RSEARCH - Incidence of lymphoma in a large primary care derived cohort of cases of inflammatory polyarthritis

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Ann Rheum Dis. 2006 May;65(5):617-22. Epub 2005 Oct 25.

Incidence of lymphoma in a large primary care derived cohort of cases of

inflammatory polyarthritis.

lin J, Lunt M, Bunn D, Symmons D, Silman A.

ARC Epidemiology Research Unit, Manchester University Medical School, Oxford

Road, Manchester M13 9PT, UK.

OBJECTIVE: To determine the risk of lymphoma in a primary care derived

cohort of new onset cases of inflammatory polyarthritis and assess the

contribution of disease severity and standard immunosuppressive treatment.

DESIGN: Prospective cohort study. METHODS: 2105 subjects with new onset

inflammatory polyarthritis were recruited to the Norfolk Arthritis Register

(NOAR) and followed annually for (median) 8.4 years. Occurrence of lymphoma

was determined by annual morbidity review and linkage to the central

hospital database serving the NOAR area. Cases of lymphoma were verified by

record review. Standardised incidence ratios (SIRs) for lymphoma were

calculated compared with the local, age, sex, and calendar year expected

rates. Stratified analyses were undertaken for various markers of disease

severity and treatment history. RESULTS: There were 11 cases of lymphoma

during 15,548 person years of follow up, the majority of which were of large

B cell type. Compared with the local population the SIR was 2.4 (95%

confidence interval, 1.2 to 4.2). The risks in cases classified as

rheumatoid arthritis, ever rheumatoid factor positive, or ever treated with

DMARDs were all higher, the highest risk group being those treated with

methotrexate: SIR = 4.9 (1.8 to 10.6).

CONCLUSIONS: There was a doubling in risk of lymphoma in new onset cases of

inflammatory polyarthritis. Patients with the most severe disease were twice

as likely as other patients to develop lymphoma. These results need to be

taken into account when considering reported increased risks of lymphoma

compared to background population risk in users of new biological agents.

PMID: 16249224

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6249224 & dopt=Abstract

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