Lymphoma risk in systemic lupus: effects of disease activity versus treatment

Research output: Contribution to journalArticlepeer-review

Standard

Lymphoma risk in systemic lupus : effects of disease activity versus treatment. / Bernatsky, Sasha; Ramsey-Goldman, Rosalind; Joseph, Lawrence; Boivin, Jean-Francois; Costenbader, Karen H; Urowitz, Murray B; Gladman, Dafna D; Fortin, Paul R; Nived, Ola; Petri, Michelle A; Jacobsen, Soren; Manzi, Susan; Ginzler, Ellen M; Isenberg, David; Rahman, Anisur; Gordon, Caroline; Ruiz-Irastorza, Guillermo; Yelin, Edward; Bae, Sang-Cheol; Wallace, Daniel J; Peschken, Christine A; Dooley, Mary Anne; Edworthy, Steven M; Aranow, Cynthia; Kamen, Diane L; Romero-Diaz, Juanita; Askanase, Anca; Witte, Torsten; Barr, Susan G; Criswell, Lindsey A; Sturfelt, Gunnar K; Blanco, Irene; Feldman, Candace H; Dreyer, Lene; Patel, Neha M; St Pierre, Yvan; Clarke, Ann E.

In: Annals of the Rheumatic Diseases, 08.01.2013.

Research output: Contribution to journalArticlepeer-review

Harvard

Bernatsky, S, Ramsey-Goldman, R, Joseph, L, Boivin, J-F, Costenbader, KH, Urowitz, MB, Gladman, DD, Fortin, PR, Nived, O, Petri, MA, Jacobsen, S, Manzi, S, Ginzler, EM, Isenberg, D, Rahman, A, Gordon, C, Ruiz-Irastorza, G, Yelin, E, Bae, S-C, Wallace, DJ, Peschken, CA, Dooley, MA, Edworthy, SM, Aranow, C, Kamen, DL, Romero-Diaz, J, Askanase, A, Witte, T, Barr, SG, Criswell, LA, Sturfelt, GK, Blanco, I, Feldman, CH, Dreyer, L, Patel, NM, St Pierre, Y & Clarke, AE 2013, 'Lymphoma risk in systemic lupus: effects of disease activity versus treatment', Annals of the Rheumatic Diseases. https://doi.org/10.1136/annrheumdis-2012-202099

APA

Bernatsky, S., Ramsey-Goldman, R., Joseph, L., Boivin, J-F., Costenbader, K. H., Urowitz, M. B., Gladman, D. D., Fortin, P. R., Nived, O., Petri, M. A., Jacobsen, S., Manzi, S., Ginzler, E. M., Isenberg, D., Rahman, A., Gordon, C., Ruiz-Irastorza, G., Yelin, E., Bae, S-C., ... Clarke, A. E. (2013). Lymphoma risk in systemic lupus: effects of disease activity versus treatment. Annals of the Rheumatic Diseases. https://doi.org/10.1136/annrheumdis-2012-202099

Vancouver

Author

Bernatsky, Sasha ; Ramsey-Goldman, Rosalind ; Joseph, Lawrence ; Boivin, Jean-Francois ; Costenbader, Karen H ; Urowitz, Murray B ; Gladman, Dafna D ; Fortin, Paul R ; Nived, Ola ; Petri, Michelle A ; Jacobsen, Soren ; Manzi, Susan ; Ginzler, Ellen M ; Isenberg, David ; Rahman, Anisur ; Gordon, Caroline ; Ruiz-Irastorza, Guillermo ; Yelin, Edward ; Bae, Sang-Cheol ; Wallace, Daniel J ; Peschken, Christine A ; Dooley, Mary Anne ; Edworthy, Steven M ; Aranow, Cynthia ; Kamen, Diane L ; Romero-Diaz, Juanita ; Askanase, Anca ; Witte, Torsten ; Barr, Susan G ; Criswell, Lindsey A ; Sturfelt, Gunnar K ; Blanco, Irene ; Feldman, Candace H ; Dreyer, Lene ; Patel, Neha M ; St Pierre, Yvan ; Clarke, Ann E. / Lymphoma risk in systemic lupus : effects of disease activity versus treatment. In: Annals of the Rheumatic Diseases. 2013.

