{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:02:54Z","timestamp":1780963374653,"version":"3.54.1"},"reference-count":64,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T00:00:00Z","timestamp":1717804800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T00:00:00Z","timestamp":1717804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100015077","name":"Wydzia\u0142 Lekarski, Uniwersytet Jagiello\u0144ski Collegium Medicum","doi-asserted-by":"publisher","award":["N41\/DBS\/000936"],"award-info":[{"award-number":["N41\/DBS\/000936"]}],"id":[{"id":"10.13039\/100015077","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Rheumatol Int"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a variable clinical manifestation, potentially leading to death. Importantly, patients with SLE have an increased risk of neoplastic disorders. Thus, this study aimed to comprehensively evaluate the clinical and laboratory characteristics of patients with SLE and with or without malignancy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a retrospective analysis of medical records of 932 adult Caucasian patients with SLE treated at the University Hospital in Krak\u00f3w, Poland, from 2012 to 2022. We collected demographic, clinical, and laboratory characteristics, but also treatment modalities with disease outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 932 patients with SLE, malignancy was documented in 92 (9.87%), with 7 (7.61%) patients experiencing more than one such complication. Non-hematologic malignancies were more prevalent (<jats:italic>n<\/jats:italic>\u2009=\u200977, 83.7%) than hematologic malignancies (<jats:italic>n<\/jats:italic>\u2009=\u200915, 16.3%). Patients with SLE and malignancy had a higher mean age of SLE onset and a longer mean disease duration than patients without malignancy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>p<\/jats:italic>\u2009=\u20090.027, respectively). The former group also presented more frequently with weight loss (odds ratio [OR]\u2009=\u20092.62, 95% confidence interval [CI] 1.61\u20134.23, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), fatigue\/weakness (OR\u2009=\u20092.10, 95% CI 1.22\u20133.77, <jats:italic>p<\/jats:italic>\u2009=\u20090.005), and fever (OR\u2009=\u20091.68, 95% CI 1.06\u20132.69, <jats:italic>p<\/jats:italic>\u2009=\u20090.024). In the malignancy-associated group, we noticed a higher prevalence of some clinical manifestations, such as pulmonary hypertension (OR\u2009=\u20093.47, 95% CI 1.30\u20138.42, <jats:italic>p<\/jats:italic>\u2009=\u20090.007), lung involvement (OR\u2009=\u20092.64, 95% CI 1.35\u20134.92, <jats:italic>p<\/jats:italic>\u2009=\u20090.003) with pleural effusion (OR\u2009=\u20092.39, 95% CI 1.43\u20133.94, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and anemia (OR\u2009=\u20092.24, 95% CI 1.29\u20134.38, <jats:italic>p<\/jats:italic>\u2009=\u20090.006). Moreover, the patients with SLE and malignancy more frequently had internal comorbidities, including peripheral arterial obliterans disease (OR\u2009=\u20093.89, 95% CI 1.86\u20137.75, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), myocardial infarction (OR\u2009=\u20093.08, 95% CI 1.41\u20136.30, <jats:italic>p<\/jats:italic>\u2009=\u20090.003), heart failure (OR\u2009=\u20092.94, 95% CI 1.30\u20136.17, <jats:italic>p<\/jats:italic>\u2009=\u20090.005), diabetes mellitus (OR\u2009=\u20092.15, 95% CI 1.14\u20133.91, <jats:italic>p<\/jats:italic>\u2009=\u20090.011), hypothyroidism (OR\u2009=\u20092.08, 95% CI 