Pemphigus and hematologic malignancies: A population-based study of 11,859 patients

Publication date: Available online 2 December 2017
Source:Journal of the American Academy of Dermatology
Author(s): Khalaf Kridin, Shira Zelber-Sagi, Doron Comaneshter, Erez Batat, Arnon D. Cohen
BackgroundThe association of non-paraneoplastic pemphigus with comorbid hematologic malignancies is yet to be established.ObjectiveTo estimate the association between pemphigus and the common types of hematologic malignancies.MethodsA cross-sectional study was conducted comparing pemphigus patients with age-, sex- and ethnicity-matched control subjects regarding the prevalence of 6 comorbid hematologic malignancies. The study was performed utilizing the computerized database of Clalit Health Services ensuring 4.5 million subjects.ResultsThe study included 1985 pemphigus patients and 9874 control subjects. The prevalence of chronic leukemia (0.9% vs. 0.4%; OR, 2.1; 95% CI, 1.2-3.6), multiple myeloma (0.8% vs. 0.4%; OR, 2.2; 95% CI, 1.2-3.9), and non-Hodgkin lymphoma (1.8% vs. 1.2%; OR, 1.5; 95% CI, 1.0-2.2) was greater in patients with pemphigus than in controls. The association with chronic leukemia remained significant following the adjustment for immunosuppressive therapy (adjusted OR, 2.0; 95% CI, 1.1-3.7). No significant associations between pemphigus and acute leukemia, Hodgkin lymphoma, myelodysplastic syndrome, and polycythemia vera were observed.LimitationsLack of immunopathological validation of the diagnosis of pemphigus.ConclusionsSignificant association was observed between pemphigus and chronic leukemia, multiple myeloma, and non-Hodgkin lymphoma. Further research is warranted to establish this observation in other cohorts.

Teaser

Hematologic malignancies have been reported sporadically in patients with pemphigus.In the current study, significant associations were observed between pemphigus and chronic leukemia, multiple myeloma, and non-Hodgkin lymphoma.Further research is needed to confirm these findings in other cohorts.