Inflammation Associated with Lymphoma Cancer - Drug Treatments Did Not
Increase Risk of Epstein Bar Virus Positive Lymphoma
Scientists have known about a link between rheumatoid arthritis (RA) and
a higher risk of lymphoma for sometime. They were unsure whether it was
due to the drugs or the condition. Now it appears the culprit is the
condition. A study associates chronic, severe inflammation with the
increased risk of cancer.
Swedish researchers have conducted the largest investigation concerning
the link between RA and lymphoma. The statistical analysis revealed
risk ratios for lymphoma for three different levels of overall disease
activity. They assessed RA according to the duration and how swollen
and tender joint were.
The researchers analyzed the medical records and case histories of 378
RA patients afflicted with malignant lymphoma between 1964 and 1995.
They compared this to 378 individually matched lymphoma-free control
subjects. None of the patients received anti-TNF (tumor necrosis
factor) blocker therapy.
In the group with medium RA activity they found an 8-fold increase in
the risk of lymphoma. The patients with high RA activity had a 70-fold
increased risk of lymphoma. According to the researchers, there was
“increased risks of lymphoma associated with pronounced, irreversible
joint damage in the hands, feet, and knees documented in the last year
before lymphoma diagnosis.”
Patients that received frequent corticosteroid injections in inflamed
joints had a substantially reduced risk of contracting lymphoma.
According to the researchers, this indicates “a possible
lymphoma-protective role of potent anti-inflammatory drugs.”
Earlier research from France showed a increased risk of Epstein-Barr
virus (EBV) positive lymphomas associated with the popular drug
methotrexate (MTX). The Swedish researchers found no increased lymphoma
risk associated with the use of MTX and other DMARDs (disease-modifying
antirheumatic drugs). Nor was there an increased cancer risk from
NSAIDs (nonsteroidal anti-inflammatory drugs), aspirin or steroids.
The researchers did find an increased cancer risk due to the use of
azathioprine (AZA), which is not regarded as a traditional DMARD for RA
and rarely used in current treatment. This was the only drug that
showed an increased lymphoma risk associated with its use.
The research is featured in the March 2006 issue of
& Rheumatism. Since lymphoma risk is strongly associated with
exceptionally severe and longstanding RA activity, aggressive treatment
may reduce the risk by reducing cumulative inflammation. The lead author
Dr. Lars Klareskog of Karolinska University Hospital in Stockholm said
“from a drug safety perspective, our results provide background data
that should be considered essential for the evaluation of lymphoma risk
following therapy with TNF blockers, for example, as well as other new
By Dan Wilson
Best Syndication Staff Writer
Books on Cancer
Keywords and misspellings: rhuematoid
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