1.29\u20133.34, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), arterial hypertension (OR\u2009=\u20091.97, 95% CI 1.23\u20133.23, <jats:italic>p<\/jats:italic>\u2009=\u20090.003), and hypercholesterolemia (OR\u2009=\u20091.87, 95% CI 1.18-3.00, <jats:italic>p<\/jats:italic>\u2009=\u20090.006). Patients with SLE and malignancy were treated more often with aggressive immunosuppressive therapies, including cyclophosphamide (OR\u2009=\u20092.07, 95% CI 1.30\u20133.28, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), however median cumulative cyclophosphamide dose in malignancy-associated SLE subgroup was 0\u00a0g (0\u20132\u00a0g). Interestingly, over a median follow-up period of 14 years (ranges: 8\u201322 years) a total of 47 patients with SLE died, with 16 cases (5.28%) in the malignancy-associated SLE group and 31 cases (5.73%) in the non-malignancy SLE group (<jats:italic>p<\/jats:italic>\u2009=\u20090.76). The most common causes of death were infections (21.28%) and SLE exacerbation (8.51%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The study highlights the relatively frequent presence of malignancies in patients with SLE, a phenomenon that demands oncological vigilance, especially in patients with a severe clinical course and comorbidities, to improve long-term outcomes in these patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00296-024-05623-3","type":"journal-article","created":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T09:02:07Z","timestamp":1717837327000},"page":"1701-1713","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Malignancy in systemic lupus erythematosus: relation to disease characteristics in 92 patients \u2013 a single center retrospective study"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1013-2253","authenticated-orcid":false,"given":"Joanna","family":"Kosa\u0142ka-W\u0119giel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6535-4841","authenticated-orcid":false,"given":"Renata","family":"Pacholczak-Madej","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0321-3557","authenticated-orcid":false,"given":"Rados\u0142aw","family":"Dziedzic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2258-0248","authenticated-orcid":false,"given":"And\u017celika","family":"Siwiec-Ko\u017alik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2209-1436","authenticated-orcid":false,"given":"Magdalena","family":"Spa\u0142kowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1511-9316","authenticated-orcid":false,"given":"Mamert","family":"Milewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2221-614X","authenticated-orcid":false,"given":"Lech","family":"Zar\u0119ba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9634-0963","authenticated-orcid":false,"given":"Stanis\u0142awa","family":"Bazan-Socha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1749-9739","authenticated-orcid":false,"given":"Mariusz","family":"Korkosz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,8]]},"reference":[{"key":"5623_CR1","doi-asserted-by":"publisher","unstructured":"Kuhn A, Bonsmann G, Anders H-J, Herzer P, Tenbrock K, Schneider M (2015) The Diagnosis and Treatment of Systemic Lupus Erythematosus, Deutsches \u00c4rzteblatt international, Jun. https:\/\/doi.org\/10.3238\/arztebl.2015.0423","DOI":"10.3238\/arztebl.2015.0423"},{"key":"5623_CR2","doi-asserted-by":"publisher","unstructured":"Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT (Jan. 2021) Update \u03bfn the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis 80(1):14\u201325. https:\/\/doi.org\/10.1136\/annrheumdis-2020-218272","DOI":"10.1136\/annrheumdis-2020-218272"},{"key":"5623_CR3","doi-asserted-by":"publisher","unstructured":"Song L, Wang Y, Zhang J, Song N, Xu X, Lu Y (2018) The risks of cancer development in systemic lupus erythematosus (SLE) patients: a systematic review and meta-analysis, Arthritis Res Ther, vol. 20, no. 1, p. 270, Dec. https:\/\/doi.org\/10.1186\/s13075-018-1760-3","DOI":"10.1186\/s13075-018-1760-3"},{"key":"5623_CR4","doi-asserted-by":"publisher","unstructured":"Clarke AE et al (2021) Dec., Risk of malignancy in patients with systemic lupus erythematosus: Systematic review and meta-analysis, Seminars in Arthritis and Rheumatism, vol. 51, no. 6, pp. 1230\u20131241, https:\/\/doi.org\/10.1016\/j.semarthrit.2021.09.009","DOI":"10.1016\/j.semarthrit.2021.09.009"},{"key":"5623_CR5","doi-asserted-by":"publisher","unstructured":"Bernatsky S (2005) Non-Hodgkin\u2019s lymphoma in systemic lupus erythematosus, Annals of the Rheumatic Diseases, vol. 64, no. 10, pp. 1507\u20131509, Oct. https:\/\/doi.org\/10.1136\/ard.2004.034504","DOI":"10.1136\/ard.2004.034504"},{"key":"5623_CR6","doi-asserted-by":"publisher","unstructured":"Gayed M, Bernatsky S, Ramsey-Goldman R, Clarke A, Gordon C (May 2009) Lupus and cancer. Lupus 18:479\u2013485. https:\/\/doi.org\/10.1177\/0961203309102556","DOI":"10.1177\/0961203309102556"},{"key":"5623_CR7","doi-asserted-by":"publisher","unstructured":"Bernatsky S, Ramsey-Goldman R, Foulkes WD, Gordon C, Clarke AE (2011) Breast, ovarian, and endometrial malignancies in systemic lupus erythematosus: a meta-analysis, Br J Cancer, vol. 104, no. 9, pp. 1478\u20131481, Apr. https:\/\/doi.org\/10.1038\/bjc.2011.115","DOI":"10.1038\/bjc.2011.115"},{"key":"5623_CR8","doi-asserted-by":"publisher","unstructured":"Hansen JE et al (Oct. 2012) Targeting Cancer with a Lupus Autoantibody. Sci Transl Med 4(157). https:\/\/doi.org\/10.1126\/scitranslmed.3004385","DOI":"10.1126\/scitranslmed.3004385"},{"key":"5623_CR9","doi-asserted-by":"publisher","unstructured":"Zhang M, Wang Y, Wang Y, Bai Y, Gu D (May 2022) Association between systemic Lupus Erythematosus and Cancer Morbidity and Mortality: findings from Cohort studies. Front Oncol 12:860794. https:\/\/doi.org\/10.3389\/fonc.2022.860794","DOI":"10.3389\/fonc.2022.860794"},{"key":"5623_CR10","doi-asserted-by":"publisher","unstructured":"Kariniemi S, Rantalaiho V, Virta LJ, Kautiainen H, Puolakka K, Elfving P (2022) Malignancies among newly diagnosed systemic lupus erythematosus patients and their survival, Lupus, vol. 31, no. 14, pp. 1750\u20131758, Dec. https:\/\/doi.org\/10.1177\/09612033221131501","DOI":"10.1177\/09612033221131501"},{"key":"5623_CR11","doi-asserted-by":"publisher","unstructured":"Aringer M (2019) EULAR\/ACR classification criteria for SLE, Seminars in Arthritis and Rheumatism, vol. 49, no. 3, pp. S14\u2013S17, Dec. https:\/\/doi.org\/10.1016\/j.semarthrit.2019.09.009","DOI":"10.1016\/j.semarthrit.2019.09.009"},{"key":"5623_CR12","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-024-05579-4","author":"J Kosa\u0142ka-W\u0119giel","year":"2024","unstructured":"Kosa\u0142ka-W\u0119giel J et al (2024) Clinical and laboratory characteristics of early-onset and delayed-onset lupus nephritis patients: a single-center retrospective study. Rheumatol Int Mar. https:\/\/doi.org\/10.1007\/s00296-024-05579-4","journal-title":"Rheumatol Int Mar"},{"key":"5623_CR13","doi-asserted-by":"publisher","unstructured":"Levey AS, Titan SM, Powe NR, Coresh J, Inker LA, Kidney