HODGKIN'S LYMPHOMA AND AUTOIMMUNE DISEASES
(Abstract release date: 05/19/16)
EHA Library. Rym B. 06/09/16; 134951; PB2051
Dr. Benhabiles Rym
Contributions
Contributions
Abstract
Abstract: PB2051
Type: Publication Only
Background
Hodgkin's lymphoma (HL) is a tumor disease of the lymphoid tissue characterized by presence of Reed-Sternberg cells. Autoimmune phenomena are associated with HL. They may precede the clinical presentation of HL, occur concurrently or later, either spontaneously or following treatment. The relationship between HL and autoimmune diseases has been reported as bi-directional, however there is a few data in general population.
Aims
Evaluation of the percentage of autoimmune diseases associated with HL on a retrospective study of 80 cases.
Methods
A retrospective study in the hematology department, conducted over a period of 5 years (from 2008 to 2012), which concerned 80 cases of HL.The diagnosis is histological completed with immunohistochemistry using anti CD15 and anti CD30 anibody. Patients are classified according to the classification of Ann Arbor.We used prognostic classifications : the EORTC for localized stages and IPS for advanced stages.A clinical assessment is performed and includes: blood glucose, renal assessment, liver function tests, viral serology, a respiratory functional exploration, electrocardiogram and echocardiography. Patients are treated with ABVD chemotherapy associated with mantle radiotherapy.In front of presence of warning signs ( palpitations, dyspnea, asthenia, bone pain, thrombosis ) an immunological assessment is carried out in search of lupus anticoagulant, anticardiolipin, anti-histone antibodies, anti-nuclear factor, thyroid function tests (TSH, FT3, FT4, ATG, ATPO), cervical ultrasound.Biopsies are sometimes carried out in the context and the type of autoimmune disease and sought by the existence of clinically detectable lesions (biopsy of the salivary glands, skin …).
Results
Eighty cases were included, 5 (6,2%) of which, had an autoimmune disease diagnosed previously, simultaneously or after lymphoma. There are 4 women and 1 man. Autoimmune diseases were: lupus erythematosus, thyroiditis autoimmune, celiac disease, sarcoidosis.The diagnosis was made after lymphoma in 4 patients and before in 1 patient,no deaths were registered.
Conclusion
HL association with an autoimmune disease is estimated at 6.2%. There was an important prevalence of autoimmune diseases in girls with HL.The contribution of the activity of the autoimmune disease and immunosuppressive drugs in the development of HL is still not understood. It might be interesting to try to define a population at risk, by personal or family history of autoimmunity and regular and rigorous monitoring of patients during and after treatment with unusual clinical and biological signs.
Session topic: E-poster
Type: Publication Only
Background
Hodgkin's lymphoma (HL) is a tumor disease of the lymphoid tissue characterized by presence of Reed-Sternberg cells. Autoimmune phenomena are associated with HL. They may precede the clinical presentation of HL, occur concurrently or later, either spontaneously or following treatment. The relationship between HL and autoimmune diseases has been reported as bi-directional, however there is a few data in general population.
Aims
Evaluation of the percentage of autoimmune diseases associated with HL on a retrospective study of 80 cases.
Methods
A retrospective study in the hematology department, conducted over a period of 5 years (from 2008 to 2012), which concerned 80 cases of HL.The diagnosis is histological completed with immunohistochemistry using anti CD15 and anti CD30 anibody. Patients are classified according to the classification of Ann Arbor.We used prognostic classifications : the EORTC for localized stages and IPS for advanced stages.A clinical assessment is performed and includes: blood glucose, renal assessment, liver function tests, viral serology, a respiratory functional exploration, electrocardiogram and echocardiography. Patients are treated with ABVD chemotherapy associated with mantle radiotherapy.In front of presence of warning signs ( palpitations, dyspnea, asthenia, bone pain, thrombosis ) an immunological assessment is carried out in search of lupus anticoagulant, anticardiolipin, anti-histone antibodies, anti-nuclear factor, thyroid function tests (TSH, FT3, FT4, ATG, ATPO), cervical ultrasound.Biopsies are sometimes carried out in the context and the type of autoimmune disease and sought by the existence of clinically detectable lesions (biopsy of the salivary glands, skin …).
