SAT0545 Giant cell arteritis and hematologic malignancies: a real-life experience

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1126
• Main Authors: Tiosano, S., Dar, L., Gendelman, O., Comaneshter, D., Watad, A., Cohen, A.D., Amital, H.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Arteritis; Arthritis; Autoimmune diseases; Blood cancer; Carotid artery; Health risk assessment; Literature reviews; Lymphoma; Malignancy; Multiple myeloma; Non-Hodgkin's lymphoma; Patients; Polymyalgia rheumatica; Population studies; Solid tumors; Steroid hormones; Vasculitis; Vein & artery diseases
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.4886

BackgroundGiant cell arteritis (GCA), also known as temporal arteritis, is a vasculitis of large and medium-sized vessels, which commonly involves the extracranial branches of the carotid artery. There are conflicting evidence regarding the association between GCA and both solid and hematologic malignancies.1–4 ObjectivesTo assess the coexistence rate of GCA and hematologic malignancies.MethodsThis cross-sectional study was performed utilising the database of Israel’s largest healthcare association, Clalit Health Services (CHS). All patients with previously documented diagnosis of GCA were included, as well as age-and sex matched controls without GCA. The proportions of Hodgkin’s lymphoma, Non-Hodgkin’s lymphoma and multiple myeloma were compared between patients and controls. Univariate analysis was compared using chi-square test for categorical variables and student’s t-test for continuous variables. A multivariable logistic regression model was built to assess the covariates associated with each Non-Hodgkin’s lymphoma, the hematologic malignancy with the highest number of patients.ResultsThe study included 5,663 GCA patients and 28 308 controls with a mean age of 71 and 68.3, respectively. Both groups consisted of 69.8% females. Multiple myeloma was observed in 27 GCA patients (0.48%) and 53 controls (0.19%), crude OR=2.56 p<0.001. Hodgkin’s lymphoma was observed in 19 GCA patients (0.34%) and 41 controls (0.14%), crude OR=2.33 p=0.004. Non-Hodgkin’s lymphoma was observed in 64 GCA patients (1.13%) and 164 controls (0.58%), crude OR=1.96 p<0.001. Multivariable logistic regression model adjusting for age and gender found GCA as independently associated with Non-Hodgkin’s lymphoma (adjusted OR 1.96, p<0.001).CharacteristicNo GCA n=28 308GCA n=5663ORp.ratio Age68.3±27.471.0±15.61.00 [1.00;1.00]<0.001Gender: Female19 767 (69.8%)3954 (69.8%)1.00 [0.94;1.06]0.991BMI28.2±5.9128.1±5.601.00 [0.99;1.00]0.081Socioeconomic status: Low5443 (36.8%)1970 (34.9%)Ref.Ref. Medium6241 (42.2%)2339 (41.4%)1.04 [0.97;1.11]0.330 High3093 (20.9%)1336 (23.7%)1.19 [1.10;1.30]<0.001Multiple Myeloma53 (0.19%)27 (0.48%)2.56 [1.59;4.04]<0.001Hodgkin’s Lymphoma41 (0.14%)19 (0.34%)2.33 [1.32;3.97]0.004Non-Hodgkin’s Lymphoma164 (0.58%)64 (1.13%)1.96 [1.46;2.61]<0.001ConclusionsGCA patients have higher rate of hematologic malignancies compared to controls. The association with Non-Hodgkin’s lymphoma is the most prominent, and proper screening methods should be applied for early detection and treatment.References[1] Askling J. Do steroids increase lymphoma risk? A case-control study of lymphoma risk in polymyalgia rheumatica/giant cell arteritis. Ann Rheum Dis64:1765–1768. doi:10.1136/ard.2005.036459[2] Liozon E, Loustaud V, Fauchais A-L, et al. Concurrent temporal (giant cell) arteritis and malignancy: report of 20 patients with review of the literature. J Rheumatol2006;33:1606–1614.[3] Kermani TA, Schäfer VS, Crowson CS, et al. Malignancy risk in patients with giant cell arteritis: A population-based cohort study. Arthritis Care Res NA-NA. doi:10.1002/acr.20062[4] Solans-Laque R, Bosch-Gil JA, Pérez-Bocanegra C, et al. Paraneoplastic vasculitis in patients with solid tumors: report of 15 cases. J Rheumatol35:294–304.Disclosure of InterestNone declared