Population‐based study of autoimmune conditions and the risk of specific lymphoid malignancies

TLDR

Autoimmune conditions are linked to higher risk of lymphoid cancers, yet subtype‑specific data are scarce. The study used SEER‑Medicare data to compare 44,350 lymphoid malignancy cases with 122,531 controls, applying adjusted logistic regression to estimate odds ratios for autoimmune conditions across subtypes. Rheumatoid arthritis, Sjögren syndrome, hemolytic anemia, psoriasis, discoid lupus erythematosus, celiac disease, systemic lupus erythematosus, and pernicious anemia were associated with higher risks of specific lymphoid malignancies, especially diffuse large B‑cell, marginal zone, and T‑cell non‑Hodgkin lymphomas, Hodgkin lymphoma, and multiple myeloma, supporting a chronic antigenic stimulation mechanism.

Abstract

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 (> or =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.