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Shu Y, Wu Z, Yang X, Song M, Ye Y, Zhang C, Yuan Q, Wang L. The burden of epilepsy in the People's Republic of China from 1990 to 2019: epidemiological trends and comparison with the global burden of epilepsy. Front Neurol 2023; 14:1303531. [PMID: 38146443 PMCID: PMC10749336 DOI: 10.3389/fneur.2023.1303531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/23/2023] [Indexed: 12/27/2023] Open
Abstract
Background Epilepsy is associated with a significant global burden of disease, affecting over 50 million people worldwide. The specific aim of this study is to compare the burden of epilepsy in the People's Republic of China (PRC) with the global burden, and to analyze the epidemiological trends of epilepsy, the relationship between the burden of epilepsy and social demographic index (SDI), and the relative contributions of epidemiological factors. Methods This is a retrospective population-based study, data were obtained from the Global Burden of Disease (GBD) study in 2019. We employed Joinpoint software and the age-period-cohort (APC) model to analyze epilepsy's epidemiological trends. Health inequality analysis was conducted to investigate the impact of SDI on epilepsy burden. Decomposition analysis was performed to examine the relative contributions of age, population, and epidemiological changes to epilepsy. Results Between 1990 and 2019, the incidence rate in the PRC increased by 45%, significantly surpassing the global incidence of epilepsy. However, Disability-Adjusted Life Years (DALY) decreased notably, and the proportion of Years of Life Lost (YLL) decreased from 62.73 to 39.03%. Concerning incidence, the period Rate Ratio (RR) in the PRC initially increased and then decreased, while the cohort RR in the PRC and globally exhibited a consistent upward trend. In terms of mortality, period RR and cohort RR in the PRC displayed a gradual decrease, with mortality starting higher but eventually falling below the global mortality. The net drifts of incidence were greater than 0, whereas the net drifts of mortality were less than 0, both were lower in the PRC than at the global level. Decomposition analysis indicated that the changes of incidence and mortality in the PRC were mainly attributed to epidemiological changes. Additionally, global disparities in epilepsy decreased, with the burden concentrating in low SDI countries. Conclusion The incidence of epilepsy in the PRC rose during the 30-year study period, while epilepsy mortality decreased. The improved survival rate in the PRC is predominantly attributable to epidemiological changes. The burden of epilepsy in the PRC predominantly affects males, children, and the elderly, Chinese government should focus on specific populations.
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Affiliation(s)
- Yun Shu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhifeng Wu
- Department of Pediatrics, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Xiaolin Yang
- National Comprehensive Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Min Song
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yangyang Ye
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunqing Zhang
- National Comprehensive Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Qing Yuan
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li Wang
- Department of Neurology, Second Affiliated Hospital, Army Medical University, Chongqing, China
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Chen X, Xiang X, Xia W, Li X, Wang S, Ye S, Tian L, Zhao L, Ai F, Shen Z, Nie K, Deng M, Wang X. Evolving Trends and Burden of Inflammatory Bowel Disease in Asia, 1990-2019: A Comprehensive Analysis Based on the Global Burden of Disease Study. J Epidemiol Glob Health 2023; 13:725-739. [PMID: 37653213 PMCID: PMC10686927 DOI: 10.1007/s44197-023-00145-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Asia's inflammatory bowel disease (IBD) burden has rapidly increased recently, but the epidemiological trends in Asia remain unclear. We report IBD's incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALY) in 52 Asian countries from 1990 to 2019. METHODS Data from the Global Burden of Disease 2019 were analyzed for IBD burden across 52 countries, using metrics like incidence, prevalence, mortality rates, and DALY. The epidemiological trend of IBD from 1990 to 2019 was assessed with the Joinpoint and APC methods. Decomposition and frontier analyses examined factors behind IBD case and death changes. The NORPRED forecasted Asia's morbidity and mortality trends from 2019 to 2044. RESULTS From 1990 to 2019, The incidence and prevalence of IBD increased in Asia, while mortality and DALY decreased. East Asia had the highest increase in disease burden. IBD incidence was highest among the 30-34 age group, with prevalence peaking in the 45-49 age group. In high-income regions, IBD peak age shifted to younger groups. Decompose analysis showed population growth as the primary factor for the increasing IBD cases in Asia. NORDPRED model predicted a continued IBD burden increase in Asia over the next 25 years. CONCLUSIONS Between 1990 and 2019, ASIR and ASPR of IBD in Asia increased, while ASMR and ASDR decreased. Due to population growth and aging, the IBD burden is expected to rise over the next 25 years, particularly in East Asia.
