TY - JOUR
T1 - The impact of rheumatological disorders on lymphomas and myeloma
T2 - a report on risk and survival from the UK's population-based Haematological Malignancy Research Network
AU - Kane, Eleanor
AU - Painter, Daniel
AU - Smith, Alexandra
AU - Crouch, Simon
AU - Oliver, Steven
AU - Patmore, Russell
AU - Roman, Eve
N1 - © 2019 The Authors
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Background: Autoimmune inflammatory disease increases the risk of diffuse large B-cell lymphoma (DLBCL) and marginal zone lymphoma (MZL), but findings for other mature B-cell malignancies are equivocal. Furthermore, it has been suggested that the increase in DLBCL is due to the activated B-cell (ABC) subtype; but data on this, and the impact of inflammatory co-morbidities on survival, are sparse and contradictory. Methods: Data are from an established UK population-based cohort. Patients (n = 6834) diagnosed between 01/2009 and 08/2015 are included; DLBCL (n = 1771), myeloma (n = 1760), chronic lymphocytic leukaemia (CLL, n = 1580), MZL (n = 936), and follicular lymphoma (FL, n = 787). Information on rheumatological disorders and deaths was obtained by record-linkage to nationally compiled Hospital Episode Statistics, with age-and sex-matched individuals (n = 68,340) from the same catchment population (˜4 million people) providing the comparator. Results: Significantly increased risks for DLBCL (OR = 2.3, 95% CI 1.8–2.8) and MZL (OR = 2.0, 95% CI 1.5–2.7) were found for those with rheumatological disorders; the site distribution of those with/without rheumatological conditions differing for DLBCL (p = 0.007) and MZL (p = 0.002). No increases in risk were observed for the remaining mature B-cell malignancies, and no associations with survival were detected for DLBCL (age-adjusted HR = 1.2, 95% CI 0.9–1.6) or MZL (age-adjusted HR = 1.0, 95% CI 0.6–1.9). Furthermore, whilst our findings provide evidence for an association with rheumatological disease severity for DLBCL, they offer little support for the notion that the association is driven by an increase in the incidence of the ABC subtype. Conclusion: Our findings support the hypothesis that the chronic activation and proliferation of specific B-cell populations which characterize autoimmune disease increase the potential for the lymphomagenic events that lead to DLBCL and MZL in both males and females; but have no impact on the development of CLL, FL or MM, or on survival.
AB - Background: Autoimmune inflammatory disease increases the risk of diffuse large B-cell lymphoma (DLBCL) and marginal zone lymphoma (MZL), but findings for other mature B-cell malignancies are equivocal. Furthermore, it has been suggested that the increase in DLBCL is due to the activated B-cell (ABC) subtype; but data on this, and the impact of inflammatory co-morbidities on survival, are sparse and contradictory. Methods: Data are from an established UK population-based cohort. Patients (n = 6834) diagnosed between 01/2009 and 08/2015 are included; DLBCL (n = 1771), myeloma (n = 1760), chronic lymphocytic leukaemia (CLL, n = 1580), MZL (n = 936), and follicular lymphoma (FL, n = 787). Information on rheumatological disorders and deaths was obtained by record-linkage to nationally compiled Hospital Episode Statistics, with age-and sex-matched individuals (n = 68,340) from the same catchment population (˜4 million people) providing the comparator. Results: Significantly increased risks for DLBCL (OR = 2.3, 95% CI 1.8–2.8) and MZL (OR = 2.0, 95% CI 1.5–2.7) were found for those with rheumatological disorders; the site distribution of those with/without rheumatological conditions differing for DLBCL (p = 0.007) and MZL (p = 0.002). No increases in risk were observed for the remaining mature B-cell malignancies, and no associations with survival were detected for DLBCL (age-adjusted HR = 1.2, 95% CI 0.9–1.6) or MZL (age-adjusted HR = 1.0, 95% CI 0.6–1.9). Furthermore, whilst our findings provide evidence for an association with rheumatological disease severity for DLBCL, they offer little support for the notion that the association is driven by an increase in the incidence of the ABC subtype. Conclusion: Our findings support the hypothesis that the chronic activation and proliferation of specific B-cell populations which characterize autoimmune disease increase the potential for the lymphomagenic events that lead to DLBCL and MZL in both males and females; but have no impact on the development of CLL, FL or MM, or on survival.
KW - Autoimmune disease
KW - Chronic lymphocytic leukaemia
KW - Diffuse large B-cell lymphoma
KW - Follicular lymphoma
KW - Marginal zone lymphoma
KW - Multiple myeloma
KW - Rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=85062221105&partnerID=8YFLogxK
U2 - 10.1016/j.canep.2019.02.014
DO - 10.1016/j.canep.2019.02.014
M3 - Article
AN - SCOPUS:85062221105
SN - 1877-7821
VL - 59
SP - 236
EP - 243
JO - Cancer Epidemiology
JF - Cancer Epidemiology
ER -