Disease, Race, and, Estimation GFR (2020) CJASN, vol. 15, no. 8, pp. 1203\u20131212, Aug. https:\/\/doi.org\/10.2215\/CJN.12791019","DOI":"10.2215\/CJN.12791019"},{"key":"5623_CR14","doi-asserted-by":"publisher","unstructured":"Kang KY et al (Apr. 2010) Incidence of cancer among female patients with systemic lupus erythematosus in Korea. Clin Rheumatol 29(4):381\u2013388. https:\/\/doi.org\/10.1007\/s10067-009-1332-7","DOI":"10.1007\/s10067-009-1332-7"},{"key":"5623_CR15","doi-asserted-by":"publisher","unstructured":"Nived O, Bengtsson A, J\u00f6nsen A, Sturfelt G, Olsson H (2001) Malignancies during follow-up in an epidemiologically defined systemic lupus erythematosus inception cohort in southern Sweden, Lupus, vol. 10, no. 7, pp. 500\u2013504, Jul. https:\/\/doi.org\/10.1191\/096120301678416079","DOI":"10.1191\/096120301678416079"},{"key":"5623_CR16","doi-asserted-by":"publisher","unstructured":"Bernatsky S et al (May 2005) An international cohort study of cancer in systemic lupus erythematosus. Arthr Rhuem 52(5):1481\u20131490. https:\/\/doi.org\/10.1002\/art.21029","DOI":"10.1002\/art.21029"},{"key":"5623_CR17","doi-asserted-by":"publisher","unstructured":"Hardenbergh D, Molina E, Naik R, Geetha D, Chaturvedi S, Timlin H (2022) Factors mediating cancer risk in systemic lupus erythematosus, Lupus, vol. 31, no. 11, pp. 1285\u20131295, Oct. https:\/\/doi.org\/10.1177\/09612033221122163","DOI":"10.1177\/09612033221122163"},{"key":"5623_CR18","doi-asserted-by":"publisher","unstructured":"Ladouceur A, Clarke AE, Ramsey-Goldman R, Bernatsky S (2019) Malignancies in systemic lupus erythematosus: an update, Current Opinion in Rheumatology, vol. 31, no. 6, pp. 678\u2013681, Nov. https:\/\/doi.org\/10.1097\/BOR.0000000000000648","DOI":"10.1097\/BOR.0000000000000648"},{"key":"5623_CR19","doi-asserted-by":"publisher","unstructured":"Ladouceur A et al (Aug. 2020) Cancer and systemic Lupus Erythematosus. Rheumatic Disease Clin North Am 46(3):533\u2013550. https:\/\/doi.org\/10.1016\/j.rdc.2020.05.005","DOI":"10.1016\/j.rdc.2020.05.005"},{"key":"5623_CR20","doi-asserted-by":"publisher","unstructured":"Hsu C-Y et al (Dec. 2016) Cumulative immunosuppressant exposure is associated with diversified cancer risk among 14 832 patients with systemic lupus erythematosus: a nested case\u2013control study. Rheumatology kew457. https:\/\/doi.org\/10.1093\/rheumatology\/kew457","DOI":"10.1093\/rheumatology\/kew457"},{"key":"5623_CR21","doi-asserted-by":"publisher","unstructured":"Parikh-Patel A, White RH, Allen M, Cress R (2008) Cancer risk in a cohort of patients with systemic lupus erythematosus (SLE) in California, Cancer Causes Control, vol. 19, no. 8, pp. 887\u2013894, Oct. https:\/\/doi.org\/10.1007\/s10552-008-9151-8","DOI":"10.1007\/s10552-008-9151-8"},{"key":"5623_CR22","doi-asserted-by":"publisher","unstructured":"Cader RA, Mei Yee AK, Yassin A, Ahmad I, Haron SN (2018) Malignancy in Systemic Lupus Erythematosus (SLE) Patients, Asian Pac J Cancer Prev, vol. 19, no. 12, pp. 3551\u20133555, Dec. https:\/\/doi.org\/10.31557\/APJCP.2018.19.12.3551","DOI":"10.31557\/APJCP.2018.19.12.3551"},{"key":"5623_CR23","doi-asserted-by":"publisher","unstructured":"Bernatsky S et al (2006) Oct., Malignancy prevalence in the first-degree relatives of persons with systemic lupus erythematous: a pilot study, Lupus, vol. 15, no. 10, pp. 695\u2013696, https:\/\/doi.org\/10.1177\/0961203306072424","DOI":"10.1177\/0961203306072424"},{"key":"5623_CR24","unstructured":"Ando B, Nawata H, Umeda F, Ibayashi H (1986) A patient with familial