Primary immunodeficiency diseases and cancer: The immunodeficiency‐cancer registry

TLDR

The Immunodeficiency‑Cancer Registry reports 151 tumors in 145 patients with primary immunodeficiency syndromes, including Bruton's agammaglobulinemia, SCID, Wiskott‑Aldrich, ataxia‑telangiectasia, CVID, IgA and IgM deficiencies. The study urges continued reporting of tumors in primary immunodeficiency patients. The registry includes data from 14 families where 12 siblings shared identical primary immunodeficiency and tumor types. Patients with primary immunodeficiency have a 2–10% malignancy risk, with 58% of tumors lymphoreticular and 17% leukemias, supporting a link between lymphoid system defects and increased malignant transformation.

Abstract

Abstract Data from the newly established Immunodeficiency‐Cancer Registry show 151 tumors in 145 patients with primary immunodeficiency syndromes, including: sex‐linked (Bruton's) agammaglobulinemia, 6 patients; severe combined system immunodeficiency, 9 patients; Wiskott‐Aldrich syndrome, 24 patients; ataxia‐telangiectasia, 52 patients; common variable (late onset) immunodeficiency, 41 patients; isolated IgA deficiency, 7 patients; and isolated IgM deficiency, 6 patients. The risk of development of malignancy is from 2–10%, indicating that these individuals have a far greater than chance risk of developing malignancies, in spite of their short life‐spans. Tumors are divided into major histologic types: lymphoreticular, 58% of total; leukemias, 17% of total; epithelial. 18% of total; mesenchymal, 3% of total; and nervous system, 4% of total. Data are reported on 14 families in which 12 siblings had the same tumors and identical primary immunodeficiency diseases. The majority of tumors are lymphoreticular or leukemias: these findings are consistent with the hypothesis that individuals with primary immunodeficiency syndromes have intrinsic abnormalities of the lymphoid system which result in increased frequency of malignant transformation and inability to eliminate transformed cells. Further reporting of tumors is urged.