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Disease activity and risk of lymphoma in patients with rheumatoid arthritis: nested case-control study
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Reumatologi. (Rheumatology)
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. (Rheumatology)
Vise andre og tillknytning
1998 (engelsk)Inngår i: British Medical Journal, Vol. 317, s. 180-181Artikkel i tidsskrift (Fagfellevurdert) Published
sted, utgiver, år, opplag, sider
1998. Vol. 317, s. 180-181
HSV kategori
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URN: urn:nbn:se:uu:diva-93460OAI: oai:DiVA.org:uu-93460DiVA, id: diva2:166940
Tilgjengelig fra: 2005-09-16 Laget: 2005-09-16 Sist oppdatert: 2018-01-13
Inngår i avhandling
1. Associations Between Rheumatoid Arthritis and Malignant Lymphomas
Åpne denne publikasjonen i ny fane eller vindu >>Associations Between Rheumatoid Arthritis and Malignant Lymphomas
2005 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Patients with rheumatoid arthritis (RA) are at increased risk of developing malignant lymphoma, although details about this association remain unclear. The aims of this thesis were to investigate risk factors for lymphoma in patients with RA and to characterize these lymphomas regarding subtype, presence of Epstein-Barr virus (EBV), clinical manifestations and prognosis.

The Swedish hospital discharge register and the cancer register were used to identify RA patients with lymphoma. Two case-control studies were performed, one smaller including RA patients with lymphoma hospitalised in Uppsala health care region 1964-1983 (n=41) and one larger study of hospitalised RA patients with lymphoma in Sweden 1964-1995 (n=378). RA patients from the same cohorts, but without lymphoma, were matched as controls. Medical records for cases and controls were scrutinized for exposure information. The lymphoma tissues were reclassified according to the WHO classification, and presence of EBV was analysed by EBER in situ hybridisation.

The most important risk factor for lymphoma development was high RA disease activity. No association was determined between treatment with traditional disease modifying drugs, non-steroidal anti-inflammatory drugs, aspirin, peroral and intra-articular corticosteroids and lymphoma risk. Diffuse large B-cell lymphoma (DLBCL) was more frequent in RA patients than in lymphoma patients in the general population and displayed stronger association with RA disease activity than other lymphoma subtypes. RA patients with DLBCL had increased extranodal involvement and more advanced lymphoma stage at presentation than DLBCL patients in general, and the prognosis was poor.

A further subdivision of DLBCL into germinal centre (GC) and non-GC subtypes by the expression patterns of CD10, bcl-6 and IRF-4 showed a predominance of the non-GC subtype. This suggested peripheral activated B-cells as the cells of origin in these lymphomas.

The presence of EBV was low in lymphomas in RA patients (12%).

sted, utgiver, år, opplag, sider
Uppsala: Acta Universitatis Upsaliensis, 2005. s. 75
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 68
Emneord
Medicine, rheumatoid arthritis, malignant lymphoma, diffuse large B-cell lymphoma, disease activity, disease modifying anti-rheumatic drug, Epstein-Barr virus, germinal centre-like/ non-germinal centre-like subtype, Medicin
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Identifikatorer
urn:nbn:se:uu:diva-5928 (URN)91-554-6335-5 (ISBN)
Disputas
2005-10-07, Fåhraeussalen, Patologen, Akademiska sjukhuset, ing C5, Uppsala, 09:15
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Tilgjengelig fra: 2005-09-16 Laget: 2005-09-16 Sist oppdatert: 2013-06-18bibliografisk kontrollert

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