An association between renal cell carcinoma (RCC) and hematologic malignancies (HM) has been reported in the literature for the past 2 decades and now evidence is also pointing towards a familial relationship, according to a recently published literature review.1
It is known that patients with a history of B-cell malignancies such as non-Hodgkin Lymphoma (NHL) are at increased risk for other malignancies.
Furthermore, an association for the development of RCC after NHL with an observed to expected ratio of 1.47 was demonstrated by 2 large epidemiological studies using data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database.
Drs. Janice P. Dutcher and Peter H. Wiernik of the Cancer Research Foundation of New York in Chappaqua, NY, have continued to collect data on this association beyond their previous publications and provided an updated literature review to summarize the data on 189 patients reported to have RCC and an HM.
Dr. Peter H. Wiernik, co-author of the article, noted in an email to Cancer Therapy Advisor, “It shows a previously unrecognized genetic connection between RCC and HMs, primarily lymphoid malignancies. We have previously shown a similar relationship between breast cancer and lymphoid malignancies. Breast and renal cancer are both adenocarcinomas.”
Compiling the data, the authors noted that of 189 patients with both RCC and HMs, there was a 2.25:1 ratio of men to women. The authors pointed out that this ratio is expected in RCC, but in NHL the ratio is reported at 1.2:1 male to female.
It was also demonstrated that a synchronous diagnosis of RCC and HM occurred more often than initially reported by the authors. Out of the 189 cases, 33% (n=62) were diagnosed with RCC and an HM concurrently.
Furthermore, the HM diagnosis occurred first in 43% (n=82) compared with RCC first in 22% (n=41). In the studied cases, 94% (n=178) had a lymphoid malignancy with B-cell type in 175 patients and T-cell type in 3 patients.
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Lymphoma was found in 136 of the 189 patients with a history of RCC and HM and 16 patients had multiple myeloma, 12 patients had chronic lymphocytic leukemia CLL (B-cell), 5 patients had Hodgkin lymphoma, 3 patients had monoclonal gammopathy with undetermined significance, 2 patients had Waldenstrom macroglobulinemia, and 1 patient had B-cell acute lymphocytic leukemia (ALL), T-cell ALL, plasmacytoma, and hairy cell leukemia, each.
Of the patients with RCC and lymphoma, 32% (n=43) had extranodal lymphoma which is consistent with the range of extranodal lymphoma overall.