Increased risk of cancer in patients with systemic lupus erythematosus.

Pettersson, Tom; Pukkala, Eero; Teppo, Lyly; Friman, Claes

doi:10.1136/ard.51.4.437

Cited by 176 publications

(157 citation statements)

References 12 publications

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“…Previous reports have suggested a possible role of cyclophosphamide in inducing malignant transformation (17). The present data and those reported by Petterson et a1 (9) indicate that the occurrence of NHL and other hematopoietic cancers is not related to the use of cyclophosphamide. None of the 6 patients with hematologic malignancies received cyclophosphamide and/or other cytotoxic agents before the diagnosis of cancer.…”

Section: Discussionsupporting

confidence: 76%

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Malignancy in systemic lupus erythematosus

Abu‐Shakra

Gladman

Urowitz

1996

Arthritis & Rheumatism

163

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Objective. To estimate the risk of cancer in patients with systemic lupus erythematosus (SLE).Methods. Patients with SLE (n = 724) have been followed prospectively, for 24 years, at the University of Toronto Lupus Clinic. The diagnosis of cancer was confirmed by histologic or autopsy reports. Standardized rates of cancer and standardized incidence rates (SIR) (ratio of observed-to-expected cancers) were used to estimate the risk for cancers.Results. Twenty-four cancers were identified in 23 SLE patients (3.2%) during 7,233 patient-years of followup. Compared with the Ontario population, the overall estimated risk for all cancers was not increased in the lupus cohort (SIR 1.08, 95% confidence interval 0.70-1.62). A 4

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Section: Discussionsupporting

confidence: 76%

“…Lewis et a1 ( 5 ) found the frequency of cancer in 484 patients with SLE to be 3.7%. Petterson et a1 (9) compared the occurrence of cancers in 205 SLE patients with that in the total Finnish population and found a 2.6-fold increased risk of all malignancies.…”

mentioning

confidence: 99%

Malignancy in systemic lupus erythematosus

Abu‐Shakra

Gladman

Urowitz

1996

Arthritis & Rheumatism

163

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“…504 Smedby et al 505 also reported a strong association of celiac disease with risk of T-cell NHL (SIR 5 51.0, 95% CI: 35.0-68.0), and a weaker, yet statistically significant, association with risk of B-cell NHL (SIR 5 2.2, 95% CI: 1.3-3.6). In a Finnish cohort, 4 cases of NHL were observed (0.09 expected) among women with SLE, 506 and an increased risk was reported in a multicenter casecontrol study (OR 5 8.4, 95% CI: 1.6-45.0). 507 Seven cases of NHL were observed (0.16 expected) in a follow-up study of patients with Sj€ ogren's syndrome.…”

Section: Interactions With Environment and Lifestyle Factorsmentioning

confidence: 99%

The non-Hodgkin lymphomas: A review of the epidemiologic literature

et al. 2007

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“…As with congenital immunodeficiencies, increases in NHL are seen with autoimmune conditions such as rheumatoid arthritis (Kamel et al, 1995), systemic lupus erythematosus (Pettersson et al, 1992), Sjogren's syndrome, and celiac disease (Harris et al, 1967). Although immunosuppressive drugs used in the treatment of these conditions may cause an increase in NHL incidence, evidence suggests that the persistent inflammatory activity of the autoimmune process may have a direct link with increased risk of lymphomagenesis (Jonsson et al, 1999).…”

Section: Immunosuppressionmentioning

confidence: 99%

The epidemiology of non-Hodgkin's lymphoma

2004

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The incidence of non-Hodgkin's lymphoma (NHL) has doubled over the past two decades in the US and most other westernized countries. While improved cancer reporting, changes in lymphoma classification, and increases in AIDS-associated lymphomas have contributed to the startling escalation of disease incidence, these factors are estimated to account for only about 50% of the increase in observed incidence. The elucidation of etiologic factors and their mechanistic role in the pathogenesis of this malignancy are critical to advancements in disease prevention and treatment. Current evidence suggests that factors/conditions that precipitate either chronic antigenic stimulation or immunosuppression may provide a preferential milieu for development of NHL. High rates of lymphoma have been observed among individuals with autoimmune disease, organ transplants, and primary or acquired immunodeficiencies. Ultraviolet radiation, previously demonstrated to have an immunosuppressive effect, has also been suggested as a possible risk factor for NHL. Several pathogens have been linked to the risk of lymphoma, including Epstein-Barr virus, human immunodeficiency virus, human T-cell lymphotropic virus-1, Helicobacter pylori, hepatitis C, and simian virus 40. Whether these microbes are responsible for specific genetic mutations that initiate tumor growth, antigenic stimulation leading to B-cell proliferation, and increased potential of random cell replication errors, or immunosuppression, which thereby promotes tumor growth, has not been clearly delineated. Other exogenous factors which have been implicated in lymphomagenesis are chemicals and agricultural exposures, hair dyes, and blood transfusions. We must build on our current knowledge regarding the etiology of NHL in order that prevention, treatment, and ultimately, cure of this malignancy becomes a reality.

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Increased risk of cancer in patients with systemic lupus erythematosus.

Abstract: To evaluate the risk of cancer in patients with systemic lupus erythematosus (SLE)

Cited by 176 publications

References 12 publications

Malignancy in systemic lupus erythematosus

Malignancy in systemic lupus erythematosus

The non-Hodgkin lymphomas: A review of the epidemiologic literature

The epidemiology of non-Hodgkin's lymphoma

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