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Affiliation(s)
- Xuejie Chen
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Xin Xiang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Weitong Xia
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Xindi Li
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Sidan Wang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Shuyu Ye
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Li Tian
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Lian Zhao
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Feiyan Ai
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Zhaohua Shen
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Kai Nie
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China
| | - Minzi Deng
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China.
| | - Xiaoyan Wang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, 410013, Hunan, People's Republic of China.
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3
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Borré CI, Boyle B, Lynch K, Kanaparthi A, Csizmar CM, Larson DP, Braithwaite MD, Johnson IM, Witzig TE, Suarez DA. Burkitt Lymphoma Presenting as Ileocolic Intussusception in an Adult. OPEN JOURNAL OF BLOOD DISEASES 2023; 13:121-132. [PMID: 38361601 PMCID: PMC10868555 DOI: 10.4236/ojbd.2023.134014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Adult intussusception is rare, highly associated with a malignant lead point, and often requires emergent surgical management. We report the case of a 44-year-old male who presented with generalized abdominal pain and was found to have early ileocolic intussusception secondary to a large ileocecal mass. Biopsies of the mass and an enlarged cardiophrenic lymph node, as well as pleural fluid cytology were all consistent with Burkitt lymphoma (BL). Curiously, the patient's abdominal exam was reassuring, and the intussusception and malignant bowel obstruction resolved over 36 hours with conservative management alone. With a Burkitt lymphoma international prognostic index (BL-IPI) score of 2, the patient proceeded to treatment with combination chemoimmunotherapy and attained a complete response after four cycles. There was no bowel perforation or recurrent intussusception throughout treatment. Thus, this report marks the first reported case of adult BL-associated intussusception to resolve with non-invasive management and establishes a precedent for conservative management in select patients.
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Affiliation(s)
| | | | - Kelsey Lynch
- Department of Medicine, Mayo Clinic, Rochester, USA
| | | | | | - Daniel Philip Larson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA
| | | | | | | | - Diego Armando Suarez
- Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, USA
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4
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Mburu W, Devesa SS, Check D, Shiels MS, Mbulaiteye SM. Incidence of Burkitt lymphoma in the United States during 2000 to 2019. Int J Cancer 2023; 153:1182-1191. [PMID: 37278097 PMCID: PMC10524887 DOI: 10.1002/ijc.34618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 06/07/2023]
Abstract
Burkitt lymphoma (BL) is an aggressive B-cell lymphoma that occurs worldwide. A study of BL in the US National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program during 1973 to 2005 (n = 3043) revealed three age-specific incidence peaks of BL and rates that were rising. We studied BL cases diagnosed in SEER 22 during 2000 to 2019 (n = 11 626) to investigate age-specific BL incidence rates and temporal trends. The age-standardized BL incidence rate was 3.96/million person-years, with a 2.85:1 male-to-female ratio. The BL rate among both Hispanic and White individuals was higher than in Black individuals (4.52, 4.12 vs 3.14). Age-specific BL rates showed peaks during pediatric, adult and elderly years in males and pediatric and elderly peaks in females. Based on 4524 BL cases with HIV status (SEER 13), only one peak in adult males (45 years) was observed. Overall age-standardized BL incidence rates rose 1.2%/year (not significant) up to 2009 then fell significantly by 2.4%/year thereafter. Temporal trends in BL rates during 2000 to 2019 varied with age group as pediatric BL rates rose 1.1%/year, while elderly BL rates fell 1.7%/year and adult BL rates rose 3.4%/year until 2007 before falling 3.1%/year thereafter. Overall survival from BL was 64% at 2 years, being highest in pediatric patients and lowest in Black and elderly individuals vs other subgroups. Survival improved by 20% between 2000 and 2019. Our data suggest that BL age-specific incidence rates are multimodal and that overall BL rates rose up to 2009 and then fell, suggesting changes in etiological factors or diagnosis.
