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Cancer Trends in Inborn Errors of Immunity: A Systematic Review and Meta-Analysis Publisher Pubmed



Fekrvand S1, 2 ; Abolhassani H1, 3 ; Esfahani ZH1, 2 ; Fard NNG4 ; Amiri M1 ; Salehi H1 ; Almasihashiani A6 ; Saeediboroujeni A7 ; Fathi N1, 2 ; Mohtashami M1, 8 ; Razavi A1, 9 ; Heidari A1, 2 ; Azizi G10, 11 ; Khanmohammadi S1, 2 Show All Authors
Authors
  1. Fekrvand S1, 2
  2. Abolhassani H1, 3
  3. Esfahani ZH1, 2
  4. Fard NNG4
  5. Amiri M1
  6. Salehi H1
  7. Almasihashiani A6
  8. Saeediboroujeni A7
  9. Fathi N1, 2
  10. Mohtashami M1, 8
  11. Razavi A1, 9
  12. Heidari A1, 2
  13. Azizi G10, 11
  14. Khanmohammadi S1, 2
  15. Ahangarzadeh M1
  16. Saleki K12, 13, 14
  17. Hassanpour G15
  18. Rezaei N1, 2
  19. Yazdani R1, 2
Show Affiliations
Authors Affiliations
  1. 1. Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  3. 3. Division of Clinical Immunology, Department of Biosciences and Nutrition, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden
  4. 4. Thalassemia & amp
  5. 5. Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  6. 6. Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
  7. 7. Department of Basic Medical Sciences, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
  8. 8. Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
  9. 9. Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  10. 10. Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  11. 11. Department of Neurology, Thomas Jefferson University, Philadelphia, PA, United States
  12. 12. Student Research Committee, Babol University of Medical Sciences, Babol, Iran
  13. 13. Department of E-Learning, Virtual School of Medical Education and Management, Shahid Beheshti University of MedicalSciences (SBMU), Tehran, Iran
  14. 14. USERN Office, Babol University of Medical Sciences, Babol, Iran
  15. 15. Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Clinical Immunology Published:2025


Abstract

Background: Patients with inborn errors of immunity (IEI) are susceptible to developing cancer due to defects in the immune system. The prevalence of cancer is higher in IEI patients compared to the immunocompetent population and cancers are considered as an important and common cause of death in IEI patients. Objectives: To systematically review demographic, genetic and cancer-related data of IEI patients with a history of malignancy. Moreover, we performed a meta-analysis aiming to determine the frequency of cancer in patients with different types of IEI. Methods: We conducted electronic searches on Embase, Web of Science, PubMed, and Scopus (until September 2023) introducing terms related to IEI and cancer. Studies with human subjects with confirmed IEI who had developed at least one malignancy during their lifetime were included. Results: A total number of 4607 IEI patients with a cancer history were included in the present study. Common variable immunodeficiency (CVID) had the highest number of reported cases (1284 cases), mainly due to a higher relative proportion of patients with predominantly antibody deficiencies (PAD) and their increased life expectancy contributing to the higher detection and reporting of cancers among these patients. The most common malignancy was hematologic/blood cancers (3026 cases, mainly diffuse large B cell lymphoma). A total number of 1173 cases (55.6%) succumbed to cancer, with the highest rate of bone marrow failure (64.9%). Among the patients with monogenic defects in IEI-associated genes, the majority of cases had ATM deficiency (926 cases), but the highest cancer frequency rate belonged to NBS1 deficiency (50.5%). 1928 cases out of total 4607 eligible cases had detailed data to allow further statistical analysis that revealed BRCA2 deficiency had the earliest cancer development (~ 38 months), lowest cure frequency, and highest fatality rate (85%), while ATM deficiency had the lowest cure frequency and highest fatality rate (72%) among total cases reviewed with exclusion of Fanconi anemia. Conclusion: The overall reported cancer frequency in the cases reviewed with and without exclusion of Fanconi anemia was 11.1% (95% confidence interval: 9.8–12.5%) and 12.0% (95% confidence interval: 10.6–13.5%), respectively. Our study revealed that the incidence of cancer is significantly dependent on the molecular and pathway defects in IEI patients, and individualized early screening and appropriate treatment, might improve the prognosis of these patients. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
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