Hematological malignancies in connective tissue diseases

Noureldine, Hussein A; Nour‐Eldine, Wared; Hodroj, Mohammad Hassan; Noureldine, Mohammad Hassan A.; Taher, Alì; Uthman, Imad

doi:10.1177/0961203319899986

Cited by 8 publications

(7 citation statements)

References 97 publications

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“…However, the absence of any solid association between vaccines in general and autoimmune dysregulation or autoimmune markers makes the autoimmune theory less likely. Granted, immune dysregulation—which echoes autoimmune diseases’ complex symptoms, presentations, and markers—may be difficult to identify [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of the BNT162b2 vaccine on antinuclear antibody and antiphospholipid antibody levels

et al. 2022

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The Food and Drug Administration (FDA) approved the first SARS-CoV-2 mRNA vaccine (Pfizer-BioNTech) in December 2020. New adverse events have emerged since these vaccines have reached market. Although no clear association between messenger ribonucleic acid (mRNA) vaccines and autoimmunity has emerged, the significance of such an association warrants further exploration. After obtaining consent, a standardized survey on baseline characteristics and other relevant variables was conducted on unvaccinated individuals who were scheduled for vaccination and had not previously contracted COVID-19. Blood samples were collected from participants prior to the first dose, prior to the second dose, and 1 month after the second dose. All collected samples were tested for antinuclear antibody (ANA) titers using indirect immunofluorescence microscopy kits, and antiphospholipid (APS) immunoglobulin M (IgM) and immunoglobulin G (IgG) levels using an enzyme-linked immunoassay (ELISA) technique. ANA titers were positive for 9 participants out of 101 (8.9%) in the first pre-vaccination draw. For the second draw, the number of participants testing positive for ANA decreased to 5 (5%). For the last draw, 6 (5.9%) participants tested positive for ANA titers. One participant tested positive for APS IgM at the first pre-vaccination draw, 2 tested positive at the second draw, and 2 at the third draw. As for APS IgG titers, all participants tested negative in the three draws. McNemar’s test for two dependent categorical outcomes was conducted on all variables and did not show a statistical significance. The McNemar test of these two composite variables (i.e., ANA/APS, first draw vs. ANA/APS, second and third draws) did not show statistical significance. The 2-sided exact significance of the McNemar test was 1.0. The Friedman test also showed no significance ( p = 0.459). No association was found between BNT162b2 vaccine administration and changes in APS and ANA titers. The benefits of the BNT162b2 vaccine significantly outweigh any possible risk of autoimmune dysregulation considering the current evidence.

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Section: Discussionmentioning

confidence: 99%

The effect of the BNT162b2 vaccine on antinuclear antibody and antiphospholipid antibody levels

et al. 2022

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“…On the other hand, there is evidence that patients with prior systemic autoimmune rheumatic diseases have an increased risk for the development of hematological malignancies, particularly lymphomas and MDS. This has been reported for RA, SS, SLE, ITP, myasthenia gravis, and giant cell arteritis, suggesting that the immune dysregulation underlying the autoimmune disease may be involved in the generation of a "tumor permissive" soil, although the contribution of treatment with immunosuppressive/cytotoxic drugs cannot be excluded (15)(16)(17).…”

Section: Epidemiological Association Of Autoimmune Diseases and Myeloid Neoplasmsmentioning

confidence: 88%

Immune Phenomena in Myeloid Neoplasms: An “Egg or Chicken” Question

Barcellini

Fattizzo

2021

Front. Immunol.

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Immune phenomena are increasingly reported in myeloid neoplasms, and include autoimmune cytopenias/diseases and immunodeficiency, either preceding or complicating acute myeloid leukemia, myelodysplastic syndromes (MDS), chronic myeloproliferative neoplasms, and bone marrow failure (BMF) syndromes. Autoimmunity and immunodeficiency are the two faces of a dysregulated immune tolerance and surveillance and may result, along with contributing environmental and genetic factors, in an increased incidence of both tumors and infections. The latter may fuel both autoimmunity and immune activation, triggering a vicious circle among infections, tumors and autoimmune phenomena. Additionally, alterations of the microbiota and of mesenchymal stem cells (MSCs) pinpoint to the importance of a permissive or hostile microenvironment for tumor growth. Finally, several therapies of myeloid neoplasms are aimed at increasing host immunity against the tumor, but at the price of increased autoimmune phenomena. In this review we will examine the epidemiological association of myeloid neoplasms with autoimmune diseases and immunodeficiencies, and the pivotal role of autoimmunity in the pathogenesis of MDS and BMF syndromes, including the paroxysmal nocturnal hemoglobinuria conundrum. Furthermore, we will briefly examine autoimmune complications following therapy of myeloid neoplasms, as well as the role of MSCs and microbiota in these settings.

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“…Systemic sclerosis (SSc) is characterized by small vessel vasculopathy, immune dysregulation with production of specific autoantibodies, and fibrosis of skin and internal organs [1]. The disease significantly impacts on patients' quality of life and on life expectancy with a standardized mortality ratio estimated between 1.5 and 7.2 [2][3][4][5]. Today, interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are the most frequent causes of death [6][7][8]; however, infections, cancers, and cardiovascular diseases are the most frequent non SSc-related causes of death [4,7].…”

Section: Introductionmentioning

confidence: 99%

Systemic Sclerosis Association with Malignancy

Lepri

Catalano

Bellando-Randone

et al. 2022

Clinic Rev Allerg Immunol

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The association of systemic sclerosis (SSc) and cancer is well known from several decades suggesting common genetic and environmental risk factors involved in the development of both diseases. Immunosuppressive drugs widely used in SSc may increase the risk of cancer occurrence and different SSc clinical and serological features identify patients at major risk to develop malignancy. In this context, among serological features, presence of anti-RNA polymerase III and anti-topoisomerase I autoantibodies seems to increase cancer frequency in SSc patients (particularly lung and breast cancers). Lung fibrosis and a long standing SSc pulmonary involvement have been largely proposed as lung cancer risk factors, and the exposure to cyclophosphamide and an upper gastrointestinal involvement have been traditionally linked to bladder and oesophagus cancers, respectively. Furthermore, immune checkpoint inhibitors used for cancer therapy can induce immune-related adverse events, which are more frequent and severe in patients with pre-existing autoimmune diseases such as SSc. The strong association between SSc and cancer occurrence steers clinicians to carefully survey SSc patients performing periodical malignancy screening. In the present review, the most relevant bilateral relationships between SSc and cancer will be addressed.

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Hematological malignancies in connective tissue diseases

Cited by 8 publications

References 97 publications

The effect of the BNT162b2 vaccine on antinuclear antibody and antiphospholipid antibody levels

The effect of the BNT162b2 vaccine on antinuclear antibody and antiphospholipid antibody levels

Immune Phenomena in Myeloid Neoplasms: An “Egg or Chicken” Question

Systemic Sclerosis Association with Malignancy

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