History of autoimmune conditions and lymphoma prognosis

Autoimmune conditions are strong risk factors for developing lymphoma, but their role in lymphoma prognosis is less clear. In a prospective cohort study, we evaluated self-reported history of eight autoimmune conditions with outcomes in 736 diffuse large B-cell, 703 follicular, 302 marginal zone (MZ...

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Bibliographic Details
Published in:Blood cancer journal (New York) 2018-08, Vol.8 (8), p.73-10, Article 73
Main Authors: Kleinstern, Geffen, Maurer, Matthew J., Liebow, Mark, Habermann, Thomas M., Koff, Jean L., Allmer, Cristine, Witzig, Thomas E., Nowakowski, Grzegorz S., Micallef, Ivana N., Johnston, Patrick B., Inwards, David J., Thompson, Carrie A., Feldman, Andrew L., Link, Brian K., Flowers, Christopher, Slager, Susan L., Cerhan, James R.
Format: Article
Language:English
Subjects:
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Adult
Aged
Autoimmune Diseases - complications
Autoimmune Diseases - epidemiology
Autoimmune Diseases - immunology
Autoimmunity
B-Lymphocytes - immunology
B-Lymphocytes - metabolism
Biomedical and Life Sciences
Biomedicine
Cancer Research
Female
Health risk assessment
Hematology
Humans
Lymphoma
Lymphoma - complications
Lymphoma - epidemiology
Lymphoma - immunology
Lymphoma - mortality
Male
Medical prognosis
Middle Aged
Oncology
Prognosis
Proportional Hazards Models
Risk Factors
T cell receptors
T-Lymphocytes - immunology
T-Lymphocytes - metabolism
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Summary:Autoimmune conditions are strong risk factors for developing lymphoma, but their role in lymphoma prognosis is less clear. In a prospective cohort study, we evaluated self-reported history of eight autoimmune conditions with outcomes in 736 diffuse large B-cell, 703 follicular, 302 marginal zone (MZL), 193 mantle cell (MCL), 297 Hodgkin lymphoma (HL), and 186 T-cell lymphomas. We calculated event-free survival (EFS) and overall survival (OS), and estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for sex, prognostic score, and treatment. History of any of the eight autoimmune conditions ranged from 7.4% in HL to 18.2% in MZL, and was not associated with EFS or OS for any lymphoma subtype. However, there was a positive association of autoimmune conditions primarily mediated by B-cell responses with inferior EFS in MCL (HR = 2.23, CI: 1.15–4.34) and HL (HR = 2.63, CI: 1.04–6.63), which was largely driven by rheumatoid arthritis. Autoimmune conditions primarily mediated by T-cell responses were not found to be associated with EFS or OS in any lymphoma subtype, although there were few events for this exposure. Our results indicate that distinguishing autoimmune conditions primarily mediated by B-cell/T-cell responses may yield insight regarding the impact of this comorbid disease, affecting ~10% of lymphoma patients, on survival.
ISSN:2044-5385
2044-5385
DOI:10.1038/s41408-018-0105-4