Abstract
Giriş ve Amaç: Multipl skleroz santral sinir sisteminin en yaygın inflamatuar demiyelinizan hastalığı olup takip ve tedavi sürecinde risk yönetimini iyi yapmak önemlidir. Multiple sklerozlu hastalarda en önemli komorbiditelerden biri olan kanser gelişim riski ile ilişkili literatürde çelişkili sonuçlar mevcuttur. Bu çalışmada kliniğimizde takip edilen multipl sklerozlularda kanser sıklığının belirlenmesi ve bu hastalarda hastalık seyrinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Ege Üniversitesi multipl skleroz polikliniğinden düzenli takipleri ve güncel verileri olan 1280 hastanın elektronik hasta kayıtları retrospektif incelendi. Hastaların demografik bilgileri, komorbiditeleri, aile öyküsü, engellilik düzeyi, kullandığı hastalık modifiye edici tedavileri, kanser varlığı, kanser tipi, multipl skleroz tanısı ile kronolojik sırası gibi veriler hastalar ile görüşülerek teyit edildi.
Bulgular: On yedi hastada kanser varlığı saptanmış olup sıklık %1,33 olarak hesaplandı. On yedi hastanın üçü sekonder progresif fenotipte iken 14’ü relapsing remitting multipl sklerozdu. Multipl skleroz ve kanser birlikteliği olan hastalarımızdaki en sık görülen tip meme kanseriydi. Hastalık modifiye edici tedavilerin kanser gelişimi ile ilişkisine bakıldığında öne çıkan bir ajan saptanmadı. Kanser gelişen hastalarımızın MS seyrine baktığımızda hepsinin inaktif, meme kanseri nedeniyle exitus olan bir hastamız dışında diğerlerinin kanser açısından da remisyonda olduğu görülmüştür.
Sonuç: Multipl skleroz hastalarında kanser gelişimi sık görülmemesine ve hastalık seyrini olumsuz etkisi gösterilmemiş olmasına karşın takip ve tedavide kanser riski değerlendirilmeli, yaş ve cinsiyete göre sık görülen kanserler açısından rutin taramalar atlanmamalıdır.
Anahtar kelimeler: Multipl skleroz, kanser, komorbidite
Keywords
Ethical Statement
Ege Üniversitesi Tıp Fakültesi Tıbbi Etik Kurul'dan onay alınmış ve Helsinki Bildirgesi İlkelerine uyulmuştur.
Supporting Institution
yok
Thanks
Hastalar ile iletişimi sağlayan Hemş. Meltem Baklan'a teşekkür ederiz.
References
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- 15. Ghajarzadeh M, Mohammadi A, Sahraian MA. Risk of cancer in multiple sclerosis (MS): A systematic review and meta-analysis. Autoimmun Rev 2020; 19(10):102650.
- 16. Kingwell E, Bajdik C, Phillips N, Zhu F, Oger J, Hashimoto S, Tremlett H. Cancer risk in multiple sclerosis: findings from British Columbia, Canada. Brain 2012; 135(Pt 10):2973-9.
- 17. Roshanisefat H, Bahmanyar S, Hillert J, Olsson T, Montgomery S. All-cause mortality following a cancer diagnosis amongst multiple sclerosis patients: a Swedish population-based cohort study. Eur J Neurol 2015; 22(7):1074-80.
- 18. Marrie RA, Reider N, Cohen J, Stuve O, Trojano M, Sorensen PS, Reingold SC, Cutter G. A systematic review of the incidence and prevalence of cancer in multiple sclerosis. Mult Scler 2015; 21(3):294-304.
- 19. Hajiebrahimi M, Montgomery S, Burkill S, Bahmanyar S. Risk of Premenopausal and Postmenopausal Breast Cancer among Multiple Sclerosis Patients. PLoS One 2016; 11(10):e0165027.
- 20. Lebrun C, Debouverie M, Vermersch P, Clavelou P, Rumbach L, de Seze J, Wiertlevski S, Defer G, Gout O, Berthier F, Danzon A. Cancer risk and impact of disease-modifying treatments in patients with multiple sclerosis. Mult Scler 2008; 14(3):399-405.
Abstract
Abstract
Aim; Multiple sclerosis is the most common inflammatory demyelinating disease of the central nervous system and it is important to do risk management well during the follow-up and treatment process. There are conflicting results in the literature regarding cancer development, which is one of the important comorbidities in multiple sclerosis. This study aimed to determine the frequency of cancer in our patients with multiple sclerosis and to evaluate the course of the disease in these patients.
Method; Electronic patient records of 1280 patients with regular follow-up and up-to-date data from Ege University multiple sclerosis outpatient clinic were retrospectively reviewed. Data such as demographic information, comorbidities, family history, disability level, disease-modifying treatments , presence of cancer, type of cancer, multiple sclerosis, and cancer diagnosis dates were verified by interviewing the patients.
Results; Seventeen patients with multiple sclerosis were found to have cancer, and the cancer frequency was calculated as 1.33%. Three of the seventeen patients had secondary progressive phenotype, while 14 had relapsing remitting multiple sclerosis. The most common cancer type in our patients with multiple sclerosis was breast cancer. There was no association between cancer development and any disease-modifying treatments. When we evaluated the course of MS in our patients who developed cancer, we see that all of them are inactive, and except for one patient who died due to breast cancer, the others are in remission in terms of cancer.