systemic lupus erythematosus associated with gastric cancer and a family study of HLA, Fukuoka Igaku Zasshi, vol. 77, no. 9, pp. 526\u2013531, Sep"},{"key":"5623_CR25","doi-asserted-by":"publisher","unstructured":"Jung J-Y, Suh C-H (May 2017) Infection in systemic lupus erythematosus, similarities, and differences with lupus flare. Korean J Intern Med 32(3):429\u2013438. https:\/\/doi.org\/10.3904\/kjim.2016.234","DOI":"10.3904\/kjim.2016.234"},{"key":"5623_CR26","doi-asserted-by":"publisher","unstructured":"Rao M, Mikdashi J (2023) A Framework to Overcome Challenges in the Management of Infections in Patients with Systemic Lupus Erythematosus, OARRR, vol. Volume 15, pp. 125\u2013137, Jul. https:\/\/doi.org\/10.2147\/OARRR.S295036","DOI":"10.2147\/OARRR.S295036"},{"key":"5623_CR27","doi-asserted-by":"publisher","unstructured":"Vlagea A et al (Jul. 2018) Antinuclear antibodies and cancer: a literature review. Crit Rev Oncol\/Hematol 127:42\u201349. https:\/\/doi.org\/10.1016\/j.critrevonc.2018.05.002","DOI":"10.1016\/j.critrevonc.2018.05.002"},{"key":"5623_CR28","doi-asserted-by":"publisher","unstructured":"Nisihara R, Machoski MCC, Neppel A, Maestri CA, Messias-Reason I, Skare TL (2018) Anti-nuclear antibodies in patients with breast cancer, Clinical and Experimental Immunology, vol. 193, no. 2, pp. 178\u2013182, Jul. https:\/\/doi.org\/10.1111\/cei.13136","DOI":"10.1111\/cei.13136"},{"key":"5623_CR29","doi-asserted-by":"publisher","unstructured":"Shah AA et al (Dec. 2021) Association of systemic lupus erythematosus autoantibody diversity with breast cancer protection. Arthritis Res Ther 23(1):64. https:\/\/doi.org\/10.1186\/s13075-021-02449-3","DOI":"10.1186\/s13075-021-02449-3"},{"key":"5623_CR30","doi-asserted-by":"publisher","unstructured":"Scandolara TB, Panis C (May 2020) Neutrophil traps, anti-myeloperoxidase antibodies and cancer: are they linked? Immunol Lett 221:33\u201338. https:\/\/doi.org\/10.1016\/j.imlet.2020.02.011","DOI":"10.1016\/j.imlet.2020.02.011"},{"key":"5623_CR31","doi-asserted-by":"publisher","unstructured":"Romero-S\u00e1nchez C et al (2020) Nov., Frecuencia de ANCA positivos en una poblaci\u00f3n con s\u00edntomas cl\u00ednicos sugestivos de enfermedad autoinmune y la interferencia de ANA en su interpretaci\u00f3n, Reumatolog\u00eda Cl\u00ednica, vol. 16, no. 6, pp. 473\u2013479, https:\/\/doi.org\/10.1016\/j.reuma.2018.09.007","DOI":"10.1016\/j.reuma.2018.09.007"},{"issue":"2","key":"5623_CR32","first-page":"227","volume":"18","author":"JB Armas","year":"2000","unstructured":"Armas JB et al (2000) Anticardiolipin and antinuclear antibodies in cancer patients\u2013a case control study. Clin Exp Rheumatol 18(2):227\u2013232","journal-title":"Clin Exp Rheumatol"},{"key":"5623_CR33","doi-asserted-by":"publisher","unstructured":"Pugliese L, Bernardini I, Pacifico E, Viola-Magni M, Albi E (2006) Antiphospholipid Antibodies in Patients with Cancer, Int J Immunopathol Pharmacol, vol. 19, no. 4, pp. 879\u2013888, Oct. https:\/\/doi.org\/10.1177\/039463200601900417","DOI":"10.1177\/039463200601900417"},{"key":"5623_CR34","doi-asserted-by":"publisher","unstructured":"G\u00f3mez-Puerta JA et al (2006) Apr., Antiphospholipid Antibodies Associated with Malignancies: Clinical and Pathological Characteristics of 120 Patients, Seminars in Arthritis and Rheumatism, vol. 35, no. 5, pp. 322\u2013332, https:\/\/doi.org\/10.1016\/j.semarthrit.2005.07.003","DOI":"10.1016\/j.semarthrit.2005.07.003"},{"key":"5623_CR35","doi-asserted-by":"publisher","unstructured":"Pham C, Shen Y-M (2008) Antiphospholipid