Factors Associated With Lymphoma in Patients With Sarcoidosis

Compared with the general population, there is a greater prevalence of lymphoma among patients with sarcoidosis, particularly in those of younger age, who are African American, or who have with cutaneous sarcoidosis, according to study results presented at the American Thoracic Society (ATS) International Conference, held virtually from May 14 to May 19, 2021.

Although sarcoidosis is believed to be associated with an increased risk for lymphoproliferative disorders, little is known about this association. Therefore, study investigators sought to assess the clinical characteristics of patients who develop lymphoma after their sarcoidosis diagnosis to compare with those of patients who do not develop lymphoma.

To this end, they conducted a national registry-based study, the Foundation for Sarcoidosis Research’s Sarcoidosis Advanced Registry for Cures Questionnaire (FSR-SARC), which included 3560 patient surveys completed between June 2014 and August 2019. Because a minority of respondents reported having lymphoma, and to remedy the large difference in number of respondents with and without lymphoma, investigators prevented the skewed comparison by randomly selecting a 2:1 ratio computer-generated control sample of patients with sarcoidosis who did not report having lymphoma.

Among 3560 patients with sarcoidosis, 1.2% (n=43) developed lymphoma after their sarcoidosis diagnosis. Patients who developed lymphoma were more likely to have been diagnosed with sarcoidosis at a younger age (39±14 vs 45±13 years; P =.008), to be African American (odds ratio [OR], 3.9; 95% CI, 1.6-9.6; P =.002) and to have a low annual income (OR 2.2; 95% CI, 1.04-4.8; P =.038). When organ involvement was examined, it was shown that patients with lymphoma were more likely to have cutaneous manifestations (OR, 2.9; 95% CI, 1.1-7.3; P =.023).

Patients with lymphoma were also more likely to have hypertension (OR, 2.6; 95% CI, 1.1-5.9; P =.021), chronic pain syndrome (OR, 4; 95% CI, 1.7-9.8; P =.001), chronic fatigue (OR, 2.6; 95% CI, 1.1-5.9; P =.021), sarcoidosis-related hospitalizations (OR, 2.2; 95% CI, 1.04-4.8; P =.038), and depression (OR, 2.5; 95% CI, 1.2-5.6; P =.019). A greater impact was seen in the lymphoma group on employment-based disability (P =.027) and disease-related job termination (P =.014).

“To our knowledge, this is the largest study to assess the prevalence and characteristics of lymphoma in patients with sarcoidosis,” the researchers wrote. “Sarcoidosis patients who developed lymphoma reported higher disease burden and more non-organ specific manifestations.”

Reference

Alzghoul BN, Zayed Y, Alzghoul B, et al. Prevalence and characteristics of self-reported lymphoma in US sarcoidosis patients. Presented at: the American Thoracic Society (ATS) International Conference 2021; May 14-19, 2021. Abstract A1823.