TY - JOUR
T1 - B-cell non-Hodgkin lymphoma linked to Coxiella burnetii
AU - Melenotte, Clea
AU - Million, Matthieu
AU - Audoly, Gilles
AU - Gorse, Audrey
AU - Dutronc, Herve
AU - Roland, Gauthier
AU - Dekel, Michal
AU - Moreno, Asuncion
AU - Cammilleri, Serge
AU - Carrieri, Maria Patrizia
AU - Protopopescu, Camelia
AU - Ruminy, Philippe
AU - Lepidi, Hubert
AU - Nadel, Bertrand
AU - Mege, Jean Louis
AU - Xerri, Luc
AU - Raoult, Didier
N1 - Publisher Copyright:
© 2016 by The American Society of Hematology.
PY - 2016/1/7
Y1 - 2016/1/7
N2 - 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 6DLBCL 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 5 .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 andIL10 overproduction. Screening for early lymphoma diagnosis should be considered in the management of patients with Q fever, especially those with persistent focalized infections.
AB - 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 6DLBCL 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 5 .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 andIL10 overproduction. Screening for early lymphoma diagnosis should be considered in the management of patients with Q fever, especially those with persistent focalized infections.
KW - Coxiella burnetii is associated with an increased risk of lymphoma
KW - Especially those with persistent focalized infections
KW - Its presence in the tumor microenvironment may favor lymphomagenesis
KW - Lymphoma has to be considered in patients with q fever and lymphoid disorders
UR - http://www.scopus.com/inward/record.url?scp=84955515248&partnerID=8YFLogxK
U2 - 10.1182/blood-2015-04-639617
DO - 10.1182/blood-2015-04-639617
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C2 - 26463422
AN - SCOPUS:84955515248
SN - 0006-4971
VL - 127
SP - 113
EP - 121
JO - Blood
JF - Blood
IS - 1
ER -
