Coexistence of Amyotrophic Lateral Sclerosis and Lymphoproliferative Disorders – Analysis from a Tertiary Center

Background: The coexistence of motor neuron diseases (MNDs) and lymphoproliferative disorders (LPDs) has been documented historically in a few small retrospective studies but an update is lacking. Objective: The goal of this study is to expand the database of patients with these coexisting diseases, and to describe the natural history and overall outcomes including presumed or identified cause of mortality (neurologic versus oncologic). Materials and methods: A retrospective analysis of all patients within the Cleveland Clinic diagnosed with one or more LPDs between January 1, 2012 and June 30, 2021, was performed to identify patients with a diagnosis of MND. Results: A total of 20 patients with one MND diagnosis and one coexisting LPD were included in the final analysis. Their clinical features are characterized. In 17 patients, the diagnosis of LPD was made prior to the MND diagnosis. Eighteen patients passed away with a mean survival of 49.1 (range: 6 to 128) months from the MND onset. In 16 patients, the cause of death was MND related. The incidence rates of MNDs and myasthenia gravis were examined in a group of 6,169 patients with LPDs. The incidence rate of MNDs in LPDs seems to be higher than those of the general population, appeared over-represented when comparing to the occurrence of myasthenia gravis in LPDs. Conclusion: Coexisting MND and LPD continue to occur. There seems to be an over representation of MND in patients with LPDs.