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Hodgkin lymphoma after autoimmune diseases by age at diagnosis and histological subtype.
[hodgkin lymphoma, classical]
Increased
risk
of
Hodgkin
lymphoma
(
HL
)
associated
with
personal
history
of
several
autoimmune
diseases
(
ADs
)
,
such
as
rheumatoid
arthritis
,
systemic
lupus
erythematosus
,
sarcoidosis
,
and
immune
thrombocytopenic
purpura
,
are
known
.
Whether
there
are
other
HL-related
ADs
and
whether
the
increased
risk
of
HL
after
ADs
holds
across
sex
,
age
,
year
of
diagnosis
,
or
HL
histological
subtype
is
unclear
.
We
systematically
analyzed
the
risk
of
HL
in
878
161
Swedish
patients
diagnosed
with
33
different
ADs
in
1964
-
2010
.
During
∼
10
-
year
follow-up
of
ADs
patients
,
371
incident
HL
cases
were
diagnosed
.
Significantly
increased
overall
standardized
incidence
ratio
(
SIR
)
for
HL
after
ADs
was
2
.
0
(
95
%
confidence
interval
:
1
.
8
-
2
.
2
)
;
AD
-
specific
SIRs
:
autoimmune
hemolytic
anemia
19
.
9
(
7
.
2
-
43
.
6
)
,
sarcoidosis
10
.
3
(
7
.
8
-
13
.
4
)
,
systemic
lupus
erythematosus
8
.
4
(
5
.
2
-
12
.
9
)
,
immune
thrombocytopenic
purpura
7
.
0
(
3
.
2
-
13
.
3
)
,
polyarteritis
nodosa
6
.
6
(
1
.
2
-
19
.
5
)
,
polymyositis
/
dermatomyositis
6
.
3
(
2
.
0
-
14
.
9
)
,
Behcet
's
disease
5
.
6
(
2
.
7
-
10
.
3
)
,
Sjögren
's
syndrome
5
.
0
(
2
.
1
-
9
.
8
)
,
rheumatoid
arthritis
3
.
2
(
2
.
6
-
3
.
9
)
,
polymyalgia
rheumatica
2
.
2
(
1
.
4
-
3
.
5
)
,
and
psoriasis
1
.
9
(
1
.
3
-
2
.
6
)
.
Men
with
AD
had
slightly
higher
risk
of
HL
(
2
.
4
,
2
.
0
-
2
.
7
)
compared
with
women
(
1
.
8
,
1
.
5
-
2
.
0
)
.
Only
23
%
of
ADs
were
diagnosed
before
age
35
years
and
the
overall
SIR
for
HL
diagnosis
before
age
35
[
1
.
4
,
(
1
.
0
-
1
.
8
)
]
was
lower
than
that
in
older
ages
[
35
≤
age
<
50
:
2
.
1
(
1
.
6
-
2
.
7
)
;
age
≥
50
:
2
.
2
(
2
.
0
-
2
.
5
)
]
,
except
for
sarcoidosis
[
age
<
35
:
19
.
3
(
10
.
5
-
32
.
5
)
;
35
≤
age
<
50
:
10
.
4
(
5
.
7
-
17
.
5
)
;
age
≥
50
:
8
.
4
(
5
.
6
-
12
.
1
)
]
.
Risks
of
all
classical
HLs
significantly
increased
after
ADs
:
lymphocyte
depletion
3
.
7
(
1
.
5
-
7
.
6
)
,
lymphocyte-rich
3
.
7
(
2
.
3
-
5
.
9
)
,
mixed
cellularity
2
.
4
(
1
.
8
-
3
.
2
)
,
and
nodular
sclerosis
1
.
7
(
1
.
3
-
2
.
1
)
.
Several
,
but
not
all
ADs
(
11
/
33
)
,
had
a
positive
association
with
all
classical
histological
subtypes
of
HL
.
Higher
risks
of
classical
HL
after
polyarteritis
nodosa
,
polymyositis
/
dermatomyositis
,
Behcet
's
disease
,
Sjögren
's
syndrome
,
polymyalgia
rheumatica
,
and
psoriasis
were
novel
findings
of
this
study
.
Diseases
Validation
Diseases presenting
"mixed cellularity"
symptom
hodgkin lymphoma, classical
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