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Dialogue
Dialogue: what can we learn about the relationship between systemic lupus erythematosus and haematological malignancies from linking disease registries?
  1. Rosalind Ramsey-Goldman1,
  2. Sasha Bernatsky2 and
  3. Ann Clarke3
  1. 1Division of Rheumatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
  2. 2Division of Rheumatology and Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
  3. 3Division of Rheumatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
  1. Correspondence to Dr Rosalind Ramsey-Goldman; rgramsey{at}northwestern.edu

https://doi.org/10.1136/lupus-2014-000068

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    In systemic lupus erythematosus (SLE), there appears to be specific differences in the cancer susceptibility compared with the general population. While the overall cancer incidence rate in patients with SLE is increased about 14%,1 the standardised incidence ratio of a given cancer is largely dependent on the cancer type. Prominent increases are noted in haematological malignancies (HM),2 ,3 as well as lung, thyroid and vulvar cancer.1 ,4 While HM overall are increased threefold, the risk of non-Hodgkin's lymphoma is increased fourfold, with a predominance of the diffuse large B cell subtype (DLBCL);1 non-lymphoma HM, including leukaemia, are increased almost twofold and Hodgkin's lymphoma and multiple myeloma trend towards an approximately twofold increase.1 Several hypotheses are advanced to explain this heightened risk, including dysregulated lymphocyte proliferation, which may promote oncogene translocation, favouring lymphoma development;5 the predominance of DLBCL among the non-Hodgkin's lymphomas arising in SLE supports this rationale as they arise from activated lymphocytes, …

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