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Lymphoma development risk in various autoimmune disorders
A meta-analysis of all available cohort studies linking systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and primary Sjogren's syndrome (pSS), to the risk of developing non-Hodgkin's lymphoma (NHL) suggested high risk between pSS and lymphoma development (random effects (RE) standardized incidence rate SIR=18.8 [95%ci (9.5-37.3)]), moderate risk for SLE (RE SIR=7.4 [95%ci (3.3-17.0)]), and lower risk for RA (RE SIR=3.2 [95% ci (2.1-4.9]. In RA, the RE SIRs of lymphomas with conventional anti-rheumatic treatment, cytotoxic treatment and treatment with biological agent were 2.5 [95%ci (0.7-9.0)], 5.1 [95%ci (0.9-28.6)], and 11.5 [95%ci (3.7-26.9)], respectively. However, the major limitation of the meta-analysis is the large heterogeneity between studies which might be due to different baseline risk populations, study designs, and data source. In addition, there is a decline risk of lymphoma development during time which might be due to revised and/or more accurate classification of non-Hodgkin's lymphoma during this period or to better treatment of autoimmune diseases. Thus, there is evidence that rheumatic disease may present a potential risk factor for NHL development, and there are differences of lymphoma development risk in various autoimmune disorders.
Bibliographical reference:
Elias Zintzaras Department of Biomathematics, University of Thessaly School of Medicine, Larissa, Greece
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