Antibodies and Malignancy, Hematology\/Oncology Clinics of North America, vol. 22, no. 1, pp. 121\u2013130, Feb. https:\/\/doi.org\/10.1016\/j.hoc.2007.10.004","DOI":"10.1016\/j.hoc.2007.10.004"},{"key":"5623_CR36","doi-asserted-by":"publisher","unstructured":"Seleznick MJ, Fries JF (Oct. 1991) Variables associated with decreased survival in systemic lupus erythematosus. Semin Arthritis Rheum 21(2):73\u201380. https:\/\/doi.org\/10.1016\/0049-0172(91)90040-7","DOI":"10.1016\/0049-0172(91)90040-7"},{"key":"5623_CR37","doi-asserted-by":"crossref","unstructured":"Ward MM, Pyun E, Studenski S (1996) Mortality risks associated with specific clinical manifestations of systemic lupus erythematosus, Arch Intern Med, vol. 156, no. 12, pp. 1337\u20131344, Jun","DOI":"10.1001\/archinte.156.12.1337"},{"key":"5623_CR38","doi-asserted-by":"publisher","unstructured":"Borchers AT, Keen CL, Shoenfeld Y, Gershwin ME (Aug. 2004) Surviving the butterfly and the wolf: mortality trends in systemic lupus erythematosus. Autoimmun rev 3(6):423\u2013453. https:\/\/doi.org\/10.1016\/j.autrev.2004.04.002","DOI":"10.1016\/j.autrev.2004.04.002"},{"key":"5623_CR39","doi-asserted-by":"publisher","unstructured":"Singh RR, Yen EY (2018) SLE mortality remains disproportionately high, despite improvements over the last decade, Lupus, vol. 27, no. 10, pp. 1577\u20131581, Sep. https:\/\/doi.org\/10.1177\/0961203318786436","DOI":"10.1177\/0961203318786436"},{"key":"5623_CR40","doi-asserted-by":"publisher","unstructured":"Trager J, Ward MM (2001) Mortality and causes of death in systemic lupus erythematosus, Curr Opin Rheumatol, vol. 13, no. 5, pp. 345\u2013351, Sep. https:\/\/doi.org\/10.1097\/00002281-200109000-00002","DOI":"10.1097\/00002281-200109000-00002"},{"key":"5623_CR41","doi-asserted-by":"publisher","unstructured":"Cervera R et al (2003) Sep., Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients, Medicine (Baltimore), vol. 82, no. 5, pp. 299\u2013308, https:\/\/doi.org\/10.1097\/01.md.0000091181.93122.55","DOI":"10.1097\/01.md.0000091181.93122.55"},{"key":"5623_CR42","doi-asserted-by":"publisher","unstructured":"Yurkovich M, Vostretsova K, Chen W, Avi\u00f1a-Zubieta JA (2014) Overall and Cause\u2010Specific Mortality in Patients With Systemic Lupus Erythematosus: A Meta\u2010Analysis of Observational Studies, Arthritis Care & Research, vol. 66, no. 4, pp. 608\u2013616, Apr. https:\/\/doi.org\/10.1002\/acr.22173","DOI":"10.1002\/acr.22173"},{"key":"5623_CR43","doi-asserted-by":"publisher","unstructured":"Raposeiras Roub\u00edn S, Cordero A (2019) The Two-way Relationship Between Cancer and Atherosclerosis, Revista Espa\u00f1ola de Cardiolog\u00eda (English Edition), vol. 72, no. 6, pp. 487\u2013494, Jun. https:\/\/doi.org\/10.1016\/j.rec.2018.12.010","DOI":"10.1016\/j.rec.2018.12.010"},{"key":"5623_CR44","doi-asserted-by":"publisher","unstructured":"Sun M et al (2023) Apr., Metabolically (un)healthy obesity and risk of obesity-related cancers: a pooled study, JNCI: Journal of the National Cancer Institute, vol. 115, no. 4, pp. 456\u2013467, https:\/\/doi.org\/10.1093\/jnci\/djad008","DOI":"10.1093\/jnci\/djad008"},{"key":"5623_CR45","doi-asserted-by":"publisher","unstructured":"Pacholczak R, Dropi\u0144ski J, Walocha J, Musia\u0142 J (Nov. 2018) Anti-cancer agents and endothelium. Oncol Clin Pract 14(5):249\u2013256. https:\/\/doi.org\/10.5603\/OCP.2018.0032","DOI":"10.5603\/OCP.2018.0032"},{"key":"5623_CR46","doi-asserted-by":"publisher","unstructured":"Kuszmiersz P et al (2021) Jul., Thrombin generation