Re: RESEARCH - Population-based study of autoimmune conditions and the risk of lymphoid malignancies

[Guest guest]

Fascinating!

Stan,

Seattle, Sun!

[ ] RESEARCH - Population-based study of autoimmune conditions

and the  risk of lymphoid malignancies

Int J Cancer. 2009 Jan 22;125(2):398-405.

Population-based study of autoimmune conditions and the risk of

specific lymphoid malignancies.

LA, Gadalla S, Morton LM, Landgren O, Pfeiffer R, Warren JL,

Berndt SI, Ricker W, Parsons R, Engels EA.

Division of Cancer Epidemiology and Genetics, National Cancer

Institute, Bethesda, MD.

Some autoimmune conditions are associated with increased risk of

lymphoid malignancies, but information on specific malignancy subtypes

is limited. From the U.S. Surveillance Epidemiology and End

Results-Medicare database, we selected 44,350 lymphoid malignancy

cases (>/=67 years) and 122,531 population-based controls. Logistic

regression was used to derive odds ratios (ORs) comparing the

prevalence of autoimmune conditions in cases and controls, by lymphoid

malignancy subtype, adjusted for gender, age at malignancy/selection,

year of malignancy/selection, race and number of physician claims. The

strongest associations observed by non-Hodgkin lymphoma (NHL) subtypes

were diffuse large B-cell lymphoma with rheumatoid arthritis (OR 1.4,

95%CI 1.2-1.5) and Sjögren syndrome (2.0, 1.5-2.8); T-cell lymphoma

with hemolytic anemia (9.7, 4.3-22), psoriasis (3.1, 2.5-4.0), discoid

lupus erythematosus (4.4, 2.3-8.4) and celiac disease (5.0, 2.4-14.);

and marginal zone lymphoma with Sjögren syndrome (6.6, 4.6-9.5),

systemic lupus erythematosus (2.8, 1.7-4.7) and hemolytic anemia (7.4,

3.1-18). Hodgkin lymphoma was associated with systemic lupus

erythematosus (3.5, 1.9-6.7). Multiple myeloma was associated only

with pernicious anemia (1.5, 1.3-1.7). Several autoimmune conditions

were associated with increased risk of lymphoid neoplasms, especially

NHLs of diffuse large B-cell, marginal zone and T-cell subtypes. These

results support a mechanism whereby chronic antigenic stimulation

leads to lymphoid malignancy. Published 2009 UICC.

PMID: 19365835

http://www.ncbi.nlm.nih.gov/pubmed/19365835

Not an MD

------------------------------------

[Guest guest]

So, in this exerpt:

strongest associations observed by non-Hodgkin lymphoma (NHL) subtypes were

diffuse large B-cell lymphoma with rheumatoid arthritis (OR 1.4, 95%CI 1.2-1.5)

and Sjögren syndrome (2.0, 1.5-2.8)

Is it infering that if you have RA and Sjogren, you are automatically at a

significantly higher risk for NHL? Or, is this with taking some kind of

medications AND having the said diseases?

I'm confused. -

>

> Int J Cancer. 2009 Jan 22;125(2):398-405.

>

>

> Population-based study of autoimmune conditions and the risk of

> specific lymphoid malignancies.

>

>

> LA, Gadalla S, Morton LM, Landgren O, Pfeiffer R, Warren JL,

> Berndt SI, Ricker W, Parsons R, Engels EA.

> Division of Cancer Epidemiology and Genetics, National Cancer

> Institute, Bethesda, MD.

>

>

> Some autoimmune conditions are associated with increased risk of

> lymphoid malignancies, but information on specific malignancy subtypes

> is limited. From the U.S. Surveillance Epidemiology and End

> Results-Medicare database, we selected 44,350 lymphoid malignancy

> cases (>/=67 years) and 122,531 population-based controls. Logistic

> regression was used to derive odds ratios (ORs) comparing the

> prevalence of autoimmune conditions in cases and controls, by lymphoid

> malignancy subtype, adjusted for gender, age at malignancy/selection,

> year of malignancy/selection, race and number of physician claims. The

> strongest associations observed by non-Hodgkin lymphoma (NHL) subtypes

> were diffuse large B-cell lymphoma with rheumatoid arthritis (OR 1.4,

> 95%CI 1.2-1.5) and Sjögren syndrome (2.0, 1.5-2.8); T-cell lymphoma

> with hemolytic anemia (9.7, 4.3-22), psoriasis (3.1, 2.5-4.0), discoid

> lupus erythematosus (4.4, 2.3-8.4) and celiac disease (5.0, 2.4-14.);

> and marginal zone lymphoma with Sjögren syndrome (6.6, 4.6-9.5),

> systemic lupus erythematosus (2.8, 1.7-4.7) and hemolytic anemia (7.4,

> 3.1-18). Hodgkin lymphoma was associated with systemic lupus

> erythematosus (3.5, 1.9-6.7). Multiple myeloma was associated only

> with pernicious anemia (1.5, 1.3-1.7). Several autoimmune conditions

> were associated with increased risk of lymphoid neoplasms, especially

> NHLs of diffuse large B-cell, marginal zone and T-cell subtypes. These

> results support a mechanism whereby chronic antigenic stimulation

> leads to lymphoid malignancy. Published 2009 UICC.

>

>

> PMID: 19365835

>

> http://www.ncbi.nlm.nih.gov/pubmed/19365835

>

>

>

> Not an MD

>

[Guest guest]

,

The conclusion of these researchers is that the diseases themselves

confer a risk of lymphoid malignancies.

Apart from this study, whether the medications used to treat RA lead

to the development of lymphoma or the disease itself it mostly to

blame is still being argued. I'm in the camp which believes the

disease itself confers the bulk of the risk.

Here is an interesting editorial from the Journal of Rheumatology

(February 2007) on the subject:

" Rheumatoid Arthritis and Lymphoma: Risky Business for B Cells " :

http://www.jrheum.com/subscribers/07/02/243.html

Not an MD

On Fri, May 15, 2009 at 11:44 PM, D. <edalfrey@...> wrote:

>

>

> So, in this exerpt:

>

> strongest associations observed by non-Hodgkin lymphoma (NHL) subtypes were

> diffuse large B-cell lymphoma with rheumatoid arthritis (OR 1.4, 95%CI

> 1.2-1.5) and Sjögren syndrome (2.0, 1.5-2.8)

>

> Is it infering that if you have RA and Sjogren, you are automatically at a

> significantly higher risk for NHL? Or, is this with taking some kind of

> medications AND having the said diseases?

>

> I'm confused. -