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Affiliation(s)
| | - Susan S. Devesa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - David Check
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Meredith S. Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Sam M. Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
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5
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Thomas N, Dreval K, Gerhard DS, Hilton LK, Abramson JS, Ambinder RF, Barta S, Bartlett NL, Bethony J, Bhatia K, Bowen J, Bryan AC, Cesarman E, Casper C, Chadburn A, Cruz M, Dittmer DP, Dyer MA, Farinha P, Gastier-Foster JM, Gerrie AS, Grande BM, Greiner T, Griner NB, Gross TG, Harris NL, Irvin JD, Jaffe ES, Henry D, Huppi R, Leal FE, Lee MS, Martin JP, Martin MR, Mbulaiteye SM, Mitsuyasu R, Morris V, Mullighan CG, Mungall AJ, Mungall K, Mutyaba I, Nokta M, Namirembe C, Noy A, Ogwang MD, Omoding A, Orem J, Ott G, Petrello H, Pittaluga S, Phelan JD, Ramos JC, Ratner L, Reynolds SJ, Rubinstein PG, Sissolak G, Slack G, Soudi S, Swerdlow SH, Traverse-Glehen A, Wilson WH, Wong J, Yarchoan R, ZenKlusen JC, Marra MA, Staudt LM, Scott DW, Morin RD. Genetic subgroups inform on pathobiology in adult and pediatric Burkitt lymphoma. Blood 2023; 141:904-916. [PMID: 36201743 PMCID: PMC10023728 DOI: 10.1182/blood.2022016534] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/20/2022] Open
Abstract
Burkitt lymphoma (BL) accounts for most pediatric non-Hodgkin lymphomas, being less common but significantly more lethal when diagnosed in adults. Much of the knowledge of the genetics of BL thus far has originated from the study of pediatric BL (pBL), leaving its relationship to adult BL (aBL) and other adult lymphomas not fully explored. We sought to more thoroughly identify the somatic changes that underlie lymphomagenesis in aBL and any molecular features that associate with clinical disparities within and between pBL and aBL. Through comprehensive whole-genome sequencing of 230 BL and 295 diffuse large B-cell lymphoma (DLBCL) tumors, we identified additional significantly mutated genes, including more genetic features that associate with tumor Epstein-Barr virus status, and unraveled new distinct subgroupings within BL and DLBCL with 3 predominantly comprising BLs: DGG-BL (DDX3X, GNA13, and GNAI2), IC-BL (ID3 and CCND3), and Q53-BL (quiet TP53). Each BL subgroup is characterized by combinations of common driver and noncoding mutations caused by aberrant somatic hypermutation. The largest subgroups of BL cases, IC-BL and DGG-BL, are further characterized by distinct biological and gene expression differences. IC-BL and DGG-BL and their prototypical genetic features (ID3 and TP53) had significant associations with patient outcomes that were different among aBL and pBL cohorts. These findings highlight shared pathogenesis between aBL and pBL, and establish genetic subtypes within BL that serve to delineate tumors with distinct molecular features, providing a new framework for epidemiologic, diagnostic, and therapeutic strategies.
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Affiliation(s)
- Nicole Thomas
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Kostiantyn Dreval
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Daniela S. Gerhard
- Office of Cancer Genomics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Laura K. Hilton
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC, Canada
| | - Jeremy S. Abramson
- Center for Lymphoma, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Richard F. Ambinder
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stefan Barta
- University of Pennsylvania Hospital, Philadelphia, PA
| | - Nancy L. Bartlett
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO
| | - Jeffrey Bethony
- Department of Microbiology, Immunology, and Tropical Medicine, George Washington University, Washington, DC
| | | | - Jay Bowen
- Biopathology Center, Nationwide Children's Hospital, Columbus, OH
| | - Anthony C. Bryan
- Biopathology Center, Nationwide Children's Hospital, Columbus, OH
| | - Ethel Cesarman
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, Cornell University, New York, NY
| | - Corey Casper
- Infectious Disease Research Institute, Seattle, WA
| | - Amy Chadburn
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY
| | - Manuela Cruz
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Dirk P. Dittmer
- Lineberger Comprehensive Cancer Center and Department of Microbiology and Immunology, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Maureen A. Dyer
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, MD
| | - Pedro Farinha
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC, Canada
| | - Julie M. Gastier-Foster
- Biopathology Center, Nationwide Children's Hospital, Columbus, OH
- Departments of Pathology and Pediatrics, The Ohio State University, Columbus, OH
| | - Alina S. Gerrie
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC, Canada
| | | | - Timothy Greiner
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Nicholas B. Griner
- Office of Cancer Genomics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Thomas G. Gross
- Center for Global Health, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Nancy L. Harris
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - John D. Irvin
- Foundation for Burkitt Lymphoma Research, Geneva, Switzerland
| | - Elaine S. Jaffe
