PMID- 26246307
OWN - NLM
STAT- MEDLINE
DCOM- 20160314
LR  - 20220331
IS  - 2326-5205 (Electronic)
IS  - 2326-5191 (Linking)
VI  - 67
IP  - 12
DP  - 2015 Dec
TI  - Incidence of Malignancies in Patients With Antineutrophil Cytoplasmic 
      Antibody-Associated Vasculitis Diagnosed Between 1991 and 2013.
PG  - 3270-8
LID - 10.1002/art.39317 [doi]
AB  - OBJECTIVE: To investigate the incidence of malignancies during longitudinal 
      followup of patients with antineutrophil cytoplasmic antibody-associated 
      vasculitis (AAV), and to examine the effect of immunosuppressive therapy on 
      malignancy risk in these patients. METHODS: The study population consisted of 
      patients with histopathologically confirmed AAV, diagnosed between 1991 and 2013 
      at a large university hospital. The mean duration of followup was 10 years. 
      Malignancy incidence was assessed using the Dutch National Pathology Database. 
      Incidence rates from the Netherlands Cancer Registry were used to compare 
      malignancy incidence in the AAV cohort to that in the general Dutch population. 
      RESULTS: Thirty-six of 138 patients with AAV developed a total of 85 malignancies 
      during a mean followup of 9.7 years. The sex-, age-, and calendar year-adjusted 
      malignancy risk was 2.21-fold higher (95% confidence interval [95% CI] 1.64-2.92) 
      than that in the general population. Non-melanoma skin cancers occurred most 
      frequently (standardized incidence ratio 4.23 [95% CI 2.76-6.19]). The incidence 
      rates of other malignancies were not significantly increased. Malignancy risk was 
      associated with the duration of cyclophosphamide (CYC) therapy and, 
      interestingly, was not increased in patients who had received CYC for <1 year. 
      CONCLUSION: Patients with AAV have a higher risk of malignancy than the general 
      population, but this risk is accounted for solely by non-melanoma skin cancers. 
      Over the years, the risk of other malignancies-specifically bladder and 
      hematologic malignancies-has decreased in patients with AAV. This finding 
      reflects ongoing efforts to reduce CYC exposure by developing new treatment 
      regimens.
CI  - (c) 2015, American College of Rheumatology.
FAU - Rahmattulla, Chinar
AU  - Rahmattulla C
AD  - Leiden University Medical Center, Leiden, The Netherlands.
FAU - Berden, Annelies E
AU  - Berden AE
AD  - Leiden University Medical Center, Leiden, The Netherlands.
FAU - Wakker, Sophie-Charlotte
AU  - Wakker SC
AD  - Leiden University Medical Center, Leiden, The Netherlands.
FAU - Reinders, Marlies E J
AU  - Reinders ME
AD  - Leiden University Medical Center, Leiden, The Netherlands.
FAU - Hagen, Ernst C
AU  - Hagen EC
AD  - Leiden University Medical Center, Leiden, The Netherlands, and Meander Medical 
      Center, Amersfoort, The Netherlands.
FAU - Wolterbeek, Ron
AU  - Wolterbeek R
AD  - Leiden University Medical Center, Leiden, The Netherlands.
FAU - Bruijn, Jan A
AU  - Bruijn JA
AD  - Leiden University Medical Center, Leiden, The Netherlands.
FAU - Bajema, Ingeborg M
AU  - Bajema IM
AD  - Leiden University Medical Center, Leiden, The Netherlands.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Arthritis Rheumatol
JT  - Arthritis & rheumatology (Hoboken, N.J.)
JID - 101623795
RN  - 0 (Immunosuppressive Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - EC 1.11.1.7 (Peroxidase)
RN  - EC 3.4.21.76 (Myeloblastin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug 
      therapy/*epidemiology/immunology
MH  - Breast Neoplasms/epidemiology/immunology
MH  - Carcinoma/epidemiology/immunology
MH  - Carcinoma, Basal Cell/epidemiology/immunology
MH  - Carcinoma, Squamous Cell/epidemiology/immunology
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - Cyclophosphamide/therapeutic use
MH  - Female
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Incidence
MH  - Lung Neoplasms/epidemiology/immunology
MH  - Male
MH  - Middle Aged
MH  - Myeloblastin/immunology
MH  - Neoplasms/*epidemiology/immunology
MH  - Neoplasms, Unknown Primary/epidemiology/immunology
MH  - Netherlands/epidemiology
MH  - Peroxidase/immunology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sarcoma/epidemiology/immunology
MH  - Skin Neoplasms/epidemiology/immunology
MH  - Time Factors
EDAT- 2015/08/08 06:00
MHDA- 2016/03/15 06:00
CRDT- 2015/08/07 06:00
PHST- 2014/12/02 00:00 [received]
PHST- 2015/07/30 00:00 [accepted]
PHST- 2015/08/07 06:00 [entrez]
PHST- 2015/08/08 06:00 [pubmed]
PHST- 2016/03/15 06:00 [medline]
AID - 10.1002/art.39317 [doi]
PST - ppublish
SO  - Arthritis Rheumatol. 2015 Dec;67(12):3270-8. doi: 10.1002/art.39317.