Theander et al identified a number of factors associated with the developmnet of malignant lymphoma in patients with primary Sjogren's syndrome. The authors are from Malmo University Hospital and Lund University in Sweden.
Patient selection: primary Sjogren syndrome
Outcome: non-Hodgkin lymphoma (mostly diffuse large B-cell lymphoma)
Predictors for development of malignant lymphoma:
(1) purpura, skin vasculitis (hazard ratio 4.6)
(2) low serum C3 concentration (hazard ratio 6.2)
(3) CD4 positive T cell lymphopenia (hazard ratio 8.1)
(4) ratio of CD4 to CD8 positive T cells <= 0.8 (hazard ratio 10.9)
where:
• The normal reference range for serum C3 was 0.77 to 1.38 g/L
• The normal reference range for CD4 positive lymphocytes was 300 to 2,000 per µL.
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