“Background: Several observational studies have investigated autoimmune disease and subsequent risk of monoclonal gammopathy of undetermined significance and multiple myeloma. Findings have been largely inconsistent and hindered by the rarity and heterogeneity of the autoimmune disorders investigated. A systematic review of the literature was undertaken to evaluate the strength of the evidence linking prior autoimmune disease and risk of MGUS/multiple myeloma.
Methods: A broad search strategy using key terms for pre-MM, multiple myeloma, and 50 autoimmune diseases was used to search four electronic databases (PubMed, Medline, Embase, and Web of Science) from inception through November 2011.
Results: A total of 52 studies met the inclusion criteria, of which 32 were suitably comparable to perform a meta-analysis. “Any autoimmune disorder” was associated with an increased risk of both pre-MM…
This risk was disease dependent with only pernicious anemia showing an increased risk of both MGUS and multiple myeloma.
Conclusions: Our findings, based on the largest number of autoimmune disorders and patients with MGUS/multiple myeloma reported to date, suggest that autoimmune diseases and/or their treatment may be important in the etiology of pre-MM/multiple myeloma.
The strong associations observed for pernicious anemia suggest that anemia seen in plasma cell dyscrasias may be of autoimmune origin.
Impact: Underlying mechanisms of autoimmune diseases, general immune dysfunction, and/or treatment of autoimmune diseases may be important in the pathogenesis of MGUS/multiple myeloma.”
“This article was originally published here
Eur J Haematol. 2020 Dec 9. doi: 10.1111/ejh.13563. Online ahead of print.
OBJECTIVES AND METHODS: We conducted a population-based study including 19,303 individuals diagnosed with MGUS in Sweden from 1985 to 2013, with the aim to determine whether a prior history of autoimmune disease, a well-described risk factor for MGUS) is a risk factor for progression of pre-MM to multiple myeloma (MM)…
Using the nationwide Swedish Patient registry, we identified MGUS cases with versus without an autoimmune disease present at the time of MGUS diagnosis and estimated their risk of progression.
RESULTS: A total of 5,612 (29.1%) MGUS cases had preceding autoimmune diseases. Using Cox proportional hazards models, we found the risk of progression from pre-MM to MM) to be significantly lower in MGUS cases with prior autoimmune disease (compared to MGUS cases without).
CONCLUSIONS: In this large population-based study, a history of autoimmune disease was associated with a reduced risk of progression from pre-MM to MM..
Potential underlying reason is that MGUS caused by chronic antigen stimulation is biologically less likely to undergo the genetic events that trigger progression. Our results may have implications in clinical counselling for patients with MGUS and underlying autoimmune disease.
PMID:33295006 | DOI:10.1111/ejh.13563
