Does my sister’s recent cancer diagnosis have implications for me as a person taking an immunosuppressant medication?

Here is My Question:
I am a 54-year-old woman who has had MS for approximately 20 years. I am currently taking Gilenya. My younger sister at 52 has just been diagnosed with Hodgkin’s Lymphoma stage one. My question is whether my sister’s recent diagnosis has implications for me, as a person taking an immunosuppressant medication. Additionally, I note in medical literature there may be a link between the two conditions.

Answer:
There are many epidemiological similarities between Hodgkin's lymphoma (HL) and Multiple Sclerosis (MS), most notably peak age incidence in young adults (although there is a bimodal peak with HL and your sister would be considered part of the second older peak population), higher socioeconomic status, genetic associations (especially HLA locus) and links to Epstein Barr Virus and decreased Vitamin D levels. In fact a genomic meta analysis suggested that HL is more closely associated with autoimmune diseases than cancers.

Epidemiological studies demonstrate clustering of HL and MS within families but not within individuals. This means that there is a higher risk of both diseases occurring within the first degree relatives of the same family but NOT within any individual member of the family. 

So to answer your question, I see no particular reason for your sister's HL diagnosis to have any impact on your care or management. There is no known association between treatment with Gilenya and HL. 

​Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego