Poster Session C
Sjögren’s syndrome
Ana Mafalda Abrantes, MD
Unidade Local de Saúde Santa Maria
Lisbon, Portugal
No financial relationships with ineligible companies to disclose
Results: A total of 208 patients with pSS were followed-up for 14.1 ± 9.2 years. Most patients were women (93.8%) and Caucasian (66.5%). Seventeen patients (8.2%) developed lymphoma. The diagnosis of lymphoma occurred at an average of 7.4 ± 7.0 years after pSS diagnosis. Sex, ethnicity, age at diagnosis and disease onset, and serological profile did not differ between patients with or without lymphoma (Table 1). Compared to patients who did not developed lymphoma, those who did were more frequently prescribed cyclophosphamide (31.3% vs 1.6%, p< 0.001), rituximab (56.3% vs 3.2%, p< 0.001) and steroids (68.8% vs 35.8%, p 0.01), including high doses of steroids (75.0% vs 32.4%, p 0.002). Five patients in the lymphoma group died (33.3%), two of them due to this condition. Damage developed in 165 (79.3%) and 177 (85.1%) of patients using the SSDDI and SSDI scores, respectively. Patients with lymphoma had significantly higher cumulative SSDDI (7.7 ± 2.0 vs. 2.0 ± 1.8; p< 0.001) and SSDI (4.0 ± 2.2 vs. 2.0 ± 1.6; p< 0.001) scores compared to patients without lymphoma. The prevalence of early damage was similar in patients with and without lymphoma (Table 2). However, early damage increase predicted the development of lymphoma using the SSDDI (per one-unit increase HR 1.6, 95% CI 1.3-2) and the SSDI (per one-unit increase HR 2.0, 95% CI 1.3-3) scores. Both damage variation (SSDDI: per one-unit increase HR 1.5, 95% CI 1.3-1.7; SSDI: per one-unit increase HR 1.4, 95% CI 1.2-1.7) and the cumulative score (SSDDI: per one unit increase HR 1.7, 95% CI 1.5-2; SSDI: per one-unit increase HR 1.5, 95% CI 1.2-1.8) were also associated with an increased risk for lymphoma.
Conclusion: Cumulative and evolving damage in the first years of disease should raise concern about the possible development of lymphoma in patients with pSS.
Table 1 - Comparison of characteristics of lymphoma and non-lymphoma patients.
Table 2 - Comparison of damage in lymphoma and non-lymphoma patients using SSDDI and SSDI scores.
A. Abrantes: None; P. Gaspar: None; D. Isenberg: Astra Zeneca, 2, Eli Lilly, 2, Glaxo Smith Kline, 2, merck serono, 2, Pfizer, 2, Servier, 2, UCB, 2.