- Laboratory of Pathology, Clinical Center, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - David Henry
- University of Pennsylvania Hospital, Philadelphia, PA
| | - Rebecca Huppi
- Office of HIV/AIDS Malignancies, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Fabio E. Leal
- Programa de Oncovirologia, Instituto Nacional de Cancer Jose de Alencar, Rio de Janeiro, Brazil
| | - Michael S. Lee
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | - Sam M. Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Ronald Mitsuyasu
- Center for Clinical AIDS Research and Education, University of California Los Angeles, Los Angeles, CA
| | - Vivian Morris
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | | | - Andrew J. Mungall
- Canada's Michael Smith Genome Sciences Centre at BC Cancer, Vancouver, BC, Canada
| | - Karen Mungall
- Canada's Michael Smith Genome Sciences Centre at BC Cancer, Vancouver, BC, Canada
| | | | - Mostafa Nokta
- Office of HIV/AIDS Malignancies, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Ariela Noy
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | | | | | | | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus and Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Hilary Petrello
- Biopathology Center, Nationwide Children's Hospital, Columbus, OH
| | - Stefania Pittaluga
- Laboratory of Pathology, Clinical Center, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - James D. Phelan
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Juan Carlos Ramos
- Department of Medicine, Division of Hematology, University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Lee Ratner
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO
| | - Steven J. Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Paul G. Rubinstein
- Section of Hematology/Oncology, John H. Stroger Jr Hospital of Cook County, Chicago, IL
| | - Gerhard Sissolak
- Tygerberg Academic Hospital and Stellenbosch University, Cape Town, South Africa
| | - Graham Slack
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC, Canada
| | - Shaghayegh Soudi
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Steven H. Swerdlow
- Division of Hematopathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Alexandra Traverse-Glehen
- Hospices Civils de Lyon, Université Lyon 1, Service d'Anatomie Pathologique, Hopital Lyon Sud France
| | - Wyndham H. Wilson
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Jasper Wong
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC, Canada
| | - Robert Yarchoan
- Office of HIV/AIDS Malignancies, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Jean C. ZenKlusen
- The Cancer Genome Atlas, Center for Cancer Genomics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Marco A. Marra
- Canada's Michael Smith Genome Sciences Centre at BC Cancer, Vancouver, BC, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Louis M. Staudt
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - David W. Scott
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC, Canada
| | - Ryan D. Morin
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC, Canada
- Canada's Michael Smith Genome Sciences Centre at BC Cancer, Vancouver, BC, Canada
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6
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Muhealdeen DN, Shwan A, Yaqo RT, Hassan HA, Muhammed BO, Ali RM, Hughson MD. Epstein-Barr virus and Burkitt's lymphoma. Associations in Iraqi Kurdistan and twenty-two countries assessed in the International Incidence of Childhood Cancer. Infect Agent Cancer 2022; 17:39. [PMID: 35897021 PMCID: PMC9327396 DOI: 10.1186/s13027-022-00452-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Burkitt's lymphoma (BL) has worldwide variations in incidence that are related to the age of Epstein-Barr virus (EBV) infection. This study examined the age-specific incidence rate (ASIR) of BL and community EBV seropositivity in Iraqi Kurdistan and compared results with data from countries tabulated in the International Incidence of Childhood Cancer volume 3 (IICC-3). Methods The ASIR (95% confidence intervals) of BL in Sulaimani Governorate of Iraqi Kurdistan were calculated for the years 2010–2020. Specimens from 515 outpatients were tested for IgG and IgM antibodies to EBV viral capsid antigen.
Results In Sulaimani, 84% of BL occurred under 20 years of age, with an ASIR of 6.2 (4.7–7.7) per million children. This ASIR was not significantly different than that of Egypt, Morocco, Israel, Spain, or France. It was slightly higher than the ASIR of the United States, the United Kingdom, and Germany and markedly higher than for Asia and South Africa. In Africa and much of Asia, early childhood EBV exposure predominates, with nearly all children being infected by 5 years of age. In Sulaimani, just over 50% of children were EBV seropositive at 3 years old and 90% seropositivity was reached at 15 years of age. In Europe and North America, seropositivity is commonly delayed until adolescence or young adulthood and adult predominates over childhood BL. Conclusion In the Middle East, childhood BL is relatively common and adult BL is rare. In Sulaimani, EBV seropositivity increases progressively throughout childhood and reaches 92% at mid-adolescence. This may reflect the Mid East more widely. We suggest that the high childhood and low adult BL rates may be a regional effect of a pattern of EBV exposure intermediate between early childhood and adolescent and young adult infections.
