Autoimmune disease is associated with a lower risk of progression in monoclonal gammopathy of undetermined significance

Theodóra Rún Baldursdóttir; Þorvarður Jón Löve; Gauti Kjartan Gíslason; Magnus Björkholm; Ulf Henrik Mellqvist; Sigrun Helga Lund; Cecilie Hveding Blimark; Ingemar Turesson; Malin Hultcrantz; Ola Landgren; Sigurður Yngvi Kristinsson

doi:10.1111/ejh.13563

Autoimmune disease is associated with a lower risk of progression in monoclonal gammopathy of undetermined significance

Theodóra Rún Baldursdóttir, Þorvarður Jón Löve, Gauti Kjartan Gíslason, Magnus Björkholm, Ulf Henrik Mellqvist, Sigrun Helga Lund, Cecilie Hveding Blimark, Ingemar Turesson, Malin Hultcrantz, Ola Landgren, Sigurður Yngvi Kristinsson^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

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 MGUS to multiple myeloma (MM) or lymphoproliferative diseases (LPs). 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 5612 (29.1%) MGUS cases had preceding autoimmune diseases. Using Cox proportional hazards models, we found the risk of progression from MGUS to MM (HR = 0.83, 95% CI 0.73-0.94) and LPs (HR = 0.84, 95% CI 0.75-0.94) 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 MGUS to MM/other LPs. 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 counseling for patients with MGUS and underlying autoimmune disease.

Original language	English
Pages (from-to)	380-388
Number of pages	9
Journal	European Journal of Haematology
Volume	106
Issue number	3
DOIs	https://doi.org/10.1111/ejh.13563
Publication status	Published - 28 Dec 2020

Bibliographical note

This work was supported by grants from the University of Iceland Research Fund, Icelandic Centre for Research (RANNIS), Landspitali University Hospital Research Fund, Karolinska Institutet Foundations, Marie Curie CIG, and the Swedish Cancer Society in Stockholm. Dr Landgren would like to thank funding support by the Memorial Sloan Kettering Core Grant (P30 CA008748).

Dr Landgren provided grant support from NIH, FDA, MMRF, IMF, LLS, Perelman Family Foundation, Rising Tides Foundation, Amgen, Celgene, Janssen, Takeda, Glenmark, Seattle Genetics, and Karyopharm; provided Honoraria/ad boards from Adaptive, Amgen, Binding Site, BMS, Celgene, Cellectis, Glenmark, Janssen, Juno, and Pfizer; and provided Independent Data Monitoring Committee (IDMC) from Takeda, Merck, Janssen.

Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Other keywords

autoimmune disease
lymphoproliferative
monoclonal gammopathy of undetermined significance
multiple myeloma
population-based
Disease Susceptibility
Risk Assessment
Humans
Risk Factors
Proportional Hazards Models
Disease Progression
Autoimmune Diseases/complications
Monoclonal Gammopathy of Undetermined Significance/complications
Public Health Surveillance
Registries
Sweden/epidemiology

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10.1111/ejh.13563

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Baldursdóttir, T. R., Löve, Þ. J., Gíslason, G. K., Björkholm, M., Mellqvist, U. H., Lund, S. H., Blimark, C. H., Turesson, I., Hultcrantz, M., Landgren, O., & Kristinsson, S. Y. (2020). Autoimmune disease is associated with a lower risk of progression in monoclonal gammopathy of undetermined significance. European Journal of Haematology, 106(3), 380-388. https://doi.org/10.1111/ejh.13563

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title = "Autoimmune disease is associated with a lower risk of progression in monoclonal gammopathy of undetermined significance",

abstract = "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 MGUS to multiple myeloma (MM) or lymphoproliferative diseases (LPs). 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 5612 (29.1%) MGUS cases had preceding autoimmune diseases. Using Cox proportional hazards models, we found the risk of progression from MGUS to MM (HR = 0.83, 95% CI 0.73-0.94) and LPs (HR = 0.84, 95% CI 0.75-0.94) 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 MGUS to MM/other LPs. 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 counseling for patients with MGUS and underlying autoimmune disease.",

keywords = "autoimmune disease, lymphoproliferative, monoclonal gammopathy of undetermined significance, multiple myeloma, population-based, Disease Susceptibility, Risk Assessment, Humans, Risk Factors, Proportional Hazards Models, Disease Progression, Autoimmune Diseases/complications, Monoclonal Gammopathy of Undetermined Significance/complications, Public Health Surveillance, Registries, Sweden/epidemiology",

author = "Baldursd{\'o}ttir, {Theod{\'o}ra R{\'u}n} and L{\"o}ve, {{\TH}orvar{\dh}ur J{\'o}n} and G{\'i}slason, {Gauti Kjartan} and Magnus Bj{\"o}rkholm and Mellqvist, {Ulf Henrik} and Lund, {Sigrun Helga} and Blimark, {Cecilie Hveding} and Ingemar Turesson and Malin Hultcrantz and Ola Landgren and Kristinsson, {Sigur{\dh}ur Yngvi}",

