Rheumatoid arthritis and the risk of hematologic malignancies: a nationwide cohort study

Abstract

The autoimmune and inflammatory pathogenesis of rheumatoid arthritis (RA), the use of immunomodulating therapy, and shared environmental or genetic risk factors between RA and malignancies have raised attention to cancer risk in patients with RA [1], in particular hematologic malignancies [1, 2]. In RA, the presence of autoantibodies is associated with rapid disease progression; however, it is unclear whether seropositivity is associated with hematologic malignancies.

Moreover, previous studies examining hematologic malignancy risk in patients with RA mostly reported standardized incidence ratios (SIR) [1,2,3,4,5,6], lacking consideration of confounding factors such as smoking, alcohol, and socioeconomic status. Data on Asian populations are also limited, especially regarding leukemia and multiple myeloma (MM). Hematologic malignancies may differ between Western and Asian populations in incidence and pathophysiology according to the type due to genetic and environmental factors; i.e., Hodgkin lymphoma (HL) shows higher incidence rates in Western Europe than East Asia [7].