Hematological malignancies in systemic lupus erythematosus: clinical characteristics, risk factors, and prognosis—a case-control study

Abstract Background Systemic lupus erythematosus (SLE) is a chronic and complex multi-system autoimmune disorder. Higher risks of hematological malignancies (HM) were observed in SLE patients, which was associated with higher mortality. The mechanism and risk factors of HM oncogenesis in SLE patients are still under investigation. The aim of this study was to explore clinical characteristics, risk factors, and prognosis of SLE patients with or without HM in the Chinese population. Methods A retrospective, case-controlled study was conducted in 72 SLE patients between January 2013 and December 2020. Clinical and laboratory data were collected and compared between the two groups of patients with HM and those without HM. Logistic regression analysis was performed to determine risk factors of HM oncogenesis. The survival rate was estimated by Kaplan-Meier methods and Cox proportional hazards regression analysis. Results Among 72 SLE patients in this study, fifteen complicated with HM and 57 without HM were identified. The incidence rate of HM was approximately 0.24% with elevated standardized incidence ratios of lymphoma and leukemia (27.559 and 12.708, respectively). Patients with HM were older when diagnosed with SLE, with a higher frequency of infection and splenomegaly, lower levels of hemoglobin and high-density lipoprotein compared with those without HM. Fewer patients with HM expressed positive anti-dsDNA antibody (26.7% vs 66.7%, P = 0.005) or received hydroxychloroquine treatment (40.0% vs 86.0%, P = 0.001). Older age at SLE diagnosis (OR=1.122, 95% CI: 1.037–1.214) was regarded as an independent risk factor of HM oncogenesis. Female (RR= 0.219, 95% CI: 0.070–0.681) and hydroxychloroquine (RR= 0.281, 95% CI: 0.094–0.845) were protective factors of mortality in SLE patients. Conclusions SLE patients with an older age are at an increased risk of HM carcinogenesis. The prognosis of male patients with SLE tends to be poorer whether complicated with HM. The association of antinuclear antibody spectrum, medication, and HM oncogenesis in SLE needs further investigation.

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Hematological Malignancies in Systemic Lupus Erythematosus: Clinical Characteristics, Risk Factors and Prognosis – a Case-control Study

10.21203/rs.3.rs-313607/v1 ◽

2021 ◽

Author(s):

Yuqi Zhang ◽

Wei Li ◽

Panpan Zhang ◽

Jinyan Guo ◽

Jinlei Sun ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Disease Activity ◽

Incidence Rate ◽

Lupus Erythematosus ◽

Clinical Characteristics ◽

Hematological Malignancies ◽

Lower Percentage ◽

Systemic Lupus ◽

Dsdna Antibody

Abstract Background: Systemic lupus erythematosus (SLE) is a chronic and complex multi-system autoimmune disorder. Higher risks of malignancy were observed in SLE patients, which was associated with higher mortality. We aimed to explore clinical characteristics, risk factors and prognosis between SLE patients with or without hematological malignancies (HM) in Chinese population.Methods: We retrospectively collected patients from our hospital with a diagnosis of SLE from January 2013 to December 2020. Clinical and laboratory data were collected and disease activity was evaluated according to systemic lupus erythematosus disease activity index-2000 (SLEDAI-2K). Logistic regression analysis was performed to predict risk factors. The survival rate was estimated by Kaplan-Meier and Cox proportional hazards regression analysis.Results: The study enrolled 15 SLE patients with HM as the case group and 57 without HM as the control group for analysis. The incidence rate of HM was approximately 0.24% with elevated standard incidence rate of lymphoma and leukemia (27.559 and 12.708, respectively). Patients with HM were at a higher age at the diagnosis of SLE, with a higher frequency of infection, splenomegaly and a lower level of hemoglobin compared with patients without HM. SLEDAI-2K was comparable between the two groups at the diagnosis of SLE (P = 0.184). Lower percentage of patients with HM expressed positive anti-dsDNA antibody (26.7% vs 66.7%，P = 0.005 ) or had ever been treated with hydroxychloroquine (40.0% vs 86.0%, P = 0.001). Higher age (OR 1.098, P = 0.004), infection (OR 5.759, P = 0.041) and lower hemoglobin (OR 0.954, P = 0.021) were risk factors for SLE patients to develop with HM. Female (RR 0.219, P = 0.009) and hydroxychloroquine (RR 0.281, P = 0.024) were protective factors from mortality. Conclusions: SLE patients are more prone to be complicated with HM, especially for those at a higher age, suffering with infection or anemia. The prognosis of male patients with SLE tends to be poorer whether complicated with HM. The association between antinuclear antibody spectrum and SLE complicated with HM needs further investigation.

