Can you have lupus and leukemia at the same time? Research has shown that older individuals with systemic lupus erythematosus (SLE) have a higher risk of hematologic malignancies (blood cancers), and outcomes tend to be worse for males, especially when these cancers and related complications are involved.

You may wonder, is SLE like cancer? Although SLE is an autoimmune disorder, not a type of cancer, studies have found a connection between the two. Read on to find out the connection between SLE and leukemia.

What Cancers Are Linked to Lupus?

According to the American Cancer Society, cancer affects 1 in 3 people in the United States. It can develop almost anywhere in the body and is caused by gene mutations (changes) that grow and multiply out of control.

According to the Johns Hopkins Lupus Center, some cancers that people with SLE are more likely to develop include:

• Lymphoma
• Breast cancer
• Lung cancer
• Cervical cancer
• Endometrial cancer

Solid tumors are abnormal masses of tissue that form in organs or tissues, like the breast or prostate. They may be benign (noncancerous) or malignant (cancerous). Those that develop in the blood, bone marrow, or lymphatic system (parts of the circulatory and immune systems) are called blood cancers, or hematologic malignancies.

Blood Cancers

Leukemia and lymphoma each have many subtypes. Knowing the exact type helps doctors choose the best treatment and predict outcomes. Blood cancers are grouped by where they start, how quickly they grow, and which blood cells they affect. For example:

• If cancer starts in the blood or bone marrow, it’s leukemia. If it develops in the lymph nodes or lymphatic tissues, it’s lymphoma.
• When leukemia cells multiply rapidly, causing the disease to progress quickly, it’s called acute. If cells replicate slowly, the disease is considered chronic.
• Leukemia that affects the myeloid white blood cells is called myeloid or myelogenous. If cancer affects white blood cells known as lymphocytes, it’s called lymphocytic or lymphoblastic.

Lymphoma can also progress slowly or quickly and be either more or less aggressive. The most common type of lymphoma is non-Hodgkin lymphoma (NHL), which has many subtypes. People with NHL are at increased risk of developing secondary cancers, including acute myeloid leukemia (AML).

Lupus vs. Leukemia Risk in People With Lupus

People with SLE have 28 times the risk of developing lymphoma and 13 times the risk of developing leukemia compared with the general population.

Acute Myeloid Leukemia

AML is one type of cancer that people with SLE are more likely to develop. AML is a rare disease, accounting for just 1 percent of new cancer diagnoses. Even so, AML is one of the most common types of leukemia diagnosed in adults, with an estimated 20,800 new cases in the United States in 2024.

According to Surveillance, Epidemiology, and End Results (SEER) data, published by the National Cancer Institute, the five-year relative survival rate for AML is about 32 percent. That means about 3 out of 10 people with AML will be alive five years after their diagnosis. The most common treatment for AML is chemotherapy, with promising new therapies on the horizon.

Lupus and Cancer Risk

A 2018 study found that having SLE increases a person’s risk of developing 16 types of cancer, including the blood cancers leukemia, NHL, Hodgkin lymphoma, and multiple myeloma. The same study found that SLE may reduce the risk of prostate cancer and melanoma. In this study, SLE didn’t seem to affect ovarian, pancreatic, colorectal, or brain cancer risk.

Given this information, you may wonder, can lupus turn into cancer? No, lupus itself isn’t a type of cancer, and it cannot directly cause cancer. However, there are many risks that lupus creates that may make it more likely to get cancer in the future.

Can Lupus Cause Leukemia?

In people with leukemia and SLE, which comes first? One study found that about 66 percent of people got their blood cancer diagnosis after their SLE diagnosis, whereas 33 percent got diagnosed with SLE after already having blood cancer. This stat further supports that SLE increases the risk of developing blood cancer.

Do Lupus Treatments Increase Risk of Cancer?

Methotrexate (sold under brand names including Trexall) is a drug used in rheumatology and oncology. It can treat lupus and rheumatoid arthritis, as well as acute lymphoblastic leukemia, chronic myeloid leukemia, NHL, and other types of cancer. Ironically, although it’s used to treat cancers, methotrexate can also raise the risk of developing certain types of cancer including skin cancer, lymphoma, and other blood cancers.

Other immunosuppressive medications used to treat lupus and other autoimmune diseases may also increase the risk of developing one or more types of cancer. These drugs include:

• Azathioprine (Imuran, Azasan)
• Mycophenolate mofetil (CellCept, Myfortic, Myhibbin)
• Cyclosporine (sold under the brand names Neoral, Sandimmune, and Gengraf)
• Cyclophosphamide

Newer immunosuppressive medications, like belimumab (Benlysta) and anifrolumab-fina (Saphnelo), may increase risk of certain cancers. However, because these medications haven’t been around for too long, it’s hard to tell exactly what that risk is.

