title: Prevalence and clinical impact of autoimmune diseases and chronic infections in malignant lymphomas at diagnosis.
abstract: There is increasing evidence for the role of chronic antigenic stimulation (CS) in the development of cancer. Clinical data, however, are rare as is the information on outcome. In this study, the occurrence of chronic infections (CI) and autoimmune diseases (AI) in patients with malignant lymphoma at diagnosis was assessed. Of 367 patients [non-Hodgkin's lymphoma (NHL) N = 297, Hodgkin's lymphoma N = 70], 9.8% (N = 36) had a history of chronic antigenic stimulation (4.4% AI, 5.4% CI) at diagnosis. After a median observation time of 74.7 months, 118 patients have died. There were more male patients in this cohort. However, sex ratio among patients with chronic antigenic stimulation was skewed in favor of women (p = 0.018), in particular among lymphoma patients with AI (p = 0.001). NHL patients with autoimmune diseases showed a tendency to develop diffuse large B cell lymphoma [8 of 12 AI + NHL patients (66.7%) vs. 100 of 266 non-CS NHL (37.6%); p = 0.066]. No significant difference in overall survival (OS) between CS and non-CS patients could be observed (median OS after 48 months was: CS 77.7% vs. non-CS 71.8%). In conclusion, chronic antigenic stimulation at diagnosis appears to be associated with a higher prevalence in women, in particular among patients with autoimmune disease. However, no difference in overall survival was observed. This suggests that the presence of chronic inflammatory conditions does not decisively influence the outcome of lymphoma patients.
authors.affiliation: Department of Internal Medicine I, Division of Hematology and Hemostaseology, Comprehensive Cancer Center (CCC), Medical University of Vienna, Vienna, Austria.
authors.forename: Katrina
authors.initials: K
authors.lastname: Vanura
authors.forename: Florentin
authors.initials: F
authors.lastname: Späth
authors.forename: Andreas
authors.initials: A
authors.lastname: Gleiss
authors.forename: Trang
authors.initials: T
authors.lastname: Le
authors.forename: Edit
authors.initials: E
authors.lastname: Porpaczy
authors.forename: Cathrin
authors.initials: C
authors.lastname: Skrabs
authors.forename: Alexander
authors.initials: A
authors.lastname: Hauswirth
authors.forename: Karin
authors.initials: K
authors.lastname: Fleiss
authors.forename: Florian
authors.initials: F
authors.lastname: Wessely
authors.forename: Alexander
authors.initials: A
authors.lastname: Gaiger
authors.forename: Leonhard
authors.initials: L
authors.lastname: Müllauer
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jäger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000150:complications*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications*; D007249:Inflammation; D008223:Lymphoma / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D055815:Young Adult