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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Heamatological malignancies in giant cell arteritis: a French population-based study
Hélène Greigert1,2,3, Morgane Mounier4,5,6, Louis Arnould7
1Department of Internal Medicine and Clinical Immunology.
Insights
Giant cell arteritis (GCA) patients show a higher incidence of hematological malignancies (HM), particularly myeloid HM and myeloproliferative neoplasms (MPN) in men. This suggests clonal hematopoiesis may link GCA and HM.
Area of Science:
- Hematology
- Oncology
- Rheumatology
Background:
- Giant cell arteritis (GCA) is associated with an increased risk of hematological malignancies (HM).
- Understanding the specific types and incidence of HM in GCA patients is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the incidence and types of hematological malignancies (HM) occurring in patients diagnosed with giant cell arteritis (GCA).
Main Methods:
- Retrospective analysis of GCA patients with biopsy-proven temporal artery involvement.
- Cross-referencing patient data with the RHEMCO registry for hematological malignancies.
- Calculation of standardized incidence ratios (SIR) to compare HM incidence in GCA patients with the general population.
Main Results:
- 14 hematological malignancies (HM) were identified in 12 out of 276 (4.3%) biopsy-proven GCA patients.
- GCA patients exhibited increased incidence of myeloid HM (SIR=2.71) and myeloproliferative neoplasms (MPN) (SIR=5.16) compared to the general population.
- Men with GCA showed a significantly higher incidence of myeloid HM (SIR=4.82) and MPN (SIR=9.04).
Conclusions:
- Male GCA patients have a distinct HM epidemiology, with a notable increase in myeloid HM, particularly MPN.
- The temporal relationship between myeloid HM and GCA diagnoses suggests clonal hematopoiesis may play a role in GCA pathogenesis.
Objectives:
An increased risk of haematological malignancies (HM) has been reported in GCA patients. Our study aimed to investigate the incidence and the type of HM occurring in GCA.
Methods:
All patients with GCA and HM living in Côte d'Or (France) were identified by crossing data from the RHEMCO (Registre des Hémopathies Malignes de Côte d'Or) and those having a positive temporal artery biopsy between 1 January 2001 and 31 December 2018.
Results:
Among 276 biopsy-proven GCA patients, 14 HM were identified in 12 patients (4.3%). In comparison with the general population aged >50 y, the incidence of myeloid HM and myeloproliferative syndromes were increased in GCA patients [standardized incidence ratios (SIR) = 2.71 and 5.16, respectively], with a specific increase in men with GCA (SIR = 4.82 and 9.04, respectively) but not in women. In addition, the study of SIR depending on the chronology between GCA and HM diagnoses suggests that there was an increased risk of developing GCA in men but not in women, after a diagnosis of myeloid HM (SIR = 9.56), especially if it was a MPS (SIR = 17.56).
Conclusions:
Our study shows a particular epidemiology of HM in GCA patients, which is characterized by an increased incidence of myeloid HM, especially MPS, in male GCA patients. The chronology of the diagnoses of GCA and HM raises the hypothesis that clonal hematopoiesis may be implicated in some cases of GCA.
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