Rheumatology 2000; 39: 1147-1152
© 2000 British Society for Rheumatology
Is there an association of malignancy with systemic lupus erythematosus? An analysis of 276 patients under long-term review
Centre for Rheumatology, Bloomsbury Rheumatology Unit, Department of Medicine, University College London, London W1P 9PG, UK
Objective. To estimate the risk of malignancy in a UK cohort of patients with systemic lupus erythematosus (SLE) under long-term review.
Method. The University College London Lupus Clinic Database was used to identify a cohort of 276 patients followed up prospectively between 1978 and 1999. Standardized incidence ratios and 95% confidence intervals for all cancers were calculated using age and sex-specific cancer incidence rates for the southeast of England.
Results. In total, 16 malignancies were diagnosed in 15 patients. However, five malignancies were diagnosed before the diagnosis of SLE and were therefore excluded from the final statistical analysis. One case of basal cell carcinoma was also identified, but this was also excluded from the final analysis as no comparable figures were available for the general population. Death as a direct consequence of the malignancy occurred in six (2.3%) patients, accounting for 22.6% of the deaths in our cohort of SLE patients. Compared with the general population, the overall estimated risk for all cancers was not increased in the lupus cohort (standardized incidence rate 1.16 (95% confidence interval 0.55–2.13). Hodgkin's lymphoma was the only individual cancer that was increased in our cohort of patients [standardized incidence rate 17.82 (95% confidence interval 0.45–99.23)].
Conclusions. In our cohort of patients with SLE we did not show an overall increased risk of malignancy. However, SLE was associated with an increased risk of Hodgkin's lymphoma compared with the general population. From our cohort of 276 patients, none of those treated with cyclosporin (3%) developed malignancy, and out of 49 (18%) patients treated with cyclophosphamide only one patient developed malignancy. Out of the 10 patients in the final analysis who developed malignancy, six had treatment with prednisolone, four with azathioprine, five with hydroxychloroquine and only one with cyclophosphamide. No statistical difference in the above cytotoxic therapy was observed between those patients who developed malignancy and those who did not.
KEY WORDS: Systemic lupus erythematosus (SLE), Malignancy, Cytotoxic therapy, Hodgkin's lymphoma.
Correspondence to: D. Isenberg, Centre for Rheumatology, 4th Floor, Arthur Stanley House, 40–50 Tottenham Street, London W1P 9PG, UK.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  B Lofstrom, C Backlin, C Sundstrom, A Ekbom, and I E Lundberg A closer look at non-Hodgkin's lymphoma cases in a national Swedish systemic lupus erythematosus cohort: a nested case-control study Ann Rheum Dis, December 1, 2007; 66(12): 1627 - 1632. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G Ruiz-Irastorza, A Ugarte, M V Egurbide, M Garmendia, J I Pijoan, A Martinez-Berriotxoa, and C Aguirre Antimalarials may influence the risk of malignancy in systemic lupus erythematosus Ann Rheum Dis, June 1, 2007; 66(6): 815 - 817. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B-C Chun and S-C Bae Mortality and cancer incidence in Korean patients with systemic lupus erythematosus: results from the Hanyang Lupus Cohort in Seoul, Korea Lupus, August 1, 2005; 14(8): 635 - 638. [Abstract] [PDF]
|
|
|
|
|
|
O Ragnarsson, G Grondal, and K Steinsson Risk of malignancy in an unselected cohort of Icelandic patients with systemic lupus erythematosus Lupus, September 1, 2003; 12(9): 687 - 691. [Abstract] [PDF]
|
|
|
|
 |
|
 M. S. COOKE, M. D. EVANS, M. DIZDAROGLU, and J. LUNEC Oxidative DNA damage: mechanisms, mutation, and disease FASEB J, July 1, 2003; 17(10): 1195 - 1214. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Gordon Long-term complications of systemic lupus erythematosus Rheumatology, October 1, 2002; 41(10): 1095 - 1100. [Full Text] [PDF]
|
|
|
|
|
|
J. R. MacGowan, S. Ellis, M. Griffiths, and D. A. Isenberg Retrospective analysis of outcome in a cohort of patients with lupus nephritis treated between 1977 and 1999 Rheumatology, September 1, 2002; 41(9): 981 - 987. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y Molad, A Gorshtein, A J Wysenbeek, D Guedj, R Majadla, A Weinberger, and M Amit-Vazina Protective effect of hydroxychloroquine in systemic lupus erythematosus. Prospective long-term study of an Israeli cohort{ Lupus, June 1, 2002; 11(6): 356 - 361. [Abstract] [PDF]
|
|
|
|
 |
|
 D. Bouros, K. Hatzakis, H. Labrakis, and K. Zeibecoglou Association of Malignancy With Diseases Causing Interstitial Pulmonary Changes* Chest, April 1, 2002; 121(4): 1278 - 1289. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Abu-Shakra, M Ehrenfeld, and Y Shoenfeld Systemic lupus erythematosus and cancer: associated or not? Lupus, March 1, 2002; 11(3): 137 - 144. [Abstract] [PDF]
|
|
|
|
|
|
N. J. Sheehan Systemic lupus erythematosus after acute lymphoblastic leukaemia Rheumatology, January 1, 2002; 41(1): 113 - 114. [Full Text] [PDF]
|
|
|
|
|
|
Y Xu and P H Wiernik Systemic lupus erythematosus and B-cell hematologic neoplasm Lupus, December 1, 2001; 10(12): 841 - 850. [Abstract] [PDF]
|
|
|
|
|
|
O Nived, A Bengtsson, A Jonsen, G Sturfelt, and H Olsson Malignancies during follow-up in an epidemiologically defined systemic lupus erythematosus inception cohort in southern Sweden Lupus, July 1, 2001; 10(7): 500 - 504. [Abstract] [PDF]
|
|
|
|
|
|
R Ramsey-Goldman and A E Clarke Double trouble: are lupus and malignancy associated? Lupus, June 1, 2001; 10(6): 388 - 391. [PDF]
|
|