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Backlin, Carin
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Vasaitis, L., Nordmark, G., Theander, E., Backlin, C., Smedby, K. E., Askling, J., . . . Baecklund, E. (2019). Comparison of patients with and without pre-existing lymphoma at diagnosis of primary Sjögren's syndrome. Scandinavian Journal of Rheumatology, 48(3), 207-212
Öppna denna publikation i ny flik eller fönster >>Comparison of patients with and without pre-existing lymphoma at diagnosis of primary Sjögren's syndrome
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2019 (Engelska)Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 48, nr 3, s. 207-212Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: In the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjögren's syndrome (pSS), pre-existing lymphoma is not an exclusion criterion for pSS diagnosis, as in earlier criteria. We aimed to explore whether there are differences between pSS patients with and without pre-existing lymphoma at pSS diagnosis.

METHOD: Patients with ICD-7-10 codes for Sjögren's syndrome (SS) and a diagnosis of malignant lymphoma before or after SS diagnosis were identified by linking the Swedish Patient Register 1964-2007 with the Cancer Register 1990-2007 (n = 224). Clinical data were collected from medical records. Lymphoma diagnoses were evaluated by tissue review. Characteristics of pSS patients with and without pre-existing lymphoma were compared.

RESULTS: We identified 107 patients with pSS as the reason for an SS diagnosis code and a verified lymphoma. Of these, 18 (17%) had a pre-existing lymphoma at pSS diagnosis, defined as lymphoma diagnosed before or within 6 months of pSS diagnosis. Male gender (39% vs 10%, p = 0.006), enlarged lymph nodes during the pSS disease (61% vs 27%, p = 0.01), mucosa-associated lymphoid tissue (MALT) lymphoma (50% vs 22%, p = 0.02), and salivary gland lymphoma (61% vs 26%, p = 0.006) were more common in patients with a pre-existing lymphoma at pSS diagnosis. Other pSS characteristics were similar.

CONCLUSION: In a substantial proportion of patients, particularly in men, pSS remains undiagnosed until after lymphoma diagnosis. The study highlights the importance of pSS investigation in patients with lymphoma, especially MALT lymphoma, in the salivary glands.

Nationell ämneskategori
Reumatologi och inflammation Klinisk laboratoriemedicin
Forskningsämne
Patologi
Identifikatorer
urn:nbn:se:uu:diva-366237 (URN)10.1080/03009742.2018.1523456 (DOI)000467940900005 ()30422723 (PubMedID)
Forskningsfinansiär
CancerfondenReumatikerförbundetSvenska läkaresällskapetStiftelsen Konung Gustaf V:s Jubileumsfond
Tillgänglig från: 2018-11-18 Skapad: 2018-11-18 Senast uppdaterad: 2020-01-08Bibliografiskt granskad
Kinch, A., Sundström, C., Baecklund, E., Backlin, C., Molin, D. & Enblad, G. (2019). Expression of PD-1, PD-L1, and PD-L2 in posttransplant lymphoproliferative disorder after solid organ transplantation. Leukemia and Lymphoma, 60(2), 376-384
Öppna denna publikation i ny flik eller fönster >>Expression of PD-1, PD-L1, and PD-L2 in posttransplant lymphoproliferative disorder after solid organ transplantation
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2019 (Engelska)Ingår i: Leukemia and Lymphoma, ISSN 1042-8194, E-ISSN 1029-2403, Vol. 60, nr 2, s. 376-384Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

We studied the expression of programed death 1 (PD-1) receptor and its ligands (PD-L1/-L2) by immunohistochemistry and its association with clinicopathological features in 81 posttransplant lymphoproliferative disorders (PTLDs) following solid organ transplantation. Overall, 67% (54/81) of the PTLDs were positive in any of the three immunostainings. PD-1 was detected on tumor-infiltrating cells in 41% (33/81) of the PTLDs. PD-L1 was expressed on ≥5% of the tumor cells in 50% (40/80) and PD-L2 in 32% (23/72) of the PTLDs. All Burkitt lymphomas were PD-L1 negative. Expression of PD-L1 tended to be associated with non-germinal center-type of diffuse large B-cell lymphoma (63% vs. 33% in GC-type, p = .14) and latent membrane protein-1+ PTLD (76% vs. 44% in LPM1-, p = .09). Heart recipients had more frequent PTLDs with PD-1+ microenvironment (p = .01). The frequent expression of PD-1 or -L1/-L2 in PTLD warrants further clinical evaluation of the efficacy and safety of PD-(L)1 inhibitors for refractory PTLD.

