Malignancy in pediatric-onset systemic lupus erythematosus

Sasha Bernatsky*, Ann E. Clarke, Omid Zahedi Niaki, Jeremy Labrecque, Laura E. Schanberg, Earl D. Silverman, Kristen Hayward, Lisa Imundo, Hermine I. Brunner, Kathleen A. Haines, Randy Q. Cron, Kiem Oen, Linda Wagner-Weiner, Alan M. Rosenberg, Kathleen M. O'Neil, Ciarán M. Duffy, Emily Von Scheven, Lawrence Joseph, Jennifer L. Lee, Rosalind Ramsey-Goldman

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective. To determine cancer incidence in a large pediatric-onset systemic lupus erythematosus (SLE) population. Methods. Data were examined from 12 pediatric SLE registries in North America. Patients were linked to their regional cancer registries to detect cancers observed after cohort entry, defined as date first seen in the clinic. The expected number of malignancies was obtained by multiplying the person-years in the cohort (defined from cohort entry to end of followup) by the geographically matched age-, sex-, and calendar year-specific cancer rates. The standardized incidence ratio (SIR; ratio of cancers observed to expected) was generated, with 95% CI. Results.A total of 1168 patients were identified from the registries. The mean age at cohort entry was 13 years (SD 3.3), and 83.7% of the subjects were female. The mean duration of followup was 7.6 years, resulting in a total observation period of 8839 years spanning the calendar period 1974-2009. During followup, fourteen invasive cancers occurred (1.6 cancers per 1000 person-yrs, SIR 4.13, 95% CI 2.26-6.93). Three of these were hematologic (all lymphomas), resulting in an SIR for hematologic cancers of 4.68 (95% CI 0.96-13.67). SIR were increased for both male and female patients, and across age groups. Conclusion. Although cancer remains a relatively rare outcome in pediatric-onset SLE, our data do suggest an increase in cancer for patients followed an average of 7.6 years. About one-fifth of the cancers were hematologic. Longer followup, and study of drug effects and disease activity, is warranted.

Original languageEnglish (US)
Pages (from-to)1484-1486
Number of pages3
JournalJournal of Rheumatology
Volume44
Issue number10
DOIs
StatePublished - Oct 1 2017

Keywords

  • Cancer
  • Childhood-onset sle
  • Malignancy
  • Pediatric systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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    Bernatsky, S., Clarke, A. E., Niaki, O. Z., Labrecque, J., Schanberg, L. E., Silverman, E. D., Hayward, K., Imundo, L., Brunner, H. I., Haines, K. A., Cron, R. Q., Oen, K., Wagner-Weiner, L., Rosenberg, A. M., O'Neil, K. M., Duffy, C. M., Von Scheven, E., Joseph, L., Lee, J. L., & Ramsey-Goldman, R. (2017). Malignancy in pediatric-onset systemic lupus erythematosus. Journal of Rheumatology, 44(10), 1484-1486. https://doi.org/10.3899/jrheum.170179