potential is enhanced in systemic sclerosis: impact of selected endothelial biomarkers, Clinical and Experimental Rheumatology, vol. 39, no. 4, pp. 13\u201319, https:\/\/doi.org\/10.55563\/clinexprheumatol\/d03dnc","DOI":"10.55563\/clinexprheumatol\/d03dnc"},{"key":"5623_CR47","doi-asserted-by":"publisher","unstructured":"Pacholczak-Madej R et al (2020) Endothelial dysfunction in patients with systemic sclerosis, pdia, vol. 37, no. 4, pp. 495\u2013502, https:\/\/doi.org\/10.5114\/ada.2019.83501","DOI":"10.5114\/ada.2019.83501"},{"key":"5623_CR48","doi-asserted-by":"publisher","unstructured":"Pacholczak R et al (Feb. 2019) Endothelial dysfunction in patients with eosinophilic granulomatosis with polyangiitis. Clin Rheumatol 38(2):417\u2013424. https:\/\/doi.org\/10.1007\/s10067-018-4253-5","DOI":"10.1007\/s10067-018-4253-5"},{"key":"5623_CR49","doi-asserted-by":"publisher","unstructured":"Pacholczak R et al (Aug. 2018) Endothelial dysfunction in patients with granulomatosis with polyangiitis: a case\u2013control study. Rheumatol Int 38(8):1521\u20131530. https:\/\/doi.org\/10.1007\/s00296-018-4061-x","DOI":"10.1007\/s00296-018-4061-x"},{"key":"5623_CR50","doi-asserted-by":"publisher","unstructured":"Gupta A, Das D, Taneja R (Mar. 2024) Targeting dysregulated lipid metabolism in Cancer with pharmacological inhibitors. Cancers 16:1313. https:\/\/doi.org\/10.3390\/cancers16071313","DOI":"10.3390\/cancers16071313"},{"key":"5623_CR51","doi-asserted-by":"publisher","unstructured":"Filippini A, Tamagnone L, D\u2019Alessio A (1929) Endothelial Cell Metabolism in Vascular Functions, Cancers, vol. 14, no. 8, p. Apr. 2022, https:\/\/doi.org\/10.3390\/cancers14081929","DOI":"10.3390\/cancers14081929"},{"key":"5623_CR52","doi-asserted-by":"publisher","unstructured":"Strippoli R et al (Feb. 2024) Contribution of autophagy to epithelial mesenchymal transition induction during Cancer Progression. Cancers 16(4):807. https:\/\/doi.org\/10.3390\/cancers16040807","DOI":"10.3390\/cancers16040807"},{"key":"5623_CR53","doi-asserted-by":"publisher","unstructured":"Emadi A, Jones RJ, Brodsky RA (2009) Cyclophosphamide and cancer: golden anniversary, Nat Rev Clin Oncol, vol. 6, no. 11, pp. 638\u2013647, Nov. https:\/\/doi.org\/10.1038\/nrclinonc.2009.146","DOI":"10.1038\/nrclinonc.2009.146"},{"key":"5623_CR54","doi-asserted-by":"publisher","unstructured":"Lofstrom B, Backlin C, Sundstrom C, Hellstrom-Lindberg E, Ekbom A, Lundberg IE (2009) Myeloid leukaemia in systemic lupus erythematosus\u2013a nested case-control study based on Swedish registers, Rheumatology, vol. 48, no. 10, pp. 1222\u20131226, Oct. https:\/\/doi.org\/10.1093\/rheumatology\/kep204","DOI":"10.1093\/rheumatology\/kep204"},{"key":"5623_CR55","doi-asserted-by":"publisher","unstructured":"Guo J, Ren Z, Li J, Li T, Liu S, Yu Z (2020) The relationship between cancer and medication exposure in patients with systemic lupus erythematosus: a nested case-control study, Arthritis Res Ther, vol. 22, no. 1, p. 159, Dec. https:\/\/doi.org\/10.1186\/s13075-020-02228-6","DOI":"10.1186\/s13075-020-02228-6"},{"key":"5623_CR56","doi-asserted-by":"publisher","unstructured":"Bernatsky S et al (2008) Jan., The relationship between cancer and medication exposures in systemic lupus erythaematosus: a case-cohort study, Annals of the Rheumatic Diseases, vol. 67, no. 1, pp. 74\u201379, https:\/\/doi.org\/10.1136\/ard.2006.069039","DOI":"10.1136\/ard.2006.069039"},{"key":"5623_CR57","doi-asserted-by":"publisher","unstructured":"Bernatsky S et al (2021) Dec., Cancer Risk in a Large