Risk of lymphohematologic malignancies in patients with chronic plaque psoriasis: A systematic review with meta-analysis - 09/12/21
, Paolo Gisondi, MD, Giampiero Girolomoni, MDAbstract |
Background |
The association between chronic plaque psoriasis and lymphohematologic malignancies (LHMs) remains controversial.
Objective |
To investigate the risk of LHMs in patients with psoriasis according to the best evidence.
Methods |
A systematic review and meta-analysis of observational cohort studies was undertaken to assess the association of psoriasis with different LHMs. A literature search for relevant studies was performed on February 28, 2021. The random-effects model in conducting meta-analyses was applied. To evaluate the risk of bias, the Newcastle-Ottawa Scale was employed.
Results |
A total of 25 observational studies were selected, comprising collectively 2,501,652 subjects. A significantly increased risk for LHM (hazard ratio [HR], 1.55; 1.24-2.94) and lymphoma (HR, 1.27; 1.08-1.50) in patients with moderate-to-severe plaque psoriasis compared to the general population was found. In detail, increased risks for Hodgkin lymphoma (HR, 1.71; 1.27-2.30), non-Hodgkin lymphoma (HR, 1.27; 1.08-1.50), multiple myeloma (HR, 1.32; 1.03-1.69), and leukemia (HR, 1.28; 1.00-1.65) were found. The risk of cutaneous T-cell lymphoma was markedly augmented in patients with psoriasis (HR, 6.22; 3.39-11.42).
Limitations |
Possible ascertainment bias related to the diagnosis of LHMs.
Conclusion |
The increased risk of LHMs, particularly cutaneous T-cell lymphoma, in patients with psoriasis could be related to exposure to systemic immunosuppressive therapies, comorbidities, and sustained immune activation, particularly in the skin.
Le texte complet de cet article est disponible en PDF.Key words : leukemia, lymphoma, meta-analysis, mycosis fungoides, oncology, psoriasis neoplasms
Abbreviations used : CI, CTCL, HL, HR, IMID, LHM, MF, NHL, SIR, TNF
Plan
| Funding sources: None. |
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| IRB approval status: Not applicable. |
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| Reprints not available from the authors. |
Vol 86 - N° 1
P. 86-96 - janvier 2022 Retour au numéro
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