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Cancer risk in amyloidosis patients in Sweden with novel findings on non-Hodgkin lymphoma and skin cancer.
[waldenström macroglobulinemia]
Systemic
amyloidoses
include
immunoglobulin
light
chain
(
AL
)
amyloidosis
,
serum
amyloid
(
AA
)
-
related
amyloidosis
and
senile
systemic
amyloidosis
(
SSA
)
.
AL
amyloidosis
is
associated
with
myeloma
,
and
we
showed
recently
that
transthyretin
-related
hereditary
amyloidosis
was
related
to
non-
Hodgkin
lymphoma
(
NHL
)
.
In
SSA
,
amyloids
constitute
wild-
type
transthyretin
.
We
wanted
to
analyze
cancer
risks
in
amyloidosis
,
particularly
in
SSA
.
Nonhereditary
amyloidosis
patients
were
identified
from
the
Swedish
Hospital
Discharge
and
Outpatients
Registers
from
years
1997
through
2010
.
Their
cancer
risk
was
assessed
based
on
the
Swedish
Cancer
Registry
using
standardized
incidence
ratio
(
SIR
)
between
amyloidosis
patients
and
the
remaining
population
.
To
gain
information
about
amyloidosis
subtypes
,
we
used
the
Swedish
Prescribed
Drug
Register
from
years
2005
through
2010
to
find
out
the
specific
medication
prescribed
.
Among
1400
identified
amyloidosis
patients
,
cancer
risk
was
increased
for
myeloma
,
NHL
and
squamous
cell
skin
cancer
.
Myeloma
and
skin
cancers
were
diagnosed
7
-
8
years
earlier
than
in
the
population
,
whereas
NHL
was
diagnosed
in
elderly
patients
.
The
SIR
was
204
for
myeloma
in
patients
who
received
AL
amyloidosis
medication
,
and
it
was
17
.
22
in
patients
receiving
rheumatoid
arthritis
medication
,
suggesting
AA
amyloidosis
.
In
remaining
patients
,
including
SSA
,
NHL
risk
was
14
.
78
,
including
lymphoplasmacytic
lymphoma
and
Waldenstrom
macroglobulinemia
(
51
.
41
)
and
diffuse
large
B-
cell
lymphoma
(
18
.
69
)
.
In
these
patients
,
endometrial
cancer
(
7
.
04
)
and
cancer
of
unknown
primary
site
(
6
.
56
)
were
also
increased
.
SSA
is
likely
to
be
a
main
cause
of
NHL
in
the
elderly
population
.
The
present
findings
suggest
a
novel
mechanism
for
amyloidosis
-related
cancer
,
highlighting
the
role
of
chronic
stimulation
by
amyloid
.
Diseases
Validation
Diseases presenting
"senile systemic amyloidosis"
symptom
waldenström macroglobulinemia
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