TOPLINE: 

A retrospective cohort study found that most connective tissue diseases (CTDs) and select neutrophilic dermatoses were associated with significantly increased 1‑, 5‑, and 10‑year risks for hematologic malignancies, while autoimmune blistering diseases showed no association.

METHODOLOGY:

• Researchers conducted a retrospective cohort study and included data from TriNetX (2010 onwards), encompassing 180 million individuals across 18 countries.
• The analysis evaluated a range of CTDs, neutrophilic/inflammatory dermatoses, and autoimmune blistering disorders. Diagnoses included systemic lupus erythematosus, discoid lupus erythematosus, subacute cutaneous lupus erythematosus, dermatomyositis, mixed CTD, systemic sclerosis, rheumatoid arthritis, Sjögren syndrome, eosinophilic fasciitis, leukocytoclastic vasculitis, erythema elevatum diutinum (EED), Sweet syndrome, pyoderma gangrenosum, and autoimmune blistering disorders.
• For each condition, exposed and control cohorts were matched by age, sex, race, and ethnicity.
• Researchers evaluated 1-, 5-, and 10-year risk of developing hematologic outcomes, including Hodgkin lymphoma, non‑Hodgkin lymphoma (NHL), lymphoid leukemia, myeloid leukemia, multiple myeloma (MM), monoclonal gammopathy, myelodysplastic syndrome (MDS), polycythemia vera, and Waldenström macroglobulinemia.

TAKEAWAY:

• Discoid lupus erythematosus was strongly associated with NHL, myeloid leukemia, MM, monoclonal gammopathy, and MDS across all time points, with the relative risk (RR) ranging from 2.50 to 9.34.
• Rheumatoid arthritis (RR, 1.22-3.12), systemic lupus erythematosus (RR, 1.36-6.65), and Sjögren syndrome (RR, 1.22-4.91) were each associated with multiple hematologic malignancies across all time points.
• EED, leukocytoclastic vasculitis, mixed CTD, and systemic sclerosis were associated with NHL, MM, monoclonal gammopathy, and MDS; EED was also associated with lymphoid leukemia.
• Dermatomyositis showed notable associations with monoclonal gammopathy (RR, 2.61, 4.22, and 4.25, at 1, 5, and 10 years, respectively), whereas eosinophilic fasciitis and subacute cutaneous lupus erythematosus showed no consistent signals across examined outcomes. N o autoimmune blistering disorders showed significant associations with hematologic malignancies.

IN PRACTICE:

"Our findings suggest timely screening of hematologic malignancies following the diagnosis of CTDs and autoimmune/inflammatory cutaneous diseases may be clinically valuable," the authors wrote. “Further research concerning the association between development of hematologic malignancies in patients with CTDs/autoimmune/inflammatory cutaneous diseases is warranted," they added.

SOURCE:

The study was led by Jagmeet S. Arora, BS, department of dermatology, University of California, Irvine, and was published online on September 25 in the Journal of the American Academy of Dermatology.

LIMITATIONS:

The study was limited by potential misclassification. Risk ratios for paraneoplastic pemphigus were not calculated due to control-group limitations. The study could not account for patients with multiple CTDs.

DISCLOSURES:

No funding sources were reported for this study. One author reported serving on advisory boards of Horizon and BMS, and being an investigator for Amgen, AstraZeneca, Boehringer Ingelheim, Bristol‑Myers Squibb, and Priovant. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.