Inception Systemic Lupus Erythematosus Cohort: Effects of Demographic Characteristics, Smoking, and Medications, Arthritis Care & Research, vol. 73, no. 12, pp. 1789\u20131795, https:\/\/doi.org\/10.1002\/acr.24425","DOI":"10.1002\/acr.24425"},{"key":"5623_CR58","doi-asserted-by":"publisher","unstructured":"Ruiz-Irastorza G et al (2007) Jan., Antimalarials may influence the risk of malignancy in systemic lupus erythematosus, Annals of the Rheumatic Diseases, vol. 66, no. 6, pp. 815\u2013817, https:\/\/doi.org\/10.1136\/ard.2006.067777","DOI":"10.1136\/ard.2006.067777"},{"key":"5623_CR59","doi-asserted-by":"publisher","unstructured":"Cook KL et al (2014) Jun., Chloroquine Inhibits Autophagy to Potentiate Antiestrogen Responsiveness in ER\u2009+\u2009Breast Cancer, Clinical Cancer Research, vol. 20, no. 12, pp. 3222\u20133232, https:\/\/doi.org\/10.1158\/1078-0432.CCR-13-3227","DOI":"10.1158\/1078-0432.CCR-13-3227"},{"key":"5623_CR60","doi-asserted-by":"publisher","unstructured":"Goldberg SB et al (Oct. 2012) A phase I study of Erlotinib and Hydroxychloroquine in Advanced non\u2013small-cell Lung Cancer. J Thorac Oncol 7(10):1602\u20131608. https:\/\/doi.org\/10.1097\/JTO.0b013e318262de4a","DOI":"10.1097\/JTO.0b013e318262de4a"},{"key":"5623_CR61","doi-asserted-by":"publisher","unstructured":"Sotelo J, Brice\u00f1o E, L\u00f3pez-Gonz\u00e1lez MA (Mar. 2006) Adding chloroquine to Conventional Treatment for Glioblastoma Multiforme: a Randomized, Double-Blind, placebo-controlled trial. Ann Intern Med 144(5):337. https:\/\/doi.org\/10.7326\/0003-4819-144-5-200603070-00008","DOI":"10.7326\/0003-4819-144-5-200603070-00008"},{"key":"5623_CR62","doi-asserted-by":"publisher","unstructured":"Li J et al (2013) Jun., Autophagy promotes hepatocellular carcinoma cell invasion through activation of epithelial\u2013mesenchymal transition, Carcinogenesis, vol. 34, no. 6, pp. 1343\u20131351, https:\/\/doi.org\/10.1093\/carcin\/bgt063","DOI":"10.1093\/carcin\/bgt063"},{"key":"5623_CR63","doi-asserted-by":"publisher","unstructured":"Pan Y et al (May 2011) Targeting Autophagy Augments in Vitro and in vivo antimyeloma activity of DNA-Damaging chemotherapy. Clin Cancer Res 17(10):3248\u20133258. https:\/\/doi.org\/10.1158\/1078-0432.CCR-10-0890","DOI":"10.1158\/1078-0432.CCR-10-0890"},{"key":"5623_CR64","doi-asserted-by":"publisher","unstructured":"Sohn TA, Bansal R, Su GH, Murphy KM, Kern SE (2002) High-throughput measurement of the Tp53 response to anticancer drugs and random compounds using a stably integrated Tp53-responsive luciferase reporter, Carcinogenesis, vol. 23, no. 6, pp. 949\u2013958, Jun. https:\/\/doi.org\/10.1093\/carcin\/23.6.949","DOI":"10.1093\/carcin\/23.6.949"}],"container-title":["Rheumatology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-024-05623-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00296-024-05623-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-024-05623-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T02:03:28Z","timestamp":1724465008000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00296-024-05623-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,8]]},"references-count":64,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["5623"],"URL":"https:\/\/doi.org\/10.1007\/s00296-024-05623-3","relation":{},"ISSN":["1437-160X"],"issn-type":[{"value":"1437-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,8]]},"assertion":[{"value":"7 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"not declared.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}