Diabetes and Risk for Lymphoma, Leukemia and Myeloma

Man doing a blood glucose test.

Does Diabetes Increase the Risk of Blood Cancer?

Type 2 diabetes has been studied as a potential risk factor for the development of hematologic malignancies, or blood cancers, but results have been inconsistent.

Some studies have found an association between type 2 diabetes and the risk of developing lymphoma, leukemia and myeloma. Such studies do not, however, explain how diabetes might increase a person’s risk.

For instance, obesity, dietary habits, physical activity levels and antidiabetic medications are all things that go with diabetes -- and any one of them could potentially explain an increased risk of cancer, as opposed to the diabetes, itself.

According to research reported in the May 2012 issue of “Blood,” type 2 diabetes was associated with a mild-to-moderately increased risk of non-Hodgkin lymphoma, but not Hodgkin lymphoma. And, when non-Hodgkin lymphoma subtypes ware examined, the increased risk with type 2 diabetes was present for peripheral T-cell lymphoma, but not for other subtypes of non-Hodgkin lymphoma.

In most cases, researchers still don’t know what causes hematologic malignancies to develop. Certain infections such as Epstein-Barr virus, autoimmune disorders like rheumatoid arthritis, Sjögren’s syndrome, and systemic lupus erythematosus, or a positive family history may be important in the development of some of these cancers.

There is no conclusive evidence showing that type 2 diabetes is a strong risk factor for the development of hematologic malignancies, however.

Diabetes and Cancer Risk

What kinds of biological factors might explain how diabetes could theoretically increase your risk for cancer? Well, the American Diabetes Association and the American Cancer Society have published a joint consensus report dealing with that very subject.

The report suggests that, theoretically, high levels of insulin, blood glucose, and overproduction of chemical messengers that cause inflammation, as well as overproduction of something called insulin-like growth factor (IGF) – and changes to receptors for this signal – are all things seen in people with type 2 diabetes that would favor not only the development of malignant cells but also progression of tumors, once established.

Diabetes and Blood Cancer Risk

There are also some theories that are more specific to blood cancers. Type 2 diabetes is a condition that is associated with suppression of the immune system, chronic inflammation, and dysfunction of the lymphocyte white blood cells known as B-cells and T-cells. All of these things have been associated with the development of lymphoproliferative disorders—an umbrella term that covers both non-cancerous proliferations of lymphoid cells as well as those that turn out to be true malignancies.

At present, evidence of a link between diabetes and lymphoma seems to be strongest for a type of non-Hodgkin’s lymphoma known as peripheral T-cell lymphoma, or PTCL.

While type 1 diabetes has long been thought of as an “immune-related” form of diabetes, the understanding that immunity and autoimmunity plays a role in many cases of type 2 diabetes is a more recent development.

Could changes to T-cells underlie aspects of both type 2 diabetes and T-cell lymphoma?

It’s unclear, but T-cell dysfunction in patients with type 2 diabetes may be characterized by weaker T-cell–mediated responses to invaders and a skewed balance favoring T-cell subsets that promote inflammation. The potential link between diabetes and T-cell lymphoma is very much in the hypothetical stage; however, those who favor the hypothesis point to certain autoimmune conditions such as psoriasis or celiac disease and the associated increased the risk of PTCL as further support for the hypothesis that the immune system is a common link between diabetes and T cell lymphoma.


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Terret C, Albrand G, Rainfray M, et al. Impact of comorbidities on the treatment of non-Hodgkin’s lymphoma: a systematic review. Expert Rev Hematol. 2015;8(3):329-41.

Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. CA Cancer J Clin. 2010;60(4):207–221.

Zintzaras E, Voulgarelis M, Moutsopoulos HM. The risk of lymphoma development in autoimmune diseases: a meta-analysis. Arch Intern Med. 2005;165(20):2337–2344.

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