outcome of lymphoma patients with pre‐existing autoimmune diseases

Burkitt’s Lymphoma in a patient with systemic lupus erythematosus

Cancer and autoimmunity: Harnessing longitudinal cohorts to probe the link

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