Non-Hodgkin's lymphoma in systemic lupus erythematosus

Abstract

Background: Recent evidence supports an association between systemic lupus erythematosus (SLE) and nonHodgkin's lymphoma (NHL). Objectives: To describe demographic factors, subtypes, and survival of patients with SLE who develop NHL. Methods: A multi-site cohort of 9547 subjects with definite SLE was assembled. Subjects at each centre were linked to regional tumour registries to determine cancer cases occurring after SLE diagnosis. For the NHL cases ascertained, descriptive statistics were calculated, and NHL subtype frequency and median survival time of patients determined.Results: 42 cases of NHL occurred in the patients with SLE during the 76 948 patient-years of observation. The median age of patients at NHL diagnosis was 57 years. Thirty six (86%) of the 42 patients developing NHL were women, reflecting the female predominance of the cohort. In the patients, aggressive histological subtypes appeared to predominate, with the most commonly identified NHL subtype being diffuse large B cell (11 out of 21 cases for which histological subtype was available). Twenty two of the patients had died a median of 1.2 years after lymphoma diagnosis. Conclusions: These data suggest aggressive disease in patients with SLE who develop NHL. Continuing work should provide further insight into the patterns of presentation, prognosis, and aetiology of NHL in SLE.

Cancer risk in a cohort of patients with systemic lupus erythematosus (SLE) in California

“…Because SLE patients are now living longer due to recent advances in treatment, the incidence of chronic comorbid conditions has been rising [2][3][4][5]. Rates of several types of cancer, particularly hematopoietic malignancies, appear to be increasing in the SLE population [6][7][8][9][10][11][12][13][14][15]. One of the proposed biologic mechanisms for this association is a defect in the body's immunosurveillance process.…”

Infectivity and insertional mutagenesis of endogenous retrovirus in autoimmune NZB and B/W mice

“…Analogous to the B/W mice, which suffer from autoimmune disease and lymphadenopathy and eventually lymphoma , human systemic lupus erythematosus patients have a well-documented increased risk of non-Hodgkin's lymphoma (Bernatsky et al, 2005). As another example, BALB/ c mice injected with mineral oil suffer from inflammation and develop both a lupus-like disease (Satoh et al, 2003) and plasmacytomas, the latter of which (in addition to translocations) are driven by de novo insertions of endogenous MLV (Knittel et al, 2014).…”

Autoimmune Disorders and Lymphomas

“…The pooled analysis combining these data with those of other large cohort studies provided a SIR estimate for HL in SLE of 3.16. Generally, aggressive lymphomas, such as DLBCL are more common in SLE patients , Simon et al, 2007, Bernatsky et al, 2005a, Lofstrom et al, 2007. In general population, DLBCL accounts for 30% of all lymphomas, but in SLE patients this percentage is between 38% and 64% , Bernatsky et al, 2005a, King & Costenbader, 2007.…”