Nyckelord
LMP1, PTLD, lymphoma, programed death protein 1, solid organ transplantation, tumor microenvironment
Nationell ämneskategori
Cancer och onkologi Klinisk laboratoriemedicin
Forskningsämne
Onkologi; Patologi
Identifikatorer
urn:nbn:se:uu:diva-365801 (URN)10.1080/10428194.2018.1480767 (DOI)000463555600014 ()30033844 (PubMedID)
Forskningsfinansiär
Cancerfonden
Tillgänglig från: 2018-11-14 Skapad: 2018-11-14 Senast uppdaterad: 2020-01-08Bibliografiskt granskad
Hellbacher, E., Hjorton, K., Backlin, C., Enblad, G., Sundström, C., Baecklund, E. & Knight, A. (2019). Malignant lymphoma in granulomatosis with polyangiitis: subtypes, clinical characteristics and prognosis [Letter to the editor]. Acta Oncologica, 58(11), 1655-1659
Öppna denna publikation i ny flik eller fönster >>Malignant lymphoma in granulomatosis with polyangiitis: subtypes, clinical characteristics and prognosis
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2019 (Engelska)Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 58, nr 11, s. 1655-1659Artikel i tidskrift, Letter (Övrigt vetenskapligt) Published
Abstract [en]

Several autoimmune and inflammatory conditions, such as rheumatoid arthritis (RA) and primary Sjögrens’s syndrome (pSS), have repeatedly been linked to an increased risk of malignant lymphoma [1,2]. Certain inflammatory conditions are also associated with the development of specific lymphoma subtypes such as mucosa-associated lymphoid tissue (MALT) lymphoma in pSS and diffuse large B-cell lymphoma (DLBCL) in RA. The underlying mechanisms behind this association remain unclear. The highly increased risk of developing MALT lymphoma of the parotid gland in pSS indicates that local inflammatory processes can promote lymphoma development at the site of chronic inflammation [3]. In RA, an association between disease severity and risk of lymphoma has been shown.

Granulomatosis with polyangiitis (GPA), formerly Wegener’s granulomatosis, is a systemic small vessel vasculitis associated with the presence of anti-neutrophil cytoplasmic antibodies (ANCA) and characterized by granulomatous inflammation and necrotizing vasculitis of the airways and kidneys but possibly affecting any organ system. An increased risk of lymphoma in patients with GPA has been reported in several epidemiological studies [4,5]. However, very little is known about risk factors for lymphoma development in this group, possible relation to disease severity, treatment and lymphoma subtypes or the prognosis for the lymphomas. This is the first published study on GPA and lymphoma, giving detailed information on the GPA characteristics and possible risk factors for lymphoma and also lymphoma subtypes treatment and survival.

