RT Journal Article
SR Electronic
T1 Malignancy in Pediatric-onset Systemic Lupus Erythematosus
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1484
OP 1486
DO 10.3899/jrheum.170179
VO 44
IS 10
A1 Sasha Bernatsky
A1 Ann E. Clarke
A1 Omid Zahedi Niaki
A1 Jeremy Labrecque
A1 Laura E. Schanberg
A1 Earl D. Silverman
A1 Kristen Hayward
A1 Lisa Imundo
A1 Hermine I. Brunner
A1 Kathleen A. Haines
A1 Randy Q. Cron
A1 Kiem Oen
A1 Linda Wagner-Weiner
A1 Alan M. Rosenberg
A1 Kathleen M. O’Neil
A1 Ciarán M. Duffy
A1 Emily von Scheven
A1 Lawrence Joseph
A1 Jennifer L. Lee
A1 Rosalind Ramsey-Goldman
YR 2017
UL http://www.jrheum.org/content/44/10/1484.abstract
AB Objective. To determine cancer incidence in a large pediatric-onset systemic lupus erythematosus (SLE) population.Methods. Data were examined from 12 pediatric SLE registries in North America. Patients were linked to their regional cancer registries to detect cancers observed after cohort entry, defined as date first seen in the clinic. The expected number of malignancies was obtained by multiplying the person-years in the cohort (defined from cohort entry to end of followup) by the geographically matched age-, sex-, and calendar year–specific cancer rates. The standardized incidence ratio (SIR; ratio of cancers observed to expected) was generated, with 95% CI.Results. A total of 1168 patients were identified from the registries. The mean age at cohort entry was 13 years (SD 3.3), and 83.7% of the subjects were female. The mean duration of followup was 7.6 years, resulting in a total observation period of 8839 years spanning the calendar period 1974–2009. During followup, fourteen invasive cancers occurred (1.6 cancers per 1000 person-yrs, SIR 4.13, 95% CI 2.26–6.93). Three of these were hematologic (all lymphomas), resulting in an SIR for hematologic cancers of 4.68 (95% CI 0.96–13.67). SIR were increased for both male and female patients, and across age groups.Conclusion. Although cancer remains a relatively rare outcome in pediatric-onset SLE, our data do suggest an increase in cancer for patients followed an average of 7.6 years. About one-fifth of the cancers were hematologic. Longer followup, and study of drug effects and disease activity, is warranted.