Remember that drug-related risks depend on dosage and treatment length, but the benefits of effective SLE treatment may outweigh a slightly increased long-term cancer risk.

Can Any Lupus Drugs Reduce the Risk of Blood Cancer?

Not all medications to treat SLE increase your risk for cancer. In fact, one drug in particular — hydroxychloroquine (Plaquenil) — has been found to significantly protect against blood cancer risk in people with lupus.

If you are living with lupus and have concerns about your lupus therapy-related cancer risk, talk with your doctor. Only they can help you weigh the benefits and risks of lupus treatments.

Do Acute Myeloid Leukemia and Lupus Share Risk Factors?

Both conditions are influenced by hereditary and environmental factors, but the exact causes of SLE and cancer remain unclear. Researchers have identified potential risk factors, however, and one risk factor that lupus and AML share seems to be genetics. Although neither condition is considered a hereditary disease, having a close family member with either SLE or AML appears to increase your risk of developing that condition.

Sex

Sex isn’t a shared risk factor for SLE and AML. According to Johns Hopkins Medicine, women are nine times more likely than men to develop lupus, and the American Cancer Society says that AML is more common in men than women. Of note, men with lupus have worse outcomes than women with lupus. Men also have higher mortality rates when their lupus is complicated by blood cancer.

Age

Age is not a shared risk factor. SLE is usually diagnosed in people 15 to 45 years old, while the risk of developing AML increases with age. The average age of a person receiving an AML diagnosis is 69. It’s important to note that people diagnosed with SLE at an older age have a slightly higher chance of developing blood cancer.

Having risk factors doesn’t mean you’ll develop lupus or AML. It only indicates that your risk is higher. Talk to your doctor if you have questions.

Can Leukemia Raise the Risk of Lupus?

Lupus raises leukemia risk, but the opposite is not true — leukemia does not raise the risk of lupus. However, some cancer treatments may cause drug-induced lupus or increase the risk of a milder form called subacute cutaneous lupus.

Cancer drugs linked to an increased risk of lupus include:

• Gemcitabine (Infugem)
• Docetaxel (Docivyx)
• Paclitaxel
• Tamoxifen (Soltamox)
• Fluorouracil
• Capecitabine (Xeloda)
• Doxorubicin with cyclophosphamide

Drug-induced lupus usually clears up within six months of the last dose of medication. If you're concerned about cancer treatment side effects, talk to your oncologist.

Leukemia and Lupus Symptoms in Common

Blood cancers often cause few or no symptoms and can go unnoticed for years. SLE symptoms also vary, come and go, and may overlap with blood cancer symptoms, sometimes being mistaken for illnesses like the common cold or flu.

Like symptoms of lupus, leukemia symptoms include:

• Fatigue
• Night sweats
• Anemia
• Bone or joint pain
• Swollen lymph nodes
• Abnormal bleeding
• Weight loss
• Headaches
• Pallor
• Shortness of breath

This isn’t a complete list. If you are concerned about new or worsening symptoms, always talk with your doctor.

What Labs Are Abnormal With Lupus?

Sometimes, SLE blood work can resemble leukemia. The most important lab results to screen for and diagnose SLE are antibodies. The key tests for SLE include antibodies like antinuclear antibodies (ANA), anti-double-stranded DNA (dsDNA), and anti-Smith antibodies (anti-Sm). Research suggests that people with both SLE and leukemia are less likely to have anti-dsDNA antibodies, which may protect against blood cancers.

Some other blood tests like complete blood count, erythrocyte sedimentation rate, and C-Reactive protein (CRP) or a complete metabolic panel may also be abnormal in cancer and SLE.

Lowering Your Risk of Leukemia

People with SLE may be at higher cancer risk, so regular checkups and cancer screenings are important. Report any health changes to your doctor, and follow these tips to lower cancer risk:

• Eat a healthy diet.
• Exercise.
• Maintain a healthy weight.
• Limit alcohol.
• Avoid tobacco.

Additionally, sun exposure may cause a flare of lupus and can also increase your risk of skin cancers, so use sunblock while you’re outdoors.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 234,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you have questions about lupus and blood cancer? Have you been diagnosed with both lupus and leukemia? Share your experiences in the comments below, or start a conversation by posting on your Activities page.