E126 Unmasking lymphoma predictors in Sjögren disease: a 40-year follow-up cohort

Abstract Background/Aims Sjögren disease (SjD) is an autoimmune rheumatic disease characterised by lymphocytic infiltration of exocrine glands and systemic immune dysregulation. B-cell hyperactivity drives chronic inflammation and increases the risk of lymphoproliferative disorders, especially mucosa-associated lymphoid tissue (MALT) lymphoma. SjD patients have a 10-44-fold higher lymphoma risk compared to the general population, making it a major cause of morbidity and mortality. Most cases are low-grade salivary gland B-cell non-Hodgkin lymphomas. This study evaluated lymphoma prevalence and clinical and serological risk factors in a SjD cohort. Methods Our retrospective observational study included patients fulfilling 2016 ACR/EULAR SjD criteria at University College London Hospital (1982-2025). Demographic, clinical, and serological data were collected from paper and electronic records. Associations between lymphoma and selected variables were analysed using Chi-square or Fisher’s exact tests, with relative risks (RR) and 95% confidence intervals (CI). Significance was set at p 0.05. Results Among 283 patients (93.3% female, mean age 50.1 ± 15.2 years), parotid swelling was the most frequent glandular feature (n = 82, 30.5%), while arthritis was the most common systemic manifestation (n = 73, 25.8%). ANA was positive in 87.4% (n = 235) (speckled 83.7%, n = 195). Anti-Ro (n = 106, 75,7%), Anti-La (n = 132, 45,2%), rheumatoid factor (n = 150, 57,3%), and hypergammaglobulinemia (n = 136, 52.5%) were positive. Overall mortality was 18.6% (n = 48), mainly due to infection (n = 11, 34.4%) and lymphoma 12.5% (n = 4). Table 1 summarises clinical and serological characteristics and their association with lymphoma development. Significant correlations were identified for hypergammaglobulinemia (p = 0.03, RR = 2.56, 95% CI:1.04-6.28) and parotid swelling (p 0.001, RR = 5.53, 95% CI:2.39-12.85). No other variables were significant. Conclusion Lymphoma prevalence was 9.9%, predominantly non-Hodgkin MALT type. Hypergammaglobulinemia and parotid swelling were significant lymphoma predictors, while others were not statistically significant. Disclosure M. Angerri-Nadal: None. U. Couto-Lareo: None. B. Viejo-Sosa: None. D.A. Isenberg: None.