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Is There a Connection Between Lupus and AML?

Posted on August 18, 2022
Medically reviewed by
Richard LoCicero, M.D.
Article written by
Suzanne Mooney

People with lupus have a greater risk of developing leukemia, lymphoma, and other types of blood cancer compared with those who are not living with this chronic disease. Although lupus, or systemic lupus erythematosus (SLE), is an autoimmune disorder, not a type of cancer, studies have found a connection between the two. Acute myeloid leukemia (AML) is one type of cancer that people with lupus are more likely to develop.

Acute Myeloid Leukemia and Other Blood Cancers

According to the American Cancer Society, cancer affects 1 in 3 people in the United States. It can develop almost anywhere in the body and is caused by gene mutations (damaged cells) that grow and multiply out of control.

Cancers that start in tissues or organs, like breast and prostate cancer, are called solid tumor cancers. Those that develop in the blood, bone marrow, or lymphatic system (part of the circulatory and immune systems) are called blood cancers, or hematologic malignancies. Blood cancers are not autoimmune conditions.

Leukemia and Lymphoma

You might hear someone say, “they have leukemia” or “they have lymphoma,” but each of those blood cancers has dozens of subtypes. Identifying the specific cancer type is essential because it helps oncologists recommend effective treatment options and provide an accurate prognosis. Blood cancers are classified based on where they originate, how fast they progress, and which blood cells are affected. For example:

  • If cancer starts in the blood or bone marrow, it is leukemia. If it develops in the lymph nodes or lymphatic tissues, it is lymphoma.
  • When leukemia cells multiply rapidly, causing the disease to progress quickly, it is called acute. If cells replicate slowly, the disease is considered chronic.
  • Leukemia that affects the myeloid white blood cells is called myeloid or myelogenous. If cancer affects white blood cells known as lymphocytes, it is called lymphocytic or lymphoblastic.

For example, AML progresses quickly (acute), affects the myeloid cells (myeloid), and starts in the blood or bone marrow (leukemia).

Lymphoma can also progress slowly or quickly and be either more or less aggressive. The most common type of lymphoma is non-Hodgkin lymphoma (NHL), which has many subtypes. People with NHL are at increased risk of developing secondary cancers, including AML.

What Is Acute Myeloid Leukemia?

AML is a rare disease, accounting for just 1 percent of all new cancer diagnoses. Even so, AML is one of the most common types of leukemia diagnosed in adults, with an estimated 20,050 new cases in the United States projected for 2022.

According to Surveillance, Epidemiology, and End Results (SEER) data, published by the National Cancer Institute, the five-year relative survival rate for AML is 30.5 percent. That means about 3 out of 10 people with AML will be alive five years after their diagnosis. The most common treatment for AML is chemotherapy, with promising new therapies on the horizon.

Can Lupus Raise the Risk of Leukemia?

A 2018 study found that having lupus increases a person’s risk of developing 16 types of cancer, including the blood cancers leukemia, NHL, Hodgkin lymphoma, and multiple myeloma. The same study found that lupus may reduce the risk of prostate cancer and melanoma. Lupus does not seem to affect breast, uterine, ovarian, pancreatic, colorectal, or brain cancer.

Do Lupus Treatments Increase Risk of Cancer?

Methotrexate (sold under brand names including Rheumatrex and Trexall) is a drug used in rheumatology and oncology. It can treat lupus and rheumatoid arthritis, as well as acute lymphoblastic leukemia, chronic myeloid leukemia, NHL, and other types of cancer. Ironically, although it is used to treat cancers, methotrexate can also raise the risk of developing certain types of cancer including skin cancer, lymphoma, and other blood cancers.

Other immunosuppressive medications used to treat lupus and other autoimmune diseases may also increase the risk of developing one or more types of cancer. These drugs include:

The level of drug-related risk may depend on the dosage level and length of treatment. However, the benefits of a treatment’s effectiveness for lupus may outweigh a slightly higher long-term risk of developing certain types of cancer.

If you are living with lupus and have concerns about your cancer risk, talk with your doctor. Only they can help you weigh the benefits and risks of lupus treatments.

Do Acute Myeloid Leukemia and Lupus Share Risk Factors?

Both conditions are influenced by hereditary and environmental factors, but the exact causes of lupus and cancer remain unclear. Researchers have identified potential risk factors, however, and one that lupus and AML share seems to be genetics. Although neither condition is considered a hereditary disease, having a close family member with either lupus or AML appears to increase your risk of developing that condition.

Gender isn’t a shared risk factor for lupus and AML. According to Johns Hopkins Medicine, women are nine times more likely than men to develop lupus, and the American Cancer Society says that AML is more common in men than women.

Age is also not a shared risk factor. Lupus is usually diagnosed in people 15 to 45 years old, while the risk of developing AML increases with age. The average age of a person receiving an AML diagnosis is 68.

Having one or more known risk factors does not mean you will develop lupus or AML — it just means your risk is higher because of those characteristics. If you have questions about your risk factors, talk with your doctor.

Can Leukemia Raise the Risk of Lupus?

Although lupus raises the risk for leukemia, the opposite does not appear to be true. However, some cancer treatments may increase the risk of developing a condition called drug-induced lupus, which is caused by prescription medications. These treatments may also raise the risk of subacute cutaneous lupus erythematosus, a milder form of the disease.

Cancer drugs linked to an increased risk of lupus include:

  • Gemcitabine
  • Docetaxel
  • Paclitaxel
  • Tamoxifen
  • Fluorouracil
  • Capecitabine
  • Doxorubicin with cyclophosphamide

Drug-induced lupus usually clears up within six months of the last dose of medication. If you are being treated for cancer and are concerned about the potential side effects, talk to your oncologist.

Leukemia and Lupus Symptoms in Common

Blood cancers may cause few or no symptoms. In some cases, chronic blood cancers go undetected for years because they progress so slowly. When symptoms do occur, they may be so minor that they are ignored or attributed to the common cold or the flu.

Lupus symptoms can also be blamed on other illnesses. They differ from person to person and tend to come and go. In some cases, the symptoms of lupus and blood cancers can overlap.

Symptoms that apply to both lupus and leukemia include:

  • Fatigue
  • Night sweats
  • Anemia
  • Bone or joint pain
  • Swollen lymph nodes
  • Abnormal bleeding
  • Weight loss
  • Headaches

This is not a complete list. If you are concerned about new or worsening symptoms, always talk with your doctor.

Lowering Your Risk of Leukemia

Research has shown a connection between lupus and cancer, so people with lupus may want to discuss proactive cancer screening with their health care providers. Attending scheduled appointments and telling your doctor about any health changes or concerns may also help you catch issues before they become serious.

You can also follow these healthy lifestyle tips for lowering your cancer risk:

  • Eat a healthy diet.
  • Exercise regularly.
  • Maintain a healthy weight.
  • Limit alcohol intake.
  • Don’t smoke or use tobacco.
  • Wear sunscreen.
  • Get regular medical care.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 214,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you have questions about lupus and acute myeloid leukemia? Have you been diagnosed with both lupus and AML? Share your experiences in the comments below, or start a conversation by posting on your Activities page.

References

All updates must be accompanied by text or a picture.
Richard LoCicero, M.D. has a private practice specializing in hematology and medical oncology at the Longstreet Clinic Cancer Center, in Gainesville, Georgia. Review provided by VeriMed Healthcare Network. Learn more about him here.
Suzanne Mooney writes about people, pets, health and wellness, and travel. Learn more about her here.

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