note = "This work was supported by grants from the University of Iceland Research Fund, Icelandic Centre for Research (RANNIS), Landspitali University Hospital Research Fund, Karolinska Institutet Foundations, Marie Curie CIG, and the Swedish Cancer Society in Stockholm. Dr Landgren would like to thank funding support by the Memorial Sloan Kettering Core Grant (P30 CA008748). Dr Landgren provided grant support from NIH, FDA, MMRF, IMF, LLS, Perelman Family Foundation, Rising Tides Foundation, Amgen, Celgene, Janssen, Takeda, Glenmark, Seattle Genetics, and Karyopharm; provided Honoraria/ad boards from Adaptive, Amgen, Binding Site, BMS, Celgene, Cellectis, Glenmark, Janssen, Juno, and Pfizer; and provided Independent Data Monitoring Committee (IDMC) from Takeda, Merck, Janssen. Publisher Copyright: {\textcopyright} 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",

year = "2020",

month = dec,

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doi = "10.1111/ejh.13563",

language = "English",

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Baldursdóttir, TR, Löve, ÞJ, Gíslason, GK, Björkholm, M, Mellqvist, UH, Lund, SH, Blimark, CH, Turesson, I, Hultcrantz, M, Landgren, O & Kristinsson, SY 2020, 'Autoimmune disease is associated with a lower risk of progression in monoclonal gammopathy of undetermined significance', European Journal of Haematology, vol. 106, no. 3, pp. 380-388. https://doi.org/10.1111/ejh.13563

TY - JOUR

T1 - Autoimmune disease is associated with a lower risk of progression in monoclonal gammopathy of undetermined significance

AU - Baldursdóttir, Theodóra Rún

AU - Löve, Þorvarður Jón

AU - Gíslason, Gauti Kjartan

AU - Björkholm, Magnus

AU - Mellqvist, Ulf Henrik

AU - Lund, Sigrun Helga

AU - Blimark, Cecilie Hveding

AU - Turesson, Ingemar

AU - Hultcrantz, Malin

AU - Landgren, Ola

AU - Kristinsson, Sigurður Yngvi

N1 - This work was supported by grants from the University of Iceland Research Fund, Icelandic Centre for Research (RANNIS), Landspitali University Hospital Research Fund, Karolinska Institutet Foundations, Marie Curie CIG, and the Swedish Cancer Society in Stockholm. Dr Landgren would like to thank funding support by the Memorial Sloan Kettering Core Grant (P30 CA008748). Dr Landgren provided grant support from NIH, FDA, MMRF, IMF, LLS, Perelman Family Foundation, Rising Tides Foundation, Amgen, Celgene, Janssen, Takeda, Glenmark, Seattle Genetics, and Karyopharm; provided Honoraria/ad boards from Adaptive, Amgen, Binding Site, BMS, Celgene, Cellectis, Glenmark, Janssen, Juno, and Pfizer; and provided Independent Data Monitoring Committee (IDMC) from Takeda, Merck, Janssen. Publisher Copyright: © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

PY - 2020/12/28

Y1 - 2020/12/28

N2 - 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 MGUS to multiple myeloma (MM) or lymphoproliferative diseases (LPs). 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 5612 (29.1%) MGUS cases had preceding autoimmune diseases. Using Cox proportional hazards models, we found the risk of progression from MGUS to MM (HR = 0.83, 95% CI 0.73-0.94) and LPs (HR = 0.84, 95% CI 0.75-0.94) 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 MGUS to MM/other LPs. 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 counseling for patients with MGUS and underlying autoimmune disease.

AB - 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 MGUS to multiple myeloma (MM) or lymphoproliferative diseases (LPs). 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 5612 (29.1%) MGUS cases had preceding autoimmune diseases. Using Cox proportional hazards models, we found the risk of progression from MGUS to MM (HR = 0.83, 95% CI 0.73-0.94) and LPs (HR = 0.84, 95% CI 0.75-0.94) 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 MGUS to MM/other LPs. 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 counseling for patients with MGUS and underlying autoimmune disease.

KW - autoimmune disease

KW - lymphoproliferative

KW - monoclonal gammopathy of undetermined significance

KW - multiple myeloma

KW - population-based

KW - Disease Susceptibility

KW - Risk Assessment

KW - Humans

KW - Risk Factors

KW - Proportional Hazards Models

KW - Disease Progression

KW - Autoimmune Diseases/complications

KW - Monoclonal Gammopathy of Undetermined Significance/complications

KW - Public Health Surveillance

KW - Registries

KW - Sweden/epidemiology

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DO - 10.1111/ejh.13563

M3 - Article

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AN - SCOPUS:85098223811

SN - 0902-4441

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SP - 380

EP - 388

JO - European Journal of Haematology

JF - European Journal of Haematology

IS - 3

ER -

Autoimmune disease is associated with a lower risk of progression in monoclonal gammopathy of undetermined significance

Abstract

Bibliographical note

Other keywords

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