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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
"hodgkin lymphoma"
symptom
esophageal adenocarcinoma
hodgkin lymphoma, classical
monosomy 21
primary effusion lymphoma
severe combined immunodeficiency
systemic capillary leak syndrome
waldenström macroglobulinemia
This symptom has already been validated