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Affiliation(s)
- Dana N Muhealdeen
- Sulaimani University College of Medicine, Sulaymaniyah, Iraq.,Hiwa Cancer Hospital, Sulaymaniyah, Iraq
| | - Alan Shwan
- Hiwa Cancer Hospital, Sulaymaniyah, Iraq
| | - Rafil T Yaqo
- Dohuk University School of Medicine, Dohuk, Iraq
| | - Hemin A Hassan
- Sulaimani University College of Medicine, Sulaymaniyah, Iraq.,Hiwa Cancer Hospital, Sulaymaniyah, Iraq
| | | | - Rawa M Ali
- Sulaimani University College of Medicine, Sulaymaniyah, Iraq.,Hiwa Cancer Hospital, Sulaymaniyah, Iraq
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7
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Malpica L, Marques‐Piubelli ML, Beltran BE, Chavez JC, Miranda RN, Castillo JJ. EBV-positive diffuse large B-cell lymphoma, not otherwise specified: 2022 update on diagnosis, risk-stratification, and management. Am J Hematol 2022; 97:951-965. [PMID: 35472248 DOI: 10.1002/ajh.26579] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/12/2022] [Accepted: 04/16/2022] [Indexed: 01/04/2023]
Abstract
DISEASE OVERVIEW Epstein Barr virus-positive (EBV+) diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) is an entity included in the WHO classification of lymphoid neoplasms since 2016. EBV+ DLBCL, NOS, is an aggressive B-cell lymphoma associated with EBV infection, and a poor prognosis with standard chemotherapeutic approaches. DIAGNOSIS The diagnosis is made through a careful pathological evaluation. Detection of EBV-encoded RNA (EBER) is considered standard for diagnosis; however, a clear cutoff for percentage of positive cells has not been defined. The differential diagnosis includes plasmablastic lymphoma (PBL), DLBCL associated with chronic inflammation, primary effusion lymphoma (PEL), among others. RISK-STRATIFICATION The International Prognostic Index (IPI) and the Oyama score can be used for risk-stratification. The Oyama score includes age >70 years and presence of B symptoms. The expression of CD30 and PD-1/PD-L1 are emerging as potential adverse but targetable biomarkers. MANAGEMENT Patients with EBV+ DLBCL, NOS, should be staged and managed following similar guidelines than patients with EBV-negative DLBCL. EBV+ DLBCL, NOS, however, might have a worse prognosis than EBV-negative DLBCL in the era of chemoimmunotherapy. Therefore, the inclusion of patients in clinical trials when available is recommended. There is an opportunity to study and develop targeted therapy in the management of patients with EBV+ DLBCL, NOS.
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Affiliation(s)
- Luis Malpica
- Department of Lymphoma and Myeloma The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Mario L. Marques‐Piubelli
- Department of Translational Molecular Pathology The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Brady E. Beltran
- Department of Oncology and Radiotherapy Hospital Nacional Edgardo Rebagliati Martins Lima Peru
- Instituto de Ciencias Biomédicas Universidad Ricardo Palma Lima Peru
| | - Julio C. Chavez
- Department of Malignant Hematology H. Lee Moffitt Cancer Center and Research Institute Tampa Florida USA
| | - Roberto N. Miranda
- Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Jorge J. Castillo
- Division of Hematologic Malignancies, Dana‐Farber Cancer Institute Harvard Medical School Boston Massachusetts USA
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8
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Improved survival of Burkitt lymphoma/leukemia patients: observations from Poland, 1999-2020. Ann Hematol 2022; 101:1059-1065. [PMID: 35293608 DOI: 10.1007/s00277-022-04758-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/10/2022] [Indexed: 11/01/2022]
Abstract
The aim of this study was to estimate the survival of Polish Burkitt lymphoma/leukemia (BL) patients diagnosed between 1999 and 2017, considering multiple covariates and periods, to reflect changes in BL treatment. We identified all BL patients registered in the Polish National Cancer Registry in 1999-2017. Observed survival (OS) was evaluated deploying the life table method. Univariate and multivariate Cox proportional hazards regression models were fit to generate hazard ratios (HR) and the corresponding 95% confidence intervals (95% CI), describing the association between exposures (sex, age at the diagnosis, year of diagnosis, and region of residence) and time-to-event (death). Two-sided log-rank test was applied to assess the significance of exposures. Overall, 937 BL cases were included in the study (654 men and 283 women). Between the periods 1999-2005 and 2015-2017, the 3-year OS changed from 56.0% (95% CI 50.4 to 62.2%) to 73.8% (68.1 to 80.0%; P < 0.001), and the 5-year OS increased from 53.8% (48.2 to 60.0%) to 73.0% (67.1 to 79.3%; P < 0.001). The death HR was significantly higher in adolescents and young adults' (AYA) and adults' groups than in pediatric patients (HR = 3.00, 95% CI 2.05 to 4.39, P < 0.001, for AYA; and HR = 7.30, 5.14 to 10.3, P < 0.001, for adults). During the last two decades, the survival of Polish BL patients has been systematically improving. The death hazard ratio is most significantly associated with the patients' age at diagnosis and year of diagnosis, and not associated with sex or region of residence.
