Non-Lymphoma Hematological Malignancies in Systemic Lupus ErythematosusLu M. · Bernatsky S. · Ramsey-Goldman R. · Petri M. · Manzi S. · Urowitz M.B. · Gladman D. · Fortin P.R. · Ginzler E.M. · Yelin E. · Bae S.-C. · Wallace D.J. · Jacobsen S. · Dooley M.A. · Peschken C.A. · Alarcón G.S. · Nived O. · Gottesman L. · Criswell L.A. · Sturfelt G. · Dreyer L. · Lee J.L. · Clarke A.E.
aDivision of Clinical Epidemiology, McGill University Health Centre, Montreal, Que., bDepartment of Rheumatology, Toronto Western Hospital, Toronto, Ont., cDivision of Rheumatology, CHU de Québec and Université Laval, Quebec City, Que., and dDepartment of Rheumatology, University of Manitoba, Winnipeg, Man., Canada; eDepartment of Medicine/Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Ill., fDivision of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Md., gDepartment of Medicine, West Penn Allegheny Health System, Pittsburgh, Pa., hDivision of Rheumatology, Downstate Medical Center, State University of New York, Brooklyn, N.Y., iDivision of Rheumatology and jRosalind Russell Medical Research Center for Arthritis, Department of Medicine, University of California San Francisco, San Francisco, Calif., kCedars-Sinai Medical Center/David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif., lDepartment of Rheumatology, University of North Carolina at Chapel Hill, Chapel Hill, N.C., mDepartment of Rheumatology, The University of Alabama, Birmingham, Ala., USA; nThe Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea; oDepartment of Rheumatology, Lund University Hospital, Lund, Sweden; pDepartment of Rheumatology, Rigshospitalet and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
Objective: To describe non-lymphoma hematological malignancies in systemic lupus erythematosus (SLE). Methods: A large SLE cohort was linked to cancer registries. We examined the types of non-lymphoma hematological cancers. Results: In 16,409 patients, 115 hematological cancers [including myelodysplastic syndrome (MDS)] occurred. Among these, 33 were non-lymphoma. Of the 33 non-lymphoma cases, 13 were of lymphoid lineage: multiple myeloma (n = 5), plasmacytoma (n = 3), B cell chronic lymphocytic leukemia (B-CLL; n = 3), precursor cell lymphoblastic leukemia (n = 1) and unspecified lymphoid leukemia (n = 1). The remaining 20 cases were of myeloid lineage: MDS (n = 7), acute myeloid leukemia (AML; n = 7), chronic myeloid leukemia (CML; n = 2) and 4 unspecified leukemias. Most of these malignancies occurred in female Caucasians, except for plasma cell neoplasms (4/5 multiple myeloma and 1/3 plasmacytoma cases occurred in blacks). Conclusions: In this large SLE cohort, the most common non-lymphoma hematological malignancies were myeloid types (MDS and AML). This is in contrast to the general population, where lymphoid types are 1.7 times more common than myeloid non-lymphoma hematological malignancies. Most (80%) multiple myeloma cases occurred in blacks; this requires further investigation.