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B-cell lymphoproliferation in chronic inflammatory rheumatic diseases
Arne Hansen1, Peter E Lipsky, Thomas Dörner
1Outpatients Department of Medicine, Charité University Hospital, Berlin, Germany. arne.hansen@charite.de
Nature Clinical Practice. Rheumatology
|October 2, 2007
Summary
Patients with inflammatory rheumatic diseases like rheumatoid arthritis and Sjögren's syndrome have a higher risk of developing non-Hodgkin lymphoma. Disease-specific factors and abnormal B-cell activity contribute to this increased risk.
Area of Science:
- Rheumatology
- Oncology
- Immunology
Background:
- Patients with chronic inflammatory rheumatic diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren's syndrome) exhibit an elevated risk of B-cell non-Hodgkin lymphoma (NHL) compared to the general population.
- Specific associations between lymphoma subtypes and rheumatic diseases suggest disease-specific and subtype-unique mechanisms driving lymphomagenesis.
- Understanding these associations offers insights into abnormal B-cell stimulation in these conditions.
Purpose of the Study:
- To review the risk of lymphoma in patients with inflammatory rheumatic diseases.
- To explore common and disease-specific mechanisms underlying B-cell lymphoma development.
- To discuss the clinical consequences of lymphoma in this patient cohort.
Main Methods:
- Literature review focusing on the relationship between inflammatory rheumatic diseases and B-cell non-Hodgkin lymphoma.
- Analysis of disease-specific and lymphoma subtype-specific associations.
- Examination of underlying mechanisms of B-cell dysregulation and clinical outcomes.
Main Results:
- Patients with primary Sjögren's syndrome, SLE, and RA have a high risk of diffuse large B-cell lymphomas.
- Primary Sjögren's syndrome patients face a particularly elevated risk of marginal-zone B-cell lymphomas.
- Disease activity and duration in RA and SLE may correlate with increased lymphoma risk.
Conclusions:
- Lymphoma development in primary Sjögren's syndrome is linked to abnormal B-cell stimulation and impaired censoring.
- Intense or long-standing disease activity in RA and SLE are potential indicators for higher lymphoma risk.
- This review synthesizes current knowledge on lymphoma risk, mechanisms, and clinical impact in inflammatory rheumatic diseases.
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