Bibtex

@article{cc6b5902f0564542bf66572257ddc82a,
title = "Lymphoma risk in systemic lupus: effects of disease activity versus treatment",
abstract = "OBJECTIVE: To examine disease activity versus treatment as lymphoma risk factors in systemic lupus erythematosus (SLE). METHODS: We performed case-cohort analyses within a multisite SLE cohort. Cancers were ascertained by regional registry linkages. Adjusted HRs for lymphoma were generated in regression models, for time-dependent exposures to immunomodulators (cyclophosphamide, azathioprine, methotrexate, mycophenolate, antimalarial drugs, glucocorticoids) demographics, calendar year, Sjogren's syndrome, SLE duration and disease activity. We used adjusted mean SLE Disease Activity Index scores (SLEDAI-2K) over time, and drugs were treated both categorically (ever/never) and as estimated cumulative doses. RESULTS: We studied 75 patients with lymphoma (72 non-Hodgkin, three Hodgkin) and 4961 cancer-free controls. Most lymphomas were of B-cell origin. As is seen in the general population, lymphoma risk in SLE was higher in male than female patients and increased with age. Lymphomas occurred a mean of 12.4 years (median 10.9) after SLE diagnosis. Unadjusted and adjusted analyses failed to show a clear association of disease activity with lymphoma risk. There was a suggestion of greater exposure to cyclophosphamide and to higher cumulative steroids in lymphoma cases than the cancer-free controls. CONCLUSIONS: In this large SLE sample, there was a suggestion of higher lymphoma risk with exposure to cyclophosphamide and high cumulative steroids. Disease activity itself was not clearly associated with lymphoma risk. Further work will focus on genetic profiles that might interact with medication exposure to influence lymphoma risk in SLE.",
author = "Sasha Bernatsky and Rosalind Ramsey-Goldman and Lawrence Joseph and Jean-Francois Boivin and Costenbader, {Karen H} and Urowitz, {Murray B} and Gladman, {Dafna D} and Fortin, {Paul R} and Ola Nived and Petri, {Michelle A} and Soren Jacobsen and Susan Manzi and Ginzler, {Ellen M} and David Isenberg and Anisur Rahman and Caroline Gordon and Guillermo Ruiz-Irastorza and Edward Yelin and Sang-Cheol Bae and Wallace, {Daniel J} and Peschken, {Christine A} and Dooley, {Mary Anne} and Edworthy, {Steven M} and Cynthia Aranow and Kamen, {Diane L} and Juanita Romero-Diaz and Anca Askanase and Torsten Witte and Barr, {Susan G} and Criswell, {Lindsey A} and Sturfelt, {Gunnar K} and Irene Blanco and Feldman, {Candace H} and Lene Dreyer and Patel, {Neha M} and {St Pierre}, Yvan and Clarke, {Ann E}",
year = "2013",
month = jan,
day = "8",
doi = "10.1136/annrheumdis-2012-202099",
language = "English",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "BMJ Publishing Group",

