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dc.contributor.authorLindqvist, Ebba K.
dc.contributor.authorLandgren, Ola
dc.contributor.authorLund, Sigrún H.
dc.contributor.authorTuresson, Ingemar
dc.contributor.authorHultcrantz, Malin
dc.contributor.authorGoldin, Lynn
dc.contributor.authorBjörkholm, Magnus
dc.contributor.authorKristinsson, Sigurdur Y.
dc.date.accessioned2018-03-21T15:40:23Z
dc.date.available2018-03-21T15:40:23Z
dc.date.issued2016-11-02
dc.identifier.citationHistory of autoimmune disease is associated with impaired survival in multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based study 2016, 96 (2):261 Annals of Hematologyen
dc.identifier.issn0939-5555
dc.identifier.issn1432-0584
dc.identifier.doi10.1007/s00277-016-2859-8
dc.identifier.urihttp://hdl.handle.net/2336/620511
dc.descriptionTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Filesen
dc.description.abstractMultiple myeloma (MM) is a plasma cell disorder preceded by monoclonal gammopathy of undetermined significance (MGUS). Incidence of MM and MGUS is higher among patients with autoimmune disease. The aim of this study was to determine whether a history of autoimmunity has an impact on survival in MM and MGUS. Using high-quality national Swedish registries, we identified 8367 patients with MM, 18,768 patients with MGUS, and 110,251 matched control subjects, and obtained information on previous autoimmune disease in patients and controls. Cox regression was used to calculate hazard ratios (HRs) for overall survival with 95 % confidence intervals (CIs). In patients with MM and a prior autoimmune disease, the risk of death was significantly increased, HR = 1.2 (95 % CI 1.2-1.3) compared to MM patients with no history of autoimmunity. In MGUS patients, a prior autoimmune disease was associated with a significantly 1.4-fold elevated risk of death (95 % CI 1.3-1.4). When analyzing different types of autoimmune diseases, a history of ulcerative colitis had a stronger impact on survival in MM than in controls. Our findings that a history of autoimmune disease has a negative impact on survival in MM and MGUS could be due to shared underlying common genetic factors, or that patients with a history of autoimmunity develop more severe cases of MM and MGUS, or cumulative comorbidity in the individual. Our results suggest that more attention should be paid to comorbidity as a prognostic factor in MGUS and MM, and underlines the need for studies aimed at tailoring therapy according to comorbidity.
dc.description.sponsorshipSwedish Blodcancerfonden Swedish Cancer Society Stockholm County Council Karolinska Institutet Karolinska Institutet Foundations University of Iceland Icelandic Centre for Research (RANNIS) Landspitali University Hospitalen
dc.language.isoenen
dc.publisherSpringeren
dc.relation.urlhttp://link.springer.com/10.1007/s00277-016-2859-8en
dc.rightsArchived with thanks to Annals of Hematologyen
dc.subjectMergæxlien
dc.subjectSjálfsofnæmissjúkdómaren
dc.subjectLífslíkuren
dc.subjectHEM12en
dc.subject.meshMultiple Myelomaen
dc.subject.meshAutoimmune Diseasesen
dc.subject.meshSurvivalen
dc.titleHistory of autoimmune disease is associated with impaired survival in multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based studyen
dc.typeArticleen
dc.contributor.department[ 1 ] Karolinska Univ Hosp, Div Hematol, Dept Med, S-17176 Stockholm, Sweden Show more [ 2 ] Karolinska Inst, S-17176 Stockholm, Sweden Show more [ 3 ] Mem Sloan Kettering Canc Ctr, Dept Med, Myeloma Serv, 1275 York Ave, New York, NY 10021 USA Show more [ 4 ] Univ Iceland, Fac Med, Reykjavik, Iceland Show more [ 5 ] Skane Univ Hosp, Dept Hematol & Coagulat Disorders, Malmo, Sweden Show more [ 6 ] NCI, Div Canc Epidemiol & Genet, NIH, Bethesda, MD 20892 USAen
dc.identifier.journalAnnals of Hematologyen
dc.rights.accessOpen Access - Opinn aðganguren
dc.departmentcodeHEM12
refterms.dateFOA2018-09-12T17:06:32Z
html.description.abstractMultiple myeloma (MM) is a plasma cell disorder preceded by monoclonal gammopathy of undetermined significance (MGUS). Incidence of MM and MGUS is higher among patients with autoimmune disease. The aim of this study was to determine whether a history of autoimmunity has an impact on survival in MM and MGUS. Using high-quality national Swedish registries, we identified 8367 patients with MM, 18,768 patients with MGUS, and 110,251 matched control subjects, and obtained information on previous autoimmune disease in patients and controls. Cox regression was used to calculate hazard ratios (HRs) for overall survival with 95 % confidence intervals (CIs). In patients with MM and a prior autoimmune disease, the risk of death was significantly increased, HR = 1.2 (95 % CI 1.2-1.3) compared to MM patients with no history of autoimmunity. In MGUS patients, a prior autoimmune disease was associated with a significantly 1.4-fold elevated risk of death (95 % CI 1.3-1.4). When analyzing different types of autoimmune diseases, a history of ulcerative colitis had a stronger impact on survival in MM than in controls. Our findings that a history of autoimmune disease has a negative impact on survival in MM and MGUS could be due to shared underlying common genetic factors, or that patients with a history of autoimmunity develop more severe cases of MM and MGUS, or cumulative comorbidity in the individual. Our results suggest that more attention should be paid to comorbidity as a prognostic factor in MGUS and MM, and underlines the need for studies aimed at tailoring therapy according to comorbidity.


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