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History of autoimmune conditions and lymphoma prognosis

Blood Cancer Journal. 2018;8(8):1-10 DOI 10.1038/s41408-018-0105-4

 

Journal Homepage

Journal Title: Blood Cancer Journal

ISSN: 2044-5385 (Print)

Publisher: Nature Publishing Group

LCC Subject Category: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens

Country of publisher: United Kingdom

Language of fulltext: English

Full-text formats available: PDF, HTML

 

AUTHORS


Geffen Kleinstern (Department of Health Sciences Research, Mayo Clinic)

Matthew J. Maurer (Department of Health Sciences Research, Mayo Clinic)

Mark Liebow (Division of General Internal Medicine, Mayo Clinic)

Thomas M. Habermann (Division of Hematology, Mayo Clinic)

Jean L. Koff (Division of Bone Marrow and Stem Cell Transplantation, Winship Cancer Institute of Emory University)

Cristine Allmer (Department of Health Sciences Research, Mayo Clinic)

Thomas E. Witzig (Division of Hematology, Mayo Clinic)

Grzegorz S. Nowakowski (Division of Hematology, Mayo Clinic)

Ivana N. Micallef (Department of Health Sciences Research, Mayo Clinic)

Patrick B. Johnston (Division of Hematology, Mayo Clinic)

David J. Inwards (Division of Hematology, Mayo Clinic)

Carrie A. Thompson (Division of Hematology, Mayo Clinic)

Andrew L. Feldman (Department of Laboratory Medicine and Pathology, Mayo Clinic)

Brian K. Link (University of Iowa Hospitals and Clinics)

Christopher Flowers (Winship Cancer Institute of Emory University)

Susan L. Slager (Department of Health Sciences Research, Mayo Clinic)

James R. Cerhan (Department of Health Sciences Research, Mayo Clinic)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 14 weeks

 

Abstract | Full Text

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.