Results
Eighty cases were included, 5 (6,2%) of which, had an autoimmune disease diagnosed previously, simultaneously or after lymphoma. There are 4 women and 1 man. Autoimmune diseases were: lupus erythematosus, thyroiditis autoimmune, celiac disease, sarcoidosis.The diagnosis was made after lymphoma in 4 patients and before in 1 patient,no deaths were registered.
| Patient | Antecedents | Histological type | Stage | Treatment | Outcome | Auto-immune disease type | Delays occured | Treatment | Decline |
| 1 | Thyroiditis autoimmune (hypothyroidism 3 years before diagnosis in Levothyrox) | 1 | II Aa | 3 ABVD+Radiotherapy | Complete remission | lupus erythematosus :Lupus anticoagulant +, anti histone +, cardiolipin + | 3months after diagnosis | Steroids | 5 years |
| 2 | Absent | 2 | I Aa | 3 ABVD + Radiotherapy | Complete remission | thyroiditis autoimmune : TSH collapsedlow FT4high ATPOhigh ACTG | 10 months after RxT | Levothyrox | 3 years |
| 3 | Absent | 2 | I Aa | 4 ABVD + Radiotherapy | Complete remission | thyroiditis autoimmune : low TSH high-TPO | 2 months after RxT | Levothyrox | 1 year |
| 4 | Celiac disease since the age of 6 years | 2 | IIIBb | 4 ABVD + Radiotherapy | Complete remission | Celiac disease | 17 years before diagnosis | diet without gluten | 6 years |
| 5 | Absent | 2 | II Ba | 3 ABVD + Radiotherapy | Complete remission | Sarcoidosis : converting enzyme / CT mediastinal biopsy of the salivary glands and skin | 25 months after diagnosis | Corticosteroid (restrictive pattern) | 4 year |
Conclusion
HL association with an autoimmune disease is estimated at 6.2%. There was an important prevalence of autoimmune diseases in girls with HL.The contribution of the activity of the autoimmune disease and immunosuppressive drugs in the development of HL is still not understood. It might be interesting to try to define a population at risk, by personal or family history of autoimmunity and regular and rigorous monitoring of patients during and after treatment with unusual clinical and biological signs.
Session topic: E-poster
Abstract: PB2051
Type: Publication Only
Background
Hodgkin's lymphoma (HL) is a tumor disease of the lymphoid tissue characterized by presence of Reed-Sternberg cells. Autoimmune phenomena are associated with HL. They may precede the clinical presentation of HL, occur concurrently or later, either spontaneously or following treatment. The relationship between HL and autoimmune diseases has been reported as bi-directional, however there is a few data in general population.
Aims
Evaluation of the percentage of autoimmune diseases associated with HL on a retrospective study of 80 cases.
Methods
A retrospective study in the hematology department, conducted over a period of 5 years (from 2008 to 2012), which concerned 80 cases of HL.The diagnosis is histological completed with immunohistochemistry using anti CD15 and anti CD30 anibody. Patients are classified according to the classification of Ann Arbor.We used prognostic classifications : the EORTC for localized stages and IPS for advanced stages.A clinical assessment is performed and includes: blood glucose, renal assessment, liver function tests, viral serology, a respiratory functional exploration, electrocardiogram and echocardiography. Patients are treated with ABVD chemotherapy associated with mantle radiotherapy.In front of presence of warning signs ( palpitations, dyspnea, asthenia, bone pain, thrombosis ) an immunological assessment is carried out in search of lupus anticoagulant, anticardiolipin, anti-histone antibodies, anti-nuclear factor, thyroid function tests (TSH, FT3, FT4, ATG, ATPO), cervical ultrasound.Biopsies are sometimes carried out in the context and the type of autoimmune disease and sought by the existence of clinically detectable lesions (biopsy of the salivary glands, skin …).
Results
Eighty cases were included, 5 (6,2%) of which, had an autoimmune disease diagnosed previously, simultaneously or after lymphoma. There are 4 women and 1 man. Autoimmune diseases were: lupus erythematosus, thyroiditis autoimmune, celiac disease, sarcoidosis.The diagnosis was made after lymphoma in 4 patients and before in 1 patient,no deaths were registered.