Nationell ämneskategori
Cancer och onkologi Klinisk laboratoriemedicin
Forskningsämne
Patologi
Identifikatorer
urn:nbn:se:uu:diva-398532 (URN)10.1080/0284186X.2019.1634833 (DOI)000481027700001 ()31407922 (PubMedID)
Forskningsfinansiär
Cancerfonden
Tillgänglig från: 2019-12-06 Skapad: 2019-12-06 Senast uppdaterad: 2020-01-08Bibliografiskt granskad
Tessier-Cloutier, B., Twa, D., Baecklund, E., Gascoyne, R., Johnson, N. A., Backlin, C., . . . Bernatsky, S. (2018). An Analysis of Cell-of-Origin in Diffuse Large B-Cell Lymphoma in Systemic Lupus Erythematosus, Including Molecular and Clinical Factors Associated with Survival. Arthritis & Rheumatology, 70
Öppna denna publikation i ny flik eller fönster >>An Analysis of Cell-of-Origin in Diffuse Large B-Cell Lymphoma in Systemic Lupus Erythematosus, Including Molecular and Clinical Factors Associated with Survival
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2018 (Engelska)Ingår i: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70Artikel i tidskrift, Meeting abstract (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2018
Nationell ämneskategori
Reumatologi och inflammation
Identifikatorer
urn:nbn:se:uu:diva-369630 (URN)000447268901243 ()
Tillgänglig från: 2018-12-17 Skapad: 2018-12-17 Senast uppdaterad: 2018-12-17Bibliografiskt granskad
Baecklund, E., Backlin, C., Rönnelid, J., Toes, R., Huizinga, T., Åhlin, E., . . . Smedby, K. E. (2018). Anti-cyclic citrullinated peptide antibodies, other common autoantibodies, and smoking as risk factors for lymphoma in patients with rheumatoid arthritis. Scandinavian Journal of Rheumatology, 47(4), 270-275
Öppna denna publikation i ny flik eller fönster >>Anti-cyclic citrullinated peptide antibodies, other common autoantibodies, and smoking as risk factors for lymphoma in patients with rheumatoid arthritis
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2018 (Engelska)Ingår i: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 47, nr 4, s. 270-275Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVES: Patients with rheumatoid arthritis (RA) are at increased risk of lymphoma. There is no biomarker to indicate future lymphoma risk in RA and it is not known whether factors associated with an increased risk of RA also confer an increased risk of lymphoma. We investigated whether anti-cyclic citrullinated peptide (CCP) antibodies, other autoantibodies, and smoking, are associated with lymphoma development in RA.

METHOD: subclasses of anti-CCP antibodies and for 15 antinuclear antibody (ANA)-associated specific autoantibodies. Relative risks were estimated as crude and adjusted odds ratios (adjOR) with 95% confidence intervals (CIs) using logistic regression.

RESULTS: We found no association between anti-CCP IgG ≥ 25 units/mL (adjOR 1.4, 95% CI 0.7-2.7), anti-CCP IgG ≥ 500 units/mL (adjOR 1.4, 95% CI 0.7-3.0), anti-CCP Ig of other isotypes, other autoantibodies (adjOR any vs none 0.6, 95% CI 0.3-1.2), or cigarette smoking (adjOR ever vs never 1.1, 95% CI 0.5-2.2) and lymphoma risk among patients with RA.

CONCLUSION: In this study, neither anti-CCP antibodies (IgG, IgG1–4, IgM, or IgA), nor other common autoantibodies, nor smoking predicted lymphoma risk in RA

Nationell ämneskategori
Reumatologi och inflammation
Identifikatorer
urn:nbn:se:uu:diva-342980 (URN)10.1080/03009742.2017.1376108 (DOI)000438147400002 ()29336646 (PubMedID)
Forskningsfinansiär
CancerfondenStiftelsen Konung Gustaf V:s Jubileumsfond
Tillgänglig från: 2018-02-24 Skapad: 2018-02-24 Senast uppdaterad: 2018-09-14Bibliografiskt granskad
Tarn, J. R., Nordmark, G., Gillespie, C., Al-Ali, S., James, K., Mitchell, S., . . . Ng, W.-F. (2018). Interleukin-22 and associated genes are targets of microRNAs dysregulated. Clinical and Experimental Rheumatology, 36(3), S327-S327
Öppna denna publikation i ny flik eller fönster >>Interleukin-22 and associated genes are targets of microRNAs dysregulated
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2018 (Engelska)Ingår i: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 36, nr 3, s. S327-S327Artikel i tidskrift, Meeting abstract (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
CLINICAL & EXPER RHEUMATOLOGY, 2018
Nationell ämneskategori
Reumatologi och inflammation
Identifikatorer
urn:nbn:se:uu:diva-369086 (URN)000446486100240 ()
Tillgänglig från: 2018-12-11 Skapad: 2018-12-11 Senast uppdaterad: 2018-12-11Bibliografiskt granskad
Hellgren, K., Baecklund, E., Backlin, C., Sundström, C., Smedby, K. E. & Askling, J. (2017). Rheumatoid Arthritis and Risk of Malignant Lymphoma - Is the risk still increased?. Arthritis & Rheumatology, 69(4), 700-708
Öppna denna publikation i ny flik eller fönster >>Rheumatoid Arthritis and Risk of Malignant Lymphoma - Is the risk still increased?
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2017 (Engelska)Ingår i: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 69, nr 4, s. 700-708Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: Patients with rheumatoid arthritis (RA) are at increased risk of malignant lymphomas with a strong correlation with RA disease severity. Given the changes in RA therapy over recent decades, we aimed at assessing whether lymphoma risk remains increased, and if so, to explore risk predictors and lymphoma subtypes.

