Autoimmunity, Clonal Hematopoiesis, and Myeloid Neoplasms

Delamo I Bekele; Mrinal M Patnaik

doi:10.1016/j.rdc.2020.03.001

Autoimmunity, Clonal Hematopoiesis, and Myeloid Neoplasms

Rheum Dis Clin North Am. 2020 Aug;46(3):429-444. doi: 10.1016/j.rdc.2020.03.001. Epub 2020 Jun 10.

Authors

Delamo I Bekele¹, Mrinal M Patnaik²

Affiliations

¹ Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Mayo Building, East 15-94, 200 First Street Southwest, Rochester, MN 55905, USA.
² Division of Hematology, Department of Internal Medicine, Mayo Clinic, Mayo Building, East 10, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: Patnaik.Mrinal@mayo.edu.

PMID: 32631598
DOI: 10.1016/j.rdc.2020.03.001

Abstract

Clonal hematopoiesis has been linked with the development of hematologic malignancy and atherosclerotic cardiovascular disease; however, the association with autoimmune diseases remains to be defined. The link between autoimmune diseases and myeloid neoplasms (MNs) is complex, often multifactorial, and seems bidirectional. The limited data suggest an increased risk of MNs in rheumatoid arthritis and systemic lupus erythematosus. Paraneoplastic manifestations of MN include arthritis, vasculitis, and connective tissue disease. Treatment options for autoimmune disease such as cyclophosphamide and azathioprine have been associated with MNs, whereas the data for methotrexate and tumor necrosis factor inhibitors are equivocal.

Keywords: Autoimmune disease; Clonal hematopoiesis; DMARDs; Myeloid neoplasms.

Publication types

Review

MeSH terms

Animals
Autoimmune Diseases* / drug therapy
Autoimmune Diseases* / immunology
Autoimmunity* / immunology
Clonal Hematopoiesis* / immunology
Humans
Leukemia, Myeloid* / immunology
Myelodysplastic Syndromes* / immunology