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AB0517 Invasive aspergillosis in patients with systemic lupus erythematosus: a retrospective study focus on clinical characteristics and risk factors of in-hospital mortality

10.1136/annrheumdis-2018-eular.1080 ◽

2018 ◽

Author(s):

H. Mingli ◽

C.-Y. Tsai

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Retrospective Study ◽

Hospital Mortality ◽

Invasive Aspergillosis ◽

Lupus Erythematosus ◽

Clinical Characteristics ◽

Systemic Lupus

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Atherosclerotic plaque in carotid arteries in systemic lupus erythematosus: frequency and associated risk factors

Sao Paulo Medical Journal ◽

10.1590/s1516-31802005000300010 ◽

2005 ◽

Vol 123 (3) ◽

pp. 137-142 ◽

Cited By ~ 19

Author(s):

Alexandre Wagner Silva de Souza ◽

Francisca Satomi Hatta ◽

Fausto Miranda Jr. ◽

Emília Inoue Sato

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Atherosclerotic Plaque ◽

Lupus Erythematosus ◽

Carotid Plaque ◽

Carotid Arteries ◽

Disease Duration ◽

Significant Risk ◽

Older Age ◽

Systemic Lupus

CONTEXT AND OBJECTIVE: Atherosclerotic disease is an important cause of morbidity and mortality in systemic lupus erythematosus (SLE) patients. No previous study has estimated carotid disease prevalence in such patients in Brazil. The aim was to evaluate the prevalence of atherosclerotic plaque in carotid arteries, in SLE patients and controls, and to verify possible associations between risk factors and carotid plaque. DESIGN AND SETTING: Cross-sectional study, at Universidade Federal de São Paulo - Escola Paulista de Medicina. METHODS: Carotid plaque prevalence was assessed by B-mode ultrasound in 82 female SLE patients of mean age 34.0 years and 62 controls of mean age 35.7 years. Plaque was defined as a distinct area of hyperechogenicity and/or focal protrusion of the vessel wall into the lumen. Risk factors for coronary disease and SLE-related variables were determined. RESULTS: 50% of patients and 29% of controls presented carotid plaque. Older age, longer disease duration, higher Systemic Lupus International Collaborating Clinics (SLICC) score, higher levels of low-density lipoprotein and greater diabetes, obesity, premature ovarian failure and family history of coronary artery disease were found in patients with carotid plaque than in those without plaque. Patients with plaque were younger than controls with plaque. SLE diagnosis, obesity, older age, higher SLICC score and longer disease duration were independent risk factors for carotid plaque. CONCLUSION: Young patients with SLE present higher prevalence of carotid plaque than controls. SLE diagnosis was a significant risk factor for carotid atherosclerosis.

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Clinical characteristics and risk factors of intracranial hemorrhage in systemic lupus erythematosus

Lupus ◽

10.1177/0961203313477226 ◽

2013 ◽

Vol 22 (5) ◽

pp. 453-460 ◽

Cited By ~ 6

Author(s):

N Gao ◽

ZL Wang ◽

MT Li ◽

SM Han ◽

YQ Dang ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Intracranial Hemorrhage ◽

Lupus Erythematosus ◽

Clinical Characteristics ◽

Systemic Lupus

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Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXV. Smoking, older age, disease activity, lupus anticoagulant, and glucocorticoid dose as risk factors for the occurrence of venous thrombosis in lupus patients

Arthritis & Rheumatism ◽

10.1002/art.21149 ◽

2005 ◽

Vol 52 (7) ◽

pp. 2060-2068 ◽

Cited By ~ 83

Author(s):

Jaime Calvo-Alén ◽

Sergio M. A. Toloza ◽

Mónica Fernández ◽

Holly M. Bastian ◽

Barri J. Fessler ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Venous Thrombosis ◽

Disease Activity ◽

Lupus Erythematosus ◽

Lupus Anticoagulant ◽

Older Age ◽

Systemic Lupus

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Plasma Platelet-derived Microparticles in Patients with Connective Tissue Diseases

The Journal of Rheumatology ◽

10.3899/jrheum.100780 ◽

2011 ◽

Vol 38 (4) ◽

pp. 680-684 ◽

Cited By ~ 13

Author(s):

CHINAMI OYABU ◽

AKIO MORINOBU ◽

DAISUKE SUGIYAMA ◽

JUN SAEGUSA ◽

SHINO TANAKA ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Regression Analysis ◽

Connective Tissue ◽

Lupus Erythematosus ◽

Clinical Characteristics ◽

Linear Regression Analysis ◽

Connective Tissue Diseases ◽

Multiple Linear Regression Analysis ◽

Systemic Lupus

Objective.To clarify the role of platelet-derived microparticles (PDMP), which are small vesicles with thrombotic and immunological properties, in systemic lupus erythematosus (SLE), systemic sclerosis (SSc), dermatomyositis/polymyositis (PM/DM), and mixed connective tissue disease (MCTD).Methods.Plasma levels of PDMP were measured by ELISA, and compared among patients with one of the 4 diseases. Association of PDMP levels with clinical characteristics and medication of the patients was also examined.Results.PDMP levels were higher in patients with MCTD and SSc than in controls. Multiple linear regression analysis revealed that patients with Raynaud’s phenomenon (RP) showed higher PDMP levels than those without. PDMP levels in individual patients did not fluctuate significantly over several months.Conclusion.PDMP level is associated with MCTD, SSc, and RP, and could be a novel marker for RP.

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