METHODS: We identified 12,656 incident RA patients from the Swedish Rheumatology Register 1997-2012 including information on therapy and inflammatory activity during the first year following diagnosis. Each patient was matched to 10 population comparator subjects. Through linkage to the Swedish Cancer Register, lymphomas including subtypes were identified. We assessed Hazard ratios (HRs) using Cox regression.

RESULTS: Overall, the HR of lymphoma was increased, 1.6, 95% confidence interval [CI] 1.2-2.1. Taking RA duration into account, risks did not appear to have declined over successive calendar years of RA diagnosis. Neither use of methotrexate the 1(st) year following RA diagnosis nor ever use of TNF inhibitors (HR=0.9; 95% CI 0.4-1.9) increased lymphoma risk. Use of oral corticosteroids the 1(st) year following RA diagnosis was associated with a reduced risk (HR=0.6; 95% CI 0.5 -0.9). Inflammatory activity during the 1(st) year following RA diagnosis did not predict future lymphoma risk. Chronic lymphocytic lymphoma occurred less, and Hodgkin lymphoma more frequently than expected compared to the general population.

CONCLUSION: The average lymphoma risk in recently diagnosed RA is of similar magnitude as that reported from historical cohorts. Standard anti-rheumatic treatment including TNF inhibitors did not predict future lymphoma risk. Distribution of lymphoma subtypes warrants further investigation.

Nationell ämneskategori
Reumatologi och inflammation Klinisk laboratoriemedicin
Forskningsämne
Patologi
Identifikatorer
urn:nbn:se:uu:diva-318580 (URN)10.1002/art.40017 (DOI)000397615900002 ()27992692 (PubMedID)
Forskningsfinansiär
Stiftelsen för strategisk forskning (SSF)VetenskapsrådetCancerfondenReumatikerförbundetStockholms läns landsting
Tillgänglig från: 2017-03-26 Skapad: 2017-03-26 Senast uppdaterad: 2020-01-08Bibliografiskt granskad
Daskalakis, K., Edfeldt, K., Norlén, O., Karakatsanis, A., Backlin, C., Tiensuu Janson, E., . . . Stålberg, P. (2016). Midkine Is a New Novel Serum Biomarker in Small Intestinal Neuroendocrine Tumors (SI-NETs). Paper presented at 13th Annual ENETS Conference for the Diagnosis and Treatment of Neuroendocrine Tumor Disease, MAR 09-11, 2016, Barcelona, SPAIN. Neuroendocrinology, 103, 45-45
Öppna denna publikation i ny flik eller fönster >>Midkine Is a New Novel Serum Biomarker in Small Intestinal Neuroendocrine Tumors (SI-NETs)
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2016 (Engelska)Ingår i: Neuroendocrinology, ISSN 0028-3835, E-ISSN 1423-0194, Vol. 103, s. 45-45Artikel i tidskrift (Refereegranskat) Published
Nyckelord
Biomarker, SI-NET
Nationell ämneskategori
Cancer och onkologi Endokrinologi och diabetes Neurologi
Identifikatorer
urn:nbn:se:uu:diva-313702 (URN)000386481600119 ()
Konferens
13th Annual ENETS Conference for the Diagnosis and Treatment of Neuroendocrine Tumor Disease, MAR 09-11, 2016, Barcelona, SPAIN
Tillgänglig från: 2017-01-23 Skapad: 2017-01-23 Senast uppdaterad: 2017-11-29Bibliografiskt granskad
Vasaitis, L., Nordmark, G., Theander, E., Backlin, C., Smedby, K. E., Askling, J., . . . Baecklund, E. (2016). Primary Sjögren's Syndrome and Lymphoma – A Population-Based Study Focused on Lymphoma as Exclusion Criterion for Primary Sjögren's Syndrome Diagnosis. Paper presented at Annual European Congress of Rheumatology (EULAR), JUN 08-11, 2016, London, ENGLAND. Annals of the Rheumatic Diseases, 75, 779-780
Öppna denna publikation i ny flik eller fönster >>Primary Sjögren's Syndrome and Lymphoma – A Population-Based Study Focused on Lymphoma as Exclusion Criterion for Primary Sjögren's Syndrome Diagnosis
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2016 (Engelska)Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 75, s. 779-780Artikel i tidskrift, Meeting abstract (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
BMJ PUBLISHING GROUP, 2016
Nationell ämneskategori
Reumatologi och inflammation
Identifikatorer
urn:nbn:se:uu:diva-347381 (URN)10.1136/annrheumdis-2016-eular.5308 (DOI)000401523103512 ()
Konferens
Annual European Congress of Rheumatology (EULAR), JUN 08-11, 2016, London, ENGLAND
Tillgänglig från: 2018-04-05 Skapad: 2018-04-05 Senast uppdaterad: 2018-04-05Bibliografiskt granskad
Vasaitis, L., Sundström, C., Backlin, C., Nordmark, G. & Baecklund, E. (2016). Sporadic occurrence of non-diagnosed IgG4-related disease in lymphoma patients with a previous Sjögren's syndrome diagnosis.. Acta Oncologica, 55(9-10), 1139-1144
Öppna denna publikation i ny flik eller fönster >>Sporadic occurrence of non-diagnosed IgG4-related disease in lymphoma patients with a previous Sjögren's syndrome diagnosis.
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2016 (Engelska)Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 55, nr 9-10, s. 1139-1144Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: IgG4-related disease (IgG4-RD) is a recently recognized fibro-inflammatory disorder, which may affect many organs, and often comes to clinical attention due to tumor-like organ swelling or is identified incidentally by specific biopsy findings. Typical histopathology of IgG4-RD is lymphoplasmacytic infiltration rich in IgG4 + plasma cells (PCs), storiform fibrosis, and obliterative phlebitis. Patients with sicca symptoms can be misdiagnosed as primary Sjögren's syndrome (pSS) instead of IgG4-RD because of clinical and histopathological similarities. Moreover, an association with lymphoma development is described in both diseases. This study investigated signs of IgG4-RD in a population-based cohort of patients diagnosed with pSS complicated by lymphoma.

