AI Article Synopsis
- Bacteria like Coxiella burnetii, which causes Q fever, may increase the risk of developing lymphomas such as diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL).
- A study of 1,468 Q fever patients revealed that 0.48% had mature B-cell lymphomas, showing a significantly higher incidence of DLBCL and FL among Q fever patients compared to the general population.
- Detection of C. burnetii in specific immune cells and IL10 overproduction in lymphoma patients suggests a possible link where this bacterium contributes to the development of certain non-Hodgkin lymphomas, indicating a need for lymphoma screening in Q fever patients, especially those with ongoing infections.
Article Abstract
Bacteria can induce human lymphomas, whereas lymphoproliferative disorders have been described in patients with Q fever. We observed a lymphoma in a patient with Q fever that prompted us to investigate the association between the 2 diseases. We screened 1468 consecutive patients of the 2004 to 2014 French National Referral Center for Q fever database. The standardized incidence ratios (SIRs) of diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) were calculated comparatively to the 2012 Francim Registry. The presence of Coxiella burnetii was tested using immunofluorescence and fluorescence in situ hybridization using a specific 16S ribosomal RNA probe and genomic DNA probe. Seven patients (0.48%) presented mature B-cell lymphoma consisting of 6 DLBCL and 1 FL. An excess risk of DLBCL and FL was found in Q fever patients compared with the general population (SIR [95% confidence interval], 25.4 [11.4-56.4] and 6.7 [0.9-47.9], respectively). C burnetii was detected in CD68(+) macrophages within both lymphoma and lymphadenitis tissues but localization in CD123(+) plasmacytoid dendritic cells (pDCs) was found only in lymphoma tissues. Q fever patients with persistent focalized infection were found more at risk of lymphoma (hazard ratio, 9.35 [1.10-79.4]). Interleukin-10 (IL10) overproduction (P = .0003) was found in patients developing lymphoma. These results suggest that C burnetii should be added to the list of bacteria that promote human B-cell non-Hodgkin lymphoma, possibly by the infection of pDCs and IL10 overproduction. Screening for early lymphoma diagnosis should be considered in the management of patients with Q fever, especially those with persistent focalized infections.
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| http://dx.doi.org/10.1182/blood-2015-04-639617 | DOI Listing |
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