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Bauer M, Jasinski-Bergner S, Mandelboim O, Wickenhauser C, Seliger B. Epstein-Barr Virus-Associated Malignancies and Immune Escape: The Role of the Tumor Microenvironment and Tumor Cell Evasion Strategies. Cancers (Basel) 2021; 13:cancers13205189. [PMID: 34680337 PMCID: PMC8533749 DOI: 10.3390/cancers13205189] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary The Epstein–Barr virus, also termed human herpes virus 4, is a human pathogenic double-stranded DNA virus. It is highly prevalent and has been linked to the development of 1–2% of cancers worldwide. EBV-associated malignancies encompass various structural and epigenetic alterations. In addition, EBV-encoded gene products and microRNAs interfere with innate and adaptive immunity and modulate the tumor microenvironment. This review provides an overview of the characteristic features of EBV with a focus on the intrinsic and extrinsic immune evasion strategies, which contribute to EBV-associated malignancies. Abstract The detailed mechanisms of Epstein–Barr virus (EBV) infection in the initiation and progression of EBV-associated malignancies are not yet completely understood. During the last years, new insights into the mechanisms of malignant transformation of EBV-infected cells including somatic mutations and epigenetic modifications, their impact on the microenvironment and resulting unique immune signatures related to immune system functional status and immune escape strategies have been reported. In this context, there exists increasing evidence that EBV-infected tumor cells can influence the tumor microenvironment to their own benefit by establishing an immune-suppressive surrounding. The identified mechanisms include EBV gene integration and latent expression of EBV-infection-triggered cytokines by tumor and/or bystander cells, e.g., cancer-associated fibroblasts with effects on the composition and spatial distribution of the immune cell subpopulations next to the infected cells, stroma constituents and extracellular vesicles. This review summarizes (i) the typical stages of the viral life cycle and EBV-associated transformation, (ii) strategies to detect EBV genome and activity and to differentiate various latency types, (iii) the role of the tumor microenvironment in EBV-associated malignancies, (iv) the different immune escape mechanisms and (v) their clinical relevance. This gained information will enhance the development of therapies against EBV-mediated diseases to improve patient outcome.
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Affiliation(s)
- Marcus Bauer
- Department of Pathology, Martin Luther University Halle-Wittenberg, Magdeburger Str. 14, 06112 Halle (Saale), Germany; (M.B.); (C.W.)
| | - Simon Jasinski-Bergner
- Department of Medical Immunology, Martin Luther University Halle-Wittenberg, Magdeburger Str. 2, 06112 Halle (Saale), Germany;
| | - Ofer Mandelboim
- Department of Immunology, Faculty of Medicine, The Hebrew University of Jerusalem, En Kerem, P.O. Box 12271, Jerusalem 91120, Israel;
| | - Claudia Wickenhauser
- Department of Pathology, Martin Luther University Halle-Wittenberg, Magdeburger Str. 14, 06112 Halle (Saale), Germany; (M.B.); (C.W.)