METHODS: Patients with pSS and lymphoma diagnoses and available lymphoma specimens were identified by linkage with the Swedish Patient Register 1964-2007 and the Cancer Register 1990-2007 (n = 79). Clinical data and lymphomas were reviewed and the diagnoses evaluated. All lymphoma tissues and available minor salivary gland biopsies (n = 11) were immunostained for IgG4 + PCs and evaluated for other histopathological signs of IgG4-RD. In a case with specific findings of IgG4-RD, other available tissue specimens of the same patient were investigated for IgG4-RD.

RESULTS: Only one patient of 79 (1.3%) had >10 IgG4 + PCs/high power field (HPF) in the lymphoma tissue, an unspecified low-grade B-cell lymphoma localized in the submandibular gland. This patient also had other histopathological features of IgG4-RD in the lymphoma and a surgical lung biopsy taken five years before lymphoma diagnosis and, therefore, fulfilled the criteria for IgG4-RD. Occasional IgG4 + PCs (<10/HPF) without signs of IgG4-RD were observed in another six lymphomas. No IgG4 + PCs were identified in the minor salivary gland biopsies.

CONCLUSION: Histopathological findings of IgG4-RD may co-exist with low malignant B-cell lymphoma in patients with initially suspected pSS and may be associated with an underlying IgG4-RD.

Nationell ämneskategori
Reumatologi och inflammation Klinisk laboratoriemedicin
Forskningsämne
Medicinsk vetenskap; Patologi
Identifikatorer
urn:nbn:se:uu:diva-300373 (URN)10.1080/0284186X.2016.1182644 (DOI)000385554200012 ()27196149 (PubMedID)
Forskningsfinansiär
ReumatikerförbundetSvenska läkaresällskapet
Tillgänglig från: 2016-08-08 Skapad: 2016-08-08 Senast uppdaterad: 2020-01-08Bibliografiskt granskad
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