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Non-Hodgkin Lymphoma Risk Increased by Some Autoimmune Disorders
NEW YORK (Reuters Health) Apr 22 - The risk of developing non-Hodgkin lymphoma (NHL) is increased in certain, but not all, autoimmune disorders, according to a report in the April 15th issue of Blood.
"Certain autoimmune disorders (Sjgren's syndrome, systemic lupus erythematosus) are indeed associated with an increased risk of lymphomas, not only in the organs affected by the autoimmune disease, but also of lymphomas with less typical locations and histologies," Dr. Karin Ekstrm Smedby from Karolinska University Hospital, Stockholm, told Reuters Health.
Dr. Smedby and associates investigated associations between a range of autoimmune disorders and the risk of NHL and explored potential variation in associations among NHL subtypes by histology and anatomic site.
The risk of NHL was increased 6.5-fold in patients with Sjgren syndrome, 2.7-fold in patients with systemic lupus erythematosus, and 2.6-fold in patients with hemolytic anemia, the authors report.
Among Sjgren syndrome and systemic lupus erythematosus patients, there was an increased risk of B-cell NHL and NHL of unknown lineage, the report indicates, whereas hemolytic anemia patients faced a significantly increased risk of B-cell NHL and diffuse B-cell lymphoma.
Celiac disease, psoriasis, and rheumatoid arthritis were not associated with an increased risk of NHL overall, but there were significant associations with certain NHL subtypes in patients with celiac disease and psoriasis and among rheumatoid arthritis patients who used corticosteroids or immunosuppressants.
Similarly, the investigators say, overall risk of NHL was not linked to inflammatory bowel disorders, type 1 diabetes, sarcoidosis, pernicious anemia, or multiple sclerosis.
"Our results further suggest new patterns of associations with some NHL subtypes in specified autoimmune disorders," the researchers conclude.
"These patterns may be based on common mechanisms of lymphomagenesis, which could be relevant for the development of the indicated NHL subtypes in a group of autoimmune disorders as well as beyond the setting of overt autoimmune disease."
"We plan to investigate gene-environment interaction for autoimmune disorders, and we're also discussing other biological markers that could help us pinpoint mechanistic pathways," Dr. Smedby said.
Blood 2008;111:4029-4038.
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