Background The association between lymphoproliferative diseases, like chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL), and autoimmunity is well-known. The risk of development of lymphoproliferative diseases, primarily lymphomas, is higher in autoimmune diseases, like systemic lupus erythematosus (SLE), Sjogren's syndrome (SS) and rheumatoid arthritis (RA). Until now, various studies evaluated markers of autoimmunity, like antinuclear antibody (ANA).
Objectives We evaluated the frequency of some autoantibodies in CLL and NHL; and investigated their association with clinical findings.
Methods Onehundred-and-ninetynine NHL patients (113 males, 86 females, mean age: 55.1+16.4) and 64 CLL patients were included into the study (36 males, 27 females, mean gae: 62.4+12.4). Blood samples were taken from the patients at the time of diagnosis. ANA, ANCA tests and ENA profile when deemed necessary were assessed by the immunofluorescence method by same technician. Rheumatoid factor (RF), anti-CCP were evaluated by the nephelometry method. The demographic and clinical features and outcome of patients were obtained from medical charts. In addition, the frequency of CLL and NHL in our RA and SLE cohort were evaluated.
Results In NHL group, ANA was positive in 44 (22.1%); RF in 13 (6.5%); anti-CCP in 3 (1.5%); and ANCA in one patient. In CLL group, ANA was positive in 20 patients (31.7%), and RF in 7 (11.1%) patients; ANCA was positive in 3 patients; and anti-CCP was positive in 2 patients. Our NHL group included 3 RA (1.5% 3/199), one SLE (0.5%, 1/199) and one SS (0.5%, 1/199) patients. Our CLL patients included one RA (1.6%, 1/63), one SS (1.6%, 1/63) and one ANCA-associated vasculitis (1.6%, 1/63). In NHL patients, the frequencies of ANA positivity (29.1% vs. 16.8%) and RF positivity (11.6% vs. 2.7%) were higher in female patients (p values, 0.039 and 0.011). In CLL group, there was a trend to more frequent ANA positivity (40.7% vs. 25%); and less frequent RF positivity (3.7% vs. 16.7%) in female patients (p values>0.05). ANA positivity in NHL patients was at least at a titer of at least 1/100 in 25 cases; in 19 patients, it was positive at higher titers. In CLL patients, on the other hand, ANA was positive at a 1/100 titer in 11 cases; in 9 cases, it was positive at a higher titer. The frequencies of ANA and RF positivity were most common in subtypes of marginal zone lymphoma (30.8% vs. 23.1%). The mean age in NHL group was also significantly higher in RF- positive patients than in other patients (64.3±12.5 vs. 54.4±16.5, p=0.036). In CLL patients, the frequency of lymphadenopathy was significantly higher in RF-positive (15.6% vs. 0%, p=0.05) and ANA-positive (42.2% vs 5.6%, p=0.005) groups than in others.
Conclusions ANA was the most commonly encountered autoantibody in both CLL and NHL patients. RF positivity was more frequent in CLL. RF and ANA were associated with the presence of lympadenopathy. The most common autoimmune disease in patients with lymphoproliferative diseases was RA.
Disclosure of Interest None declared