Greek researchers have developed a tool for doctors to better score the risk of non-Hodgkin’s lymphoma in patients diagnosed with Sjogren’s syndrome. The early identification of high-risk patients could allow for treatment at the first signs of cancer and improve the likelihood of success.
Scientists at the National and Kapodistrian University of Athens in Greece explored characteristics of 381 Sjogren’s patients and 92 Sjogren’s patients who had developed non-Hodgkin’s lymphoma.
The study, “Predicting the risk for lymphoma development in Sjogren syndrome: An easy tool for clinical use,” published in the journal Medicine, included patients without other autoimmune conditions.
Sjogren’s syndrome is an autoimmune disease that attacks tear and salivary glands, leading to dry eyes and mouth. The disease can also destroy glands in other parts of the body. A more serious complication is the chance to develop lymphoma, which effects about 5% of patients, but elevates the Sjogren’s patients’ risk up to 7 – 19 times higher than risk for the rest of the general population.
Comparing symptoms at the time of the diagnosis of Sjogren’s syndrome between the two groups, researchers found that enlarged salivary glands, abnormal lymph nodes, Raynaud’s phenomenon and the presence of certain autoantibodies and other proteins in the blood were all more frequent in patients who later developed lymphoma.
Constructing a scoring system based on the number of risk factors carried by individual patients, the team calculated a percentage risk for lymphoma.
Patients having one to two risk factors had a likelihood of 3.8 % for lymphoma. The risk jumped to 39.9% when three to six risk factors were calculated into the equation. For patients with all seven of the identified factors, getting lymphoma was inevitable.
Scientists are not sure why patients with isolated Sjogren’s syndrome develop lymphoma more often, Especially puzzling is why patients with other rheumatic conditions such as rheumatoid arthritis and systemic lupus erythematosus, which often co-occur with Sjogren’s, are not at high risk for the lymphoma.
Further investigation into the study findings might give more insight into the mechanisms that put Sjogren’s patients at risk, and support earlier studies that show how abnormal immune mechanisms and the presence of certain viruses, might contribute to processes that lead to lymphoma in Sjogren’s patients.