}

RIS

TY - JOUR

T1 - Lymphoma risk in systemic lupus

T2 - effects of disease activity versus treatment

AU - Bernatsky, Sasha

AU - Ramsey-Goldman, Rosalind

AU - Joseph, Lawrence

AU - Boivin, Jean-Francois

AU - Costenbader, Karen H

AU - Urowitz, Murray B

AU - Gladman, Dafna D

AU - Fortin, Paul R

AU - Nived, Ola

AU - Petri, Michelle A

AU - Jacobsen, Soren

AU - Manzi, Susan

AU - Ginzler, Ellen M

AU - Isenberg, David

AU - Rahman, Anisur

AU - Gordon, Caroline

AU - Ruiz-Irastorza, Guillermo

AU - Yelin, Edward

AU - Bae, Sang-Cheol

AU - Wallace, Daniel J

AU - Peschken, Christine A

AU - Dooley, Mary Anne

AU - Edworthy, Steven M

AU - Aranow, Cynthia

AU - Kamen, Diane L

AU - Romero-Diaz, Juanita

AU - Askanase, Anca

AU - Witte, Torsten

AU - Barr, Susan G

AU - Criswell, Lindsey A

AU - Sturfelt, Gunnar K

AU - Blanco, Irene

AU - Feldman, Candace H

AU - Dreyer, Lene

AU - Patel, Neha M

AU - St Pierre, Yvan

AU - Clarke, Ann E

PY - 2013/1/8

Y1 - 2013/1/8

N2 - OBJECTIVE: To examine disease activity versus treatment as lymphoma risk factors in systemic lupus erythematosus (SLE). METHODS: We performed case-cohort analyses within a multisite SLE cohort. Cancers were ascertained by regional registry linkages. Adjusted HRs for lymphoma were generated in regression models, for time-dependent exposures to immunomodulators (cyclophosphamide, azathioprine, methotrexate, mycophenolate, antimalarial drugs, glucocorticoids) demographics, calendar year, Sjogren's syndrome, SLE duration and disease activity. We used adjusted mean SLE Disease Activity Index scores (SLEDAI-2K) over time, and drugs were treated both categorically (ever/never) and as estimated cumulative doses. RESULTS: We studied 75 patients with lymphoma (72 non-Hodgkin, three Hodgkin) and 4961 cancer-free controls. Most lymphomas were of B-cell origin. As is seen in the general population, lymphoma risk in SLE was higher in male than female patients and increased with age. Lymphomas occurred a mean of 12.4 years (median 10.9) after SLE diagnosis. Unadjusted and adjusted analyses failed to show a clear association of disease activity with lymphoma risk. There was a suggestion of greater exposure to cyclophosphamide and to higher cumulative steroids in lymphoma cases than the cancer-free controls. CONCLUSIONS: In this large SLE sample, there was a suggestion of higher lymphoma risk with exposure to cyclophosphamide and high cumulative steroids. Disease activity itself was not clearly associated with lymphoma risk. Further work will focus on genetic profiles that might interact with medication exposure to influence lymphoma risk in SLE.

AB - OBJECTIVE: To examine disease activity versus treatment as lymphoma risk factors in systemic lupus erythematosus (SLE). METHODS: We performed case-cohort analyses within a multisite SLE cohort. Cancers were ascertained by regional registry linkages. Adjusted HRs for lymphoma were generated in regression models, for time-dependent exposures to immunomodulators (cyclophosphamide, azathioprine, methotrexate, mycophenolate, antimalarial drugs, glucocorticoids) demographics, calendar year, Sjogren's syndrome, SLE duration and disease activity. We used adjusted mean SLE Disease Activity Index scores (SLEDAI-2K) over time, and drugs were treated both categorically (ever/never) and as estimated cumulative doses. RESULTS: We studied 75 patients with lymphoma (72 non-Hodgkin, three Hodgkin) and 4961 cancer-free controls. Most lymphomas were of B-cell origin. As is seen in the general population, lymphoma risk in SLE was higher in male than female patients and increased with age. Lymphomas occurred a mean of 12.4 years (median 10.9) after SLE diagnosis. Unadjusted and adjusted analyses failed to show a clear association of disease activity with lymphoma risk. There was a suggestion of greater exposure to cyclophosphamide and to higher cumulative steroids in lymphoma cases than the cancer-free controls. CONCLUSIONS: In this large SLE sample, there was a suggestion of higher lymphoma risk with exposure to cyclophosphamide and high cumulative steroids. Disease activity itself was not clearly associated with lymphoma risk. Further work will focus on genetic profiles that might interact with medication exposure to influence lymphoma risk in SLE.

U2 - 10.1136/annrheumdis-2012-202099

DO - 10.1136/annrheumdis-2012-202099

M3 - Article

C2 - 23303389

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

ER -