J Cancer 2019; 10(4):829-835. doi:10.7150/jca.27970

Research Paper

The association between infection incidence and autoimmune diseases in breast cancer patients after anti-cancer treatment

Chien-Chih Chen1,2, Wei-Li Ho3, Hsin-Hua Chen1,4,5,6,7,8,9, Meei-Ling Sheu1,10, Chiann-Yi Hsu11, Jun-Peng Chen11✉

1. Ph.D. Program in Translational Medicine, National Chung-Hsing University, Taichung, Taiwan
2. Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
3. Division of Allergy, Immunology and Rheumatology, Chiayi Branch, Taichung Veterans General Hospital
4. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
5. School of Medicine, National Yang-Ming University, Taipei, Taiwan
6. Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan
7. School of Medicine, Chung-Shan Medical University, Taichung, Taiwan.
8. Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
9. Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
10. Graduate Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
11. Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan

Abstract

Purpose: To evaluate the infection incidence in breast cancer patients whether they have a major autoimmune disease or not.

Methods: This retrospective cohort study compared the infection incidence of 174 breast cancer patients with an autoimmune disease, including Sjogren's Syndrome (SS), Rheumatoid Arthritis (RA), and Systemic Lupus Erythematosus (SLE), along with 4429 patients without an autoimmune disease, for the period 2000 to 2016. Six-hundred and ninety six, age-, stage-, and diagnosis era-matched patients without any autoimmune disease were analyzed to eliminate the effects of these confounding factors may have on the results.

Results: After adjusting for age, stage and diagnosis era, breast cancer patients with an autoimmune disease had a higher Infection Incidence Ratio (IRR: 2.62) than the patients without any autoimmune disease. In the univariate analysis, patients who had an autoimmune disease (p<0.001), underwent chemotherapy (p<0.001), radiotherapy (p=0.004), and monoclonal antibody therapy (p<0.001) had a higher infection rate. In the multivariate analysis, autoimmune disease was shown to be an independent factor for infection incidence.

Conclusion: Autoimmune disease was a potential predictor of infection incidence in breast cancer patients post-treatment after adjusting for clinical confounding factors.

Keywords: breast cancer, infection, autoimmune disease

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How to cite this article:
Chen CC, Ho WL, Chen HH, Sheu ML, Hsu CY, Chen JP. The association between infection incidence and autoimmune diseases in breast cancer patients after anti-cancer treatment. J Cancer 2019; 10(4):829-835. doi:10.7150/jca.27970. Available from http://www.jcancer.org/v10p0829.htm