REVIEW - B-cell non-Hodgkin lymphoma in chronic inflammatory rheumatic diseases

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Nat Clin Pract Rheumatol. 2007 Oct;3(10):561-9.

B-cell lymphoproliferation in chronic inflammatory rheumatic diseases.

Hansen A, Lipsky PE, Dörner T.

Outpatients Department of Medicine, Charité University Hospital,

Berlin, Germany.

Patients with chronic inflammatory rheumatic diseases, such as

rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and

especially primary Sjögren's syndrome (SS), are at higher risk than

the general population of developing B-cell non-Hodgkin lymphoma

(NHL). Analyses of the association between various lymphoma subtypes

and specific disease entities suggest that this association might be

mediated by disease-specific mechanisms, as well as by mechanisms

unique to lymphoma subtype. These specific associations can provide

important information about abnormal B-cell stimulation in these

conditions. Patients with primary SS, SLE and RA are at high risk of

developing diffuse large B-cell lymphomas, a group of high-grade NHLs

with remarkable heterogeneity. Patients with primary SS are at

particularly high risk of developing marginal-zone B-cell lymphomas.

The risk factors of lymphoma development in primary SS seem to be

closely related to the underlying mechanisms of abnormal stimulation

and/or impaired censoring mechanisms of B cells. In patients with RA

and SLE, more intense disease activity and/or long-lasting disease

might be indications of a higher risk of lymphoma development. This

Review will focus on the risk of lymphoma, common and disease-specific

mechanisms of B-cell lymphoma development, and on the clinical

consequences of lymphoma in patients with inflammatory rheumatic

diseases.

PMID: 17906611

http://www.ncbi.nlm.nih.gov/pubmed/17906611

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