Format

Send to

Choose Destination
Blood Cancer J. 2018 Aug 1;8(8):73. doi: 10.1038/s41408-018-0105-4.

History of autoimmune conditions and lymphoma prognosis.

Author information

1
Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
2
Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
3
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
4
Division of Bone Marrow and Stem Cell Transplantation, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
5
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
6
University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
7
Winship Cancer Institute of Emory University, Atlanta, GA, USA.
8
Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. cerhan.james@mayo.edu.

Abstract

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.

Supplemental Content

Full text links

Icon for Nature Publishing Group Icon for PubMed Central
Loading ...
Support Center