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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
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated