Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium.
Some autoimmune disorders are increasingly recognized as risk factors for non-Hodgkin lymphoma (NHL) overall, but large-scale systematic assessments of risk of NHL subtypes are lacking. We performed a pooled analysis of self-reported autoimmune conditions and risk of NHL and subtypes, including 29 423 participants in 12 case-control studies. We computed pooled odds ratios (OR) and 95% confidence intervals (CI) in a joint fixed-effects model. Sjögren syndrome was associated with a 6.5-fold increased risk of NHL, a 1000-fold increased risk of parotid gland marginal zone lymphoma (OR = 996; 95% CI, 216-4596), and with diffuse large B-cell and follicular lymphomas. Systemic lupus erythematosus was associated with a 2.7-fold increased risk of NHL and with diffuse large B-cell and marginal zone lymphomas. Hemolytic anemia was associated with diffuse large B-cell NHL. T-cell NHL risk was increased for patients with celiac disease and psoriasis. Results for rheumatoid arthritis were heterogeneous between studies. Inflammatory bowel disorders, type 1 diabetes, sarcoidosis, pernicious anemia, and multiple sclerosis were not associated with risk of NHL or subtypes. Thus, specific autoimmune disorders are associated with NHL risk beyond the development of rare NHL subtypes in affected organs. The pattern of associations with NHL subtypes may harbor clues to lymphomagenesis.
Ekström Smedby
Karin
K
Department of Medicine, Clinical Epidemiology Unit, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. karin.ekstrom.smedby@ki.se
Vajdic
Claire M
CM
Falster
Michael
M
Engels
Eric A
EA
Martínez-Maza
Otoniel
O
Turner
Jennifer
J
Hjalgrim
Henrik
H
Vineis
Paolo
P
Seniori Costantini
Adele
A
Bracci
Paige M
PM
Holly
Elizabeth A
EA
Willett
Eleanor
E
Spinelli
John J
JJ
La Vecchia
Carlo
C
Zheng
Tongzhang
T
Becker
Nikolaus
N
De Sanjosé
Silvia
S
Chiu
Brian C-H
BC
Dal Maso
Luigino
L
Cocco
Pierluigi
P
Maynadié
Marc
M
Foretova
Lenka
L
Staines
Anthony
A
Brennan
Paul
P
Davis
Scott
S
Severson
Richard
R
Cerhan
James R
JR
Breen
Elizabeth C
EC
Birmann
Brenda
B
Grulich
Andrew E
AE
Cozen
Wendy
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000743:Anemia, Hemolytic / Q000150:complications; D001172:Arthritis, Rheumatoid / Q000150:complications; D001327:Autoimmune Diseases / Q000150:complications*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications; D019070:Cell Lineage; D003710:Demography; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008228:Lymphoma, Non-Hodgkin / Q000145:classification* / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011565:Psoriasis / Q000150:complications; D012307:Risk Factors; D012859:Sjogren's Syndrome / Q000150:complications