Conclusion
HL association with an autoimmune disease is estimated at 6.2%. There was an important prevalence of autoimmune diseases in girls with HL.The contribution of the activity of the autoimmune disease and immunosuppressive drugs in the development of HL is still not understood. It might be interesting to try to define a population at risk, by personal or family history of autoimmunity and regular and rigorous monitoring of patients during and after treatment with unusual clinical and biological signs.
Session topic: E-poster
Type: Publication Only
Background
Hodgkin's lymphoma (HL) is a tumor disease of the lymphoid tissue characterized by presence of Reed-Sternberg cells. Autoimmune phenomena are associated with HL. They may precede the clinical presentation of HL, occur concurrently or later, either spontaneously or following treatment. The relationship between HL and autoimmune diseases has been reported as bi-directional, however there is a few data in general population.
Aims
Evaluation of the percentage of autoimmune diseases associated with HL on a retrospective study of 80 cases.
Methods
A retrospective study in the hematology department, conducted over a period of 5 years (from 2008 to 2012), which concerned 80 cases of HL.The diagnosis is histological completed with immunohistochemistry using anti CD15 and anti CD30 anibody. Patients are classified according to the classification of Ann Arbor.We used prognostic classifications : the EORTC for localized stages and IPS for advanced stages.A clinical assessment is performed and includes: blood glucose, renal assessment, liver function tests, viral serology, a respiratory functional exploration, electrocardiogram and echocardiography. Patients are treated with ABVD chemotherapy associated with mantle radiotherapy.In front of presence of warning signs ( palpitations, dyspnea, asthenia, bone pain, thrombosis ) an immunological assessment is carried out in search of lupus anticoagulant, anticardiolipin, anti-histone antibodies, anti-nuclear factor, thyroid function tests (TSH, FT3, FT4, ATG, ATPO), cervical ultrasound.Biopsies are sometimes carried out in the context and the type of autoimmune disease and sought by the existence of clinically detectable lesions (biopsy of the salivary glands, skin …).
Results
Eighty cases were included, 5 (6,2%) of which, had an autoimmune disease diagnosed previously, simultaneously or after lymphoma. There are 4 women and 1 man. Autoimmune diseases were: lupus erythematosus, thyroiditis autoimmune, celiac disease, sarcoidosis.The diagnosis was made after lymphoma in 4 patients and before in 1 patient,no deaths were registered.
| Patient | Antecedents | Histological type | Stage | Treatment | Outcome | Auto-immune disease type | Delays occured | Treatment | Decline |
| 1 | Thyroiditis autoimmune (hypothyroidism 3 years before diagnosis in Levothyrox) | 1 | II Aa | 3 ABVD+Radiotherapy | Complete remission | lupus erythematosus :Lupus anticoagulant +, anti histone +, cardiolipin + | 3months after diagnosis | Steroids | 5 years |
| 2 | Absent | 2 | I Aa | 3 ABVD + Radiotherapy | Complete remission | thyroiditis autoimmune : TSH collapsedlow FT4high ATPOhigh ACTG | 10 months after RxT | Levothyrox | 3 years |
| 3 | Absent | 2 | I Aa | 4 ABVD + Radiotherapy | Complete remission | thyroiditis autoimmune : low TSH high-TPO | 2 months after RxT | Levothyrox | 1 year |
| 4 | Celiac disease since the age of 6 years | 2 | IIIBb | 4 ABVD + Radiotherapy | Complete remission | Celiac disease | 17 years before diagnosis | diet without gluten | 6 years |
| 5 | Absent | 2 | II Ba | 3 ABVD + Radiotherapy | Complete remission | Sarcoidosis : converting enzyme / CT mediastinal biopsy of the salivary glands and skin | 25 months after diagnosis | Corticosteroid (restrictive pattern) | 4 year |
Conclusion
HL association with an autoimmune disease is estimated at 6.2%. There was an important prevalence of autoimmune diseases in girls with HL.The contribution of the activity of the autoimmune disease and immunosuppressive drugs in the development of HL is still not understood. It might be interesting to try to define a population at risk, by personal or family history of autoimmunity and regular and rigorous monitoring of patients during and after treatment with unusual clinical and biological signs.
Session topic: E-poster
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