Conclusion; Although cancer development is not common in patients with multiple sclerosis and its negative effect on the course of the disease has not been shown, cancer risk should be evaluated during follow-up and treatment and routine screenings should be performed for common cancers according to age and gender.
Keywords: Multiple sclerosis, cancer, comorbities
Keywords
References
- 1. Roach ES. Is multiple sclerosis an autoimmune disorder? Arch Neurol 2004; 61(10):1615-6.
- 2. Compston A, Coles A. Multiple sclerosis. Lancet 2008; 372(9648):1502-17.
- 3. Lalmohamed A, Bazelier MT, Van Staa TP, Uitdehaag BM, Leufkens HG, De Boer A, De Vries F. Causes of death in patients with multiple sclerosis and matched referent subjects: a population-based cohort study. Eur J Neurol 2012; 19(7):1007-14.
- 4. Titcomb TJ, Bao W, Du Y, Liu B, Snetselaar LG, Wahls TL. Association of multiple sclerosis with risk of mortality among a nationally representative sample of adults in the United States. Mult Scler J Exp Transl Clin 2022; 8(2):20552173221104009.
- 5. Koch-Henriksen N, Brønnum-Hansen H, Stenager E. Underlying cause of death in Danish patients with multiple sclerosis: results from the Danish Multiple Sclerosis Registry. J Neurol Neurosurg Psychiatry 1998; 65(1):56-9.
- 6. Sumelahti ML, Tienari PJ, Wikström J, Salminen TM, Hakama M. Survival of multiple sclerosis in Finland between 1964 and 1993. Mult Scler 2002; 8(4):350-5.
- 7. Smestad C, Sandvik L, Celius EG. Excess mortality and cause of death in a cohort of Norwegian multiple sclerosis patients. Mult Scler 2009; 15(11):1263-70.
- 8. Lunde HMB, Assmus J, Myhr KM, Bø L, Grytten N. Survival and cause of death in multiple sclerosis: a 60-year longitudinal population study. J Neurol Neurosurg Psychiatry 2017; 88(8):621-5.
- 9. Ragonese P, Aridon P, Mazzola MA, Callari G, Palmeri B, Famoso G, Terruso V, Salemi G, D'Amelio M, Savettieri G. Multiple sclerosis survival: a population-based study in Sicily. Eur J Neurol 2010; 17(3):391-7.
- 10. Jick SS, Li L, Falcone GJ, Vassilev ZP, Wallander MA. Mortality of patients with multiple sclerosis: a cohort study in UK primary care. J Neurol 2014; 261(8):1508-17.
- 11. Grytten N, Myhr KM, Celius EG, Benjaminsen E, Kampman M, Midgard R, Vatne A, Aarseth JH, Riise T, Torkildsen Ø. Risk of cancer among multiple sclerosis patients, siblings, and population controls: A prospective cohort study. Mult Scler 2020; 26(12):1569-80.
- 12. Kuiper JG, Overbeek JA, Foch C, Boutmy E, Sabidó M. Incidence of malignancies in patients with multiple sclerosis versus a healthy matched cohort: A population-based cohort study in the Netherlands using the PHARMO Database Network. J Clin Neurosci 2022; 103:49-55.
- 13. Bahmanyar S, Montgomery SM, Hillert J, Ekbom A, Olsson T. Cancer risk among patients with multiple sclerosis and their parents. Neurology 2009; 72(13):1170-7.
- 14. Moisset X, Perié M, Pereira B, Dumont E, Lebrun-Frenay C, Lesage FX, Dutheil F, Taithe F, Clavelou P. Decreased prevalence of cancer in patients with multiple sclerosis: A case-control study. PLoS One 2017; 12(11):e0188120.
- 15. Ghajarzadeh M, Mohammadi A, Sahraian MA. Risk of cancer in multiple sclerosis (MS): A systematic review and meta-analysis. Autoimmun Rev 2020; 19(10):102650.
- 16. Kingwell E, Bajdik C, Phillips N, Zhu F, Oger J, Hashimoto S, Tremlett H. Cancer risk in multiple sclerosis: findings from British Columbia, Canada. Brain 2012; 135(Pt 10):2973-9.
- 17. Roshanisefat H, Bahmanyar S, Hillert J, Olsson T, Montgomery S. All-cause mortality following a cancer diagnosis amongst multiple sclerosis patients: a Swedish population-based cohort study. Eur J Neurol 2015; 22(7):1074-80.
- 18. Marrie RA, Reider N, Cohen J, Stuve O, Trojano M, Sorensen PS, Reingold SC, Cutter G. A systematic review of the incidence and prevalence of cancer in multiple sclerosis. Mult Scler 2015; 21(3):294-304.
- 19. Hajiebrahimi M, Montgomery S, Burkill S, Bahmanyar S. Risk of Premenopausal and Postmenopausal Breast Cancer among Multiple Sclerosis Patients. PLoS One 2016; 11(10):e0165027.
- 20. Lebrun C, Debouverie M, Vermersch P, Clavelou P, Rumbach L, de Seze J, Wiertlevski S, Defer G, Gout O, Berthier F, Danzon A. Cancer risk and impact of disease-modifying treatments in patients with multiple sclerosis. Mult Scler 2008; 14(3):399-405.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Neurology and Neuromuscular Diseases |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | May 22, 2025 |
| Publication Date | May 28, 2025 |
| Submission Date | August 10, 2024 |
| Acceptance Date | November 13, 2024 |
| Published in Issue | Year 2025 Volume: 11 Issue: 2 |
