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

The association of nonparaneoplastic pemphigus with comorbid hematologic malignancies has yet to be established. To estimate the association between pemphigus and the common types of hematologic malignancies. A cross-sectional study was conducted comparing pemphigus patients with age-, sex- and ethn...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology Vol. 78; no. 6; pp. 1084 - 1089.e1
Main Authors: Kridin, Khalaf, Zelber-Sagi, Shira, Comaneshter, Doron, Batat, Erez, Cohen, Arnon D.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.06.2018
Subjects:
Age Distribution
Aged
Aged, 80 and over
comorbidities
Comorbidity
Confidence Intervals
Cross-Sectional Studies
Female
hematologic malignancies
Hematologic Neoplasms - epidemiology
Hematologic Neoplasms - pathology
Humans
Incidence
Israel
leukemia
Lymphoma, Non-Hodgkin - epidemiology
Lymphoma, Non-Hodgkin - pathology
Male
Middle Aged
multiple myeloma
Multiple Myeloma - epidemiology
Multiple Myeloma - pathology
non-Hodgkin lymphoma
Odds Ratio
pemphigus
Pemphigus - epidemiology
Pemphigus - pathology
Prognosis
Severity of Illness Index
Sex Distribution
Survival Analysis
hematologic malignancies
leukemia
multiple myeloma
OR
comorbidities
pemphigus
CI
non-Hodgkin lymphoma
ISSN:0190-9622, 1097-6787, 1097-6787
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Summary:The association of nonparaneoplastic pemphigus with comorbid hematologic malignancies has yet to be established. To estimate the association between pemphigus and the common types of hematologic malignancies. A 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 using the computerized database of Clalit Health Services ensuring the availability of 4.5 million patients. The study included 1985 pemphigus patients and 9874 control subjects. The prevalence of chronic leukemia (0.9% vs 0.4%, odds ratio [OR] 2.1, 95% confidence interval [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 were observed between pemphigus and acute leukemia, Hodgkin lymphoma, myelodysplastic syndrome, and polycythemia vera. Lack of immunopathologic validation of the diagnosis of pemphigus. A significant 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.
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ISSN:0190-9622
1097-6787
1097-6787
DOI:10.1016/j.jaad.2017.11.039