Risks of myeloid malignancies in patients with autoimmune conditions

• Published in: British journal of cancer Vol. 100; no. 5; pp. 822 - 828
• Main Authors: Anderson, L A, Pfeiffer, R M, Landgren, O, Gadalla, S, Berndt, S I, Engels, E A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 10.03.2009; Nature Publishing Group
• Subjects: Aged; Aged, 80 and over; Anemia; Autoimmune Diseases - complications; Autoimmune Diseases - epidemiology; Beneficiaries; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Drug Resistance; Epidemiology; Female; Hematologic and hematopoietic diseases; Hematology; Humans; Leukemia; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical research; Medical sciences; Medicare; Medicin och hälsovetenskap; Molecular Medicine; Myelodysplastic syndromes; Myelodysplastic Syndromes - epidemiology; Myelodysplastic Syndromes - etiology; Myelodysplastic-Myeloproliferative Diseases - epidemiology; Myelodysplastic-Myeloproliferative Diseases - etiology; Myeloproliferative Disorders - epidemiology; Myeloproliferative Disorders - etiology; Odds Ratio; Oncology; Population; Radiation; Rheumatoid arthritis; Risk Factors; Surveillance; Time Factors; Tumors; United Kingdom > UK; Northern Ireland; United States > US; autoimmune conditions; myeloid leukaemia; myelodysplastic syndrome; chronic myeloproliferative diseases; Autoimmunity; Human; Chronic disease; Chronic myelogenous leukemia; Malignant hemopathy; Myelodysplastic syndrome; Myeloproliferative syndrome; Cancerology; Risk factor; Myeloid neoplasm; Cancer
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/sj.bjc.6604935

Autoimmune conditions are associated with an elevated risk of lymphoproliferative malignancies, but few studies have investigated the risk of myeloid malignancies. From the US Surveillance Epidemiology and End Results (SEER)-Medicare database, 13 486 myeloid malignancy patients (aged 67+ years) and 160 086 population-based controls were selected. Logistic regression models adjusted for gender, age, race, calendar year and number of physician claims were used to estimate odds ratios (ORs) for myeloid malignancies in relation to autoimmune conditions. Multiple comparisons were controlled for using the Bonferroni correction ( P <0.0005). Autoimmune conditions, overall, were associated with an increased risk of acute myeloid leukaemia (AML) (OR 1.29) and myelodysplastic syndrome (MDS, OR 1.50). Specifically, AML was associated with rheumatoid arthritis (OR 1.28), systemic lupus erythematosus (OR 1.92), polymyalgia rheumatica (OR 1.73), autoimmune haemolytic anaemia (OR 3.74), systemic vasculitis (OR 6.23), ulcerative colitis (OR 1.72) and pernicious anaemia (OR 1.57). Myelodysplastic syndrome was associated with rheumatoid arthritis (OR1.52) and pernicious anaemia (OR 2.38). Overall, autoimmune conditions were not associated with chronic myeloid leukaemia (OR 1.09) or chronic myeloproliferative disorders (OR 1.15). Medications used to treat autoimmune conditions, shared genetic predisposition and/or direct infiltration of bone marrow by autoimmune conditions, could explain these excess risks of myeloid malignancies.