| | - Barbara Seliger
- Department of Medical Immunology, Martin Luther University Halle-Wittenberg, Magdeburger Str. 2, 06112 Halle (Saale), Germany;
- Fraunhofer Institute for Cell Therapy and Immunology, Perlickstr. 1, 04103 Leipzig, Germany
- Correspondence: ; Tel.: +49-(345)-557-1357
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10
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Aguayo F, Boccardo E, Corvalán A, Calaf GM, Blanco R. Interplay between Epstein-Barr virus infection and environmental xenobiotic exposure in cancer. Infect Agent Cancer 2021; 16:50. [PMID: 34193233 PMCID: PMC8243497 DOI: 10.1186/s13027-021-00391-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/18/2021] [Indexed: 12/15/2022] Open
Abstract
Epstein-Barr virus (EBV) is a herpesvirus associated with lymphoid and epithelial malignancies. Both B cells and epithelial cells are susceptible and permissive to EBV infection. However, considering that 90% of the human population is persistently EBV-infected, with a minority of them developing cancer, additional factors are necessary for tumor development. Xenobiotics such as tobacco smoke (TS) components, pollutants, pesticides, and food chemicals have been suggested as cofactors involved in EBV-associated cancers. In this review, the suggested mechanisms by which xenobiotics cooperate with EBV for carcinogenesis are discussed. Additionally, a model is proposed in which xenobiotics, which promote oxidative stress (OS) and DNA damage, regulate EBV replication, promoting either the maintenance of viral genomes or lytic activation, ultimately leading to cancer. Interactions between EBV and xenobiotics represent an opportunity to identify mechanisms by which this virus is involved in carcinogenesis and may, in turn, suggest both prevention and control strategies for EBV-associated cancers.
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Affiliation(s)
| | - Enrique Boccardo
- Laboratory of Oncovirology, Department of Microbiology, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Alejandro Corvalán
- Advanced Center for Chronic Diseases (ACCDiS), Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gloria M Calaf
- Instituto de Alta Investigación, Universidad de Tarapacá, 1000000, Arica, Chile.,Center for Radiological Research, Columbia University Medical Center, New York, NY, 10032, USA
| | - Rancés Blanco
- Laboratorio de Oncovirología, Programa de Virología, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, Santiago, Chile
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11
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Roy SF, Ghazawi FM, Le M, Lagacé F, Roy CF, Rahme E, Savin E, Zubarev A, Sasseville D, Popradi G, Litvinov IV. Epidemiology of adult and pediatric Burkitt lymphoma in Canada: sequelae of the HIV epidemic. ACTA ACUST UNITED AC 2020; 27:83-89. [PMID: 32489250 DOI: 10.3747/co.27.5775] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Although the pathogenesis and epidemiology of endemic Burkitt lymphoma (bl) have been extensively studied, the epidemiologic landscape of sporadic and immunodeficiency-associated bl in North America remains poorly understood. Methods We used 3 distinct population-based cancer registries to retrospectively study bl incidence and mortality in Canada. Data for patient sex; age at the time of diagnosis; and reporting province, city, and forward sortation area (fsa, the first three characters of a postal code) were analyzed. Results During 1992-2010, 1420 patients with bl in Canada were identified (incidence rate: 2.40 cases per million patient-years), of which 71.1% were male patients. Mean age at diagnosis was 55.5 ± 20.8 years. A bimodal incidence by age distribution was seen in both sexes, with pediatric- and adult-onset peaks. An analysis based on fsas identified select communities with statistically higher rates of adult bl. Several of those fsas were located within the 3 major metropolitan areas (Montreal, Vancouver, Toronto) and within self-identified lgbtq communities. The fsas with a higher socioeconomic status score were associated with lower rates of bl. Conclusions Current results highlight the geographic and historic pattern of bl in Canada. The human immunodeficiency virus remains an important risk factor for adult bl.
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Affiliation(s)
- S F Roy
- Division of Pathology, University of Montreal, Montreal, QC
| | - F M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, ON
| | - M Le
- Division of Dermatology, McGill University, Montreal, QC
| | - F Lagacé
- Division of Dermatology, McGill University, Montreal, QC.,Faculty of Medicine, McGill University, Montreal, QC
| | - C F Roy
- Faculty of Medicine, McGill University, Montreal, QC
| | - E Rahme
- Division of Clinical Epidemiology, McGill University, Montreal, QC
| | - E Savin
- Division of Dermatology, McGill University, Montreal, QC
| | - A Zubarev
- Division of Dermatology, McGill University, Montreal, QC
| | - D Sasseville
- Division of Dermatology, McGill University, Montreal, QC
| | - G Popradi
- Division of Hematology, McGill University, Montreal, QC
| | - I V Litvