FRI0520 HOSPITALIZATIONS FOR HEMATOLOGICAL MALIGNANCIES WITH RHEUMATIC DISEASES: A NATIONAL INPATIENT SAMPLE ANALYSIS OF TEN YEARS (2005-2014)
Authors: K. Jatwani, K. Chugh, I. Tan, S. Jatwani
Journal: Annals of the Rheumatic Diseases (2020)

Background: Several rheumatic conditions have been associated with increased risk of malignancies, especially hematopoietic and lymphoproliferative malignancies. Rheumatoid arthritis has been associated with a relative risk of 1.5-4 for the development of hematological malignancies (HM)1. A variety of immunosuppressive and immunomodulatory medications have also been linked to increased risk of HM2. Moreover, with advances in the field of biologic agents being used in the treatment of rheumatic diseases (RD), the landscape keeps changing. To our knowledge, data on general trends of HM as well as in RD is limited. Objectives: Our study aimed to determine the trends of hospitalizations for HM in patients with RD. Methods: We identified admissions with HM with underlying RD (including rheumatoid arthritis systemic lupus erythematosus, inflammatory myositis, scleroderma, polymyalgia rheumatica, and connective tissue disease) from the NIS database using International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes from years 2005 to 2014. The primary outcome was the trends in hospitalizations for HM. We studied the yearly trends and the types of HM among hospitalizations with or without RD. Results: 906,556 weighted hospitalizations were estimated for HM, and amongst those, 17,675 had underlying RD. The demographic analysis suggested that the average age of hospitalizations with HM and RD was higher, were more often females, and a higher number of comorbidities (Table 1). The average number of admissions remained stable for HM with and without HM, as described in Graph 1. There was a significant difference in the frequency of various subtypes in patients with and without RD (Graph 2). Non-Hodgkin’s Lymphoma was the most common subtype in HM without and with RD (35.8% and 47.14%). Table 1. Baseline Demographics of Hospitalizations for HM with and without RD Characteristics HM without RD HM with RD p value Age (in years ± SD) 62.05 ± 0.23 67.41 ± 0.29 &lt;0.05 Gender (%) &lt;0.05 Males 55.99 33.35 Female 44.01 66.65 Race (%) &lt;0.05 White 71.24 75.88 Black 12.27 11.31 Hispanic 10.21 7.62 Asian or Pacific Islander 2.66 2.01 Native American 0.43 0.62 Other 3.18 2.55 Charlson Category (%) &lt;0.05 2 55.07 3.76 3 21.83 46.93 4 11.55 23.71 5 5.54 12.88 &gt;=6 6.01 12.73 Type of Insurance (%) &lt;0.05 Medicare 49.49 66.35 Medicaid 10.93 6.04 Private 35.8 26.19 Self-Pay 3.78 1.42 Conclusion: To our knowledge, this is the first study to analyze trends in HM with RD. There has not been any significant change in the number of hospitalizations for HM from 2005-2014 with or without RD. The most common HM in admissions with RD were Non-Hodgkin’s Lymphomas (NHL) and myeloid leukemias, followed by multiple myeloma. The trends suggest no significant change in subtypes of HM over the study period. Graph 1. Hospitalizations per year for Hematologic Malignancies With Rheumatic Diseases 2005-2014 Graph 2. Types Of Hematological Malignancies In Hospitalizations With And Without Rheumatic Diseases (%) References: [1] Thomas E, Brewster DH, Black RJ, et al. Risk of malignancy among patients with rheumatic conditions. Int J Cancer 2000;88:497 –502. [2] Jones M, Symmons D, Finn J, et al. Does exposure to immunosuppressive therapy increase the 10 year malignancy and mortality risks in rheumatoid arthritis? A matched cohort study. Br J Rheumatol 1996;35:738 –45. Disclosure of Interests: None declared