Rheumatoid arthritis and lymphoma: Incidence, pathogenesis, biology, and outcome

Klein, Alina; Polliack, Aaron; Gafter‐Gvili, Anat

doi:10.1002/hon.2525

Cited by 67 publications

(67 citation statements)

References 54 publications

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“…Immune dysregulation plays a pivotal role in the development of mature B-cell malignancies and several autoimmune conditions have been linked with increased risk. Among the strongest and most consistently reported associations are those between B-cell lymphomas – particularly diffuse large B-cell lymphoma (DLBCL) and marginal zone lymphoma (MZL) – and chronic B-cell-activating inflammatory diseases notably rheumatoid arthritis, systemic lupus erythematosus and Sjögren’s syndrome [ [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] ]. Furthermore, there is some evidence to suggest that DLBCL patients with chronic inflammatory conditions are more likely to be diagnosed with the activated B-cell (ABC) subtype [ 5 , 12 ], which has a poorer prognosis than the germinal centre B-cell (GCB) subtype and tends to be diagnosed at a slightly older age [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of rheumatological disorders on lymphomas and myeloma: a report on risk and survival from the UK’s population-based Haematological Malignancy Research Network

Kane

Painter

Smith

et al. 2019

Cancer Epidemiology

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Highlights Diffuse-large B-cell and marginal zone lymphoma: inflammatory conditions increase risk. Myeloma, follicular lymphoma and chronic lymphocytic leukaemia: inflammatory conditions do not impact on risk. Inflammatory conditions are far more common in women, but gender is not an effect modifier. Inflammatory co-morbidities do not impact adversely on mature B-cell malignancy survival. The increased risk for diffuse large B-cell lymphoma is not mediated by the activated B-cell subtype.

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Section: Introductionmentioning

confidence: 99%

The impact of rheumatological disorders on lymphomas and myeloma: a report on risk and survival from the UK’s population-based Haematological Malignancy Research Network

Kane

Painter

Smith

et al. 2019

Cancer Epidemiology

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“…A considerable higher risk was observed in Hodgkin lymphoma than for non-Hodgkin lymphoma with SIRs of 3.29 (95%CI 2.56-4.22) and 1.95 (95%CI 1.7-2.24), respectively [1]. Klein et al [2,20] worked out the incidence, pathogenesis and biology of SLE and lymphoma. This review article of 2018 examined the largest and most significant studies published in recent years including all available systemic reviews and meta-analysis as well as large observational cohort studies covering the incidence and risk of lymphoma in SLE.…”

Section: Discussionmentioning

confidence: 99%

Risk of cancer after long-term therapy of autoimmune disorders with glucocorticoids or DMARDs—a controversial issue

Rudzki

2019

memo

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Most autoimmune diseases like RA (rheumatoid arthritis) are usually associated with lifelong treatment. The etiology of RA remains unclear, but it depends on a high-risk genetic background and an environmental trigger, which leads to autoimmune dysregulation and results in autoinflammation. This process preferentially affects joints but may spread to different organs and systems. Several studies have illustrated that patients with RA have an increased overall incidence of malignancy compared to the general population (risk of 5-10%). However, it remains unclear if biological agents like DMARDs (disease-modifying antirheumatic drugs) are associated with a potential increased risk of generating new neoplasms. Data indicate that it is unlikely that RA patients who have received biological agents have a much higher risk of developing lymphoproliferative disorder, other hematologic malignancies or solid tumors compared to MTX (methotrexate) users. In most cases, it also depends on the activity of the underlying rheumatic disease. Thus, clinical decision making must carefully weigh benefits and risks of both aspects of antirheumatic treatment and the risk of elevating the likelihood of developing cancer. The decision to treat with a DMARD must always be based on clinical features and reflect the risk pattern of the individual patient. Up to now, there is no clear evidence that proves the link between longterm DMARD or glucocorticoid use and the increased incidence of newly developed neoplasms. The pathophysiological context is still not well understood and

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“…Patients with RA have reported higher incidence rates of malignant lymphoma, although the surface phenotype of lymphoma found in RA is B-cell predominant (Klein et al, 2018).…”

Section: Development Of Atl and Ham/tsp In Htlv-1-positive Patients Wmentioning

confidence: 99%

HTLV-1 Infection and Rheumatic Diseases

Umekita

Okayama

2020

Front. Microbiol.

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Some major research and clinical questions about human T-cell leukemia virus type 1 (HTLV-1) infection and rheumatic diseases remain: (1) Does HTLV-1 infection cause rheumatic diseases? (2) Do patients with rheumatic diseases display different responses to treatment with anti-rheumatic agents when they are HTLV-1 carriers? (3) Is adult T-cell leukemia/lymphoma (ATL) or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) more prevalent in HTLV-1 carriers with rheumatic diseases who are treated with anti-rheumatic agents? These questions are important because increasing numbers of patients with rheumatic diseases are currently receiving treatment with aggressive medicines such as immunosuppressants and biologics. Studies on HTLV-1 gene-transgenic mice have shown manifestations resembling rheumatic diseases. Epidemiological studies have shown a high incidence of HTLV-1 infection in patients with rheumatic diseases including rheumatoid arthritis (RA), Sjogren's syndrome, and polymyositis. HTLV-1-positive and HTLV-1-negative patients with RA have displayed similar immunological features including the seroprevalence of anticitrullinated peptide antibodies. Conversely, attenuated effectiveness of tumor necrosis factor inhibitors for HTLV-1-positive patients with RA in Japan has been reported. Therefore, although no direct evidence has shown that HTLV-1 infection alone causes rheumatic diseases, HTLV-1 may affect the inflammation of RA. Although the incidence of ATL or HAM/TSP among patients with rheumatic diseases has not been investigated in large-scale studies, ATL or HAM/TSP has developed among HTLV-1-positive patients with rheumatic diseases. HTLV-1 infection may affect the clinical course of patients with rheumatic diseases, particularly after receiving anti-rheumatic agents. Because studies on these issues are limited, further investigation with large sample sizes is necessary.

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Rheumatoid arthritis and lymphoma: Incidence, pathogenesis, biology, and outcome

Cited by 67 publications

References 54 publications

The impact of rheumatological disorders on lymphomas and myeloma: a report on risk and survival from the UK’s population-based Haematological Malignancy Research Network

The impact of rheumatological disorders on lymphomas and myeloma: a report on risk and survival from the UK’s population-based Haematological Malignancy Research Network

Risk of cancer after long-term therapy of autoimmune disorders with glucocorticoids or DMARDs—a controversial issue

HTLV-1 Infection and Rheumatic Diseases

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