Kaposi sarcoma and Merkel cell carcinoma after autoimmune disease

Hemminki, Kari; Liu, Xiangdong; Ji, Jianguang; Sundquist, Jan; Sundquist, Kristina

doi:10.1002/ijc.27376

Cited by 36 publications

(30 citation statements)

References 10 publications

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“…Patients with inflammatory connective tissue diseases and diabetes were at the highest risk for MCC. The results are similar to the relative risk estimates of MCC following rheumatoid arthritis published in the United States (OR 1.39, 95% CI 1.10–1.74) and Sweden (SIR 2.42, 95% CI 0.96–5.01) (Lanoy and Engels, 2010; Hemminki et al , 2012). The tumours of patients with a history of CID were also larger and expressed elevated levels of the proliferation marker Ki-67.…”

Section: Discussionsupporting

confidence: 85%

History of chronic inflammatory disorders increases the risk of Merkel cell carcinoma, but does not correlate with Merkel cell polyomavirus infection

et al. 2016

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Background:We aimed to assess the connection between chronic inflammatory disorders (CIDs) and Merkel cell carcinoma (MCC).Methods:Merkel cell carcinoma cases diagnosed in 1978–2009 were extracted from the Finnish Cancer Registry and controls from the Population Registry. Information on reimbursed CIDs was linked to clinicopathological data including Merkel cell polyomavirus (MCV) status by qPCR and immunohistochemistry for the large T antigen of MCV (LTA), Ki-67 and tumour-infiltrating lymphocytes.Results:Chronic inflammatory disorders increased the risk of MCC significantly (odds ratio (OR) 1.39, 95% confidence interval (CI) 1.03–1.88), specifically connective tissue/systemic diseases (OR 1.75, 95% CI 1.09–1.80) and diabetic conditions (OR 1.51, 95% CI 1.03–2.22). Chronic inflammatory disorders associated with larger tumour diameter (P=0.02) and higher Ki-67 expression (P=0.005). The expression of LTA was seen significantly more often in the absence of CIDs (P=0.05).Conclusions:Patients with CID are at significantly higher risk for aggressive MCC. Merkel cell polyomavirus positivity is more common in MCC patients unafflicted by CID.

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Section: Discussionsupporting

confidence: 85%

History of chronic inflammatory disorders increases the risk of Merkel cell carcinoma, but does not correlate with Merkel cell polyomavirus infection

et al. 2016

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“…The present paper is a continuation in a series of studies on cancers following AIDs, including so far digestive tract, lung cancers and skin cancers [6,26-28]. Although there is no general pattern of certain AIDs leading to increases of all or most cancers, systemic sclerosis, leading to the highest SIR of myeloma, causes also significant increases in esophageal cancer, lung adenocarcinoma and squamous cell carcinoma and skin squamous cell carcinoma.…”

Section: Discussionmentioning

confidence: 93%

Effect of autoimmune diseases on incidence and survival in subsequent multiple myeloma

et al. 2012

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BackgroundPatients with many types of autoimmune diseases (AIDs) are at an increased risk of cancer, which may depend on underlying dysregulation of the immune system or treatment. We systematically analyzed myeloma risk and survival in patients diagnosed with 33 different AIDs.MethodsData on patients with AIDs were retrieved from the Swedish Hospital Discharge Register and were linked to myeloma diagnoses from the Cancer Registry. Standardized incidence ratios (SIR) and hazard ratios (HRs) were calculated for subsequent myeloma between 1964 and 2008.ResultsAmong patients with the 33 AIDs analyzed, 457 cases of myeloma were diagnosed. The overall SIR for myeloma was 1.12 and the overall HR was 0.92 and non-significant. SIRs for myeloma were significantly increased after ankylosing spondylitis (2.02) and systemic sclerosis (2.63). Only the HR for myeloma after rheumatic fever (5.27) was significantly increased. The SIR for myeloma before age 60 years was 1.45; the SIR for myeloma was only increased in the period 1964–1990 (1.31) and not later (1.04). Only the SIR for myeloma after ankylosing spondylitis was increased in the period 1991–2008 (2.09); the HRs for myeloma were increased after polymyositis/dermatomyositis (6.44) and rheumatic fever (4.43) but there were only three deaths of myeloma after these AIDs.ConclusionsThe present data showed an increase in myeloma SIR after two AIDs, ankylosing spondylitis and systemic sclerosis, and in HR after rheumatic fever. The overall myeloma risk after any AID was no longer increased in the latter follow-up period of 1991 through 2008.

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“…3 This is a significant overrepresentation compared with the general population, and suggests an important role for the immune system as a gatekeeper of carcinogenesis for MCC. Immunosuppression in the setting of MCC is most commonly caused by comorbid hematologic malignancy (eg, chronic lymphocytic leukemia [CLL]), 17 HIV/AIDS, 18 and immunosuppressive medications in the setting of advanced autoimmune disease 19 or solid organ transplantation. 20 …”

Section: Etiologymentioning

confidence: 99%

Milestones in the Staging, Classification, and Biology of Merkel Cell Carcinoma

Moshiri¹,

Nghiem²

2014

J Natl Compr Canc Netw

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Merkel cell carcinoma (MCC) is an aggressive skin cancer that is causally associated with ultraviolet light exposure and a recently discovered polyomavirus. Before 2010, MCC was staged using any of 5 unique systems in active use. In 2010, a consensus staging system for MCC was adopted worldwide and replaced these systems. This consensus system includes substages that reflect prognostic differences based on whether nodal evaluation was performed by pathologic analysis or clinical assessment alone. MCC-specific disease classification in ICD-9, to be expanded in the upcoming ICD-10, has improved the ability to track and manage this malignancy. Several biomarkers and histopathologic features have been identified that improve understanding of this cancer and may lead to future refinement of the current staging system. In 2008, the Merkel cell polyomavirus was discovered and is now thought to be a critical mechanism of transformation in at least 80% of MCCs. In patients who produce antibodies to the viral T-antigen oncoprotein, the titer increases and decreases with MCC disease burden and can be a clinically useful marker of recurrence. Diverse studies link CD8-positive T-cell function with outcomes in MCC and serve as the rational basis for ongoing trials of therapies to augment cellular immunity. This article reviews basic and translational research insights that will lead to improved staging, prognostic accuracy, and mechanism-based therapy for this often-lethal skin cancer.

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Kaposi sarcoma and Merkel cell carcinoma after autoimmune disease

Cited by 36 publications

References 10 publications

History of chronic inflammatory disorders increases the risk of Merkel cell carcinoma, but does not correlate with Merkel cell polyomavirus infection

History of chronic inflammatory disorders increases the risk of Merkel cell carcinoma, but does not correlate with Merkel cell polyomavirus infection

Effect of autoimmune diseases on incidence and survival in subsequent multiple myeloma

Milestones in the Staging, Classification, and Biology of Merkel Cell Carcinoma

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