Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; University of Minnesota Masonic Cancer Center, Minneapolis, MN, USA.
Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Cancer Epidemiol. 2022 Feb;76:102090. doi: 10.1016/j.canep.2021.102090. Epub 2022 Jan 5.
Autoimmune diseases and hematopoietic malignancies are known to cluster within individuals, suggesting intertwined etiologies. A limited number of studies have evaluated pre-existing medical conditions as risk factors for myelodysplastic syndromes (MDS). We evaluated associations between autoimmune disease and other medical conditions and risk of MDS.
Cases were identified through the Minnesota Cancer Reporting System. Controls were identified through the Minnesota State driver's license/identification card list. History of autoimmune disease and other medical conditions was based on self-report; proxy interviews were not conducted. Unconditional logistic regression was used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CI).
We included 395 cases and 694 controls. Cases were significantly more likely to report a diagnosis of any autoimmune disease when compared with controls (aOR=1.41, 95% CI: 1.05-1.89) after adjustment for age, sex, education, NSAID use, exposure to benzene and body mass index. When we evaluated specific autoimmune conditions, a statistically significant association was observed for hypothyroidism (aOR=2.16, 95% CI: 1.39-3.34) and odds ratios were elevated for inflammatory bowel disease (aOR=1.75) and systemic lupus erythematosus (SLE; aOR=3.65), although these associations did not reach statistical significance. Presence of an autoimmune condition did not impact overall survival (p = 0.91).
Our results validate previous findings of an association between autoimmune disease and MDS. Further studies are required to determine whether this association is due to shared etiology, treatment for autoimmune diseases, or altered immune surveillance or bone marrow damage caused by the autoimmune condition.
自身免疫性疾病和血液系统恶性肿瘤在个体中已知存在聚集现象，这表明它们之间存在相互关联的病因。已有少数研究评估了先前存在的医疗状况作为骨髓增生异常综合征 (MDS) 的危险因素。我们评估了自身免疫性疾病和其他医疗状况与 MDS 风险之间的关联。
通过明尼苏达州癌症报告系统确定病例。通过明尼苏达州驾驶执照/身份证清单确定对照。自身免疫性疾病和其他医疗状况的病史基于自我报告；未进行代理访谈。采用非条件逻辑回归计算调整后的比值比 (aOR) 和 95%置信区间 (CI)。
我们纳入了 395 例病例和 694 例对照。在调整年龄、性别、教育程度、非甾体抗炎药使用、苯暴露和体重指数后，与对照组相比，病例更有可能报告任何自身免疫性疾病的诊断(aOR=1.41, 95%CI: 1.05-1.89)。当我们评估特定的自身免疫性疾病时，观察到甲状腺功能减退症(aOR=2.16, 95%CI: 1.39-3.34)存在统计学显著关联，并且炎症性肠病(aOR=1.75)和系统性红斑狼疮(aOR=3.65)的比值比升高，尽管这些关联没有达到统计学意义。自身免疫性疾病的存在并不影响总生存(p=0.91)。
我们的结果验证了先前发现的自身免疫性疾病与 MDS 之间存在关联。需要进一步的研究来确定这种关联是由于共同的病因、自身免疫性疾病的治疗、或自身免疫状况引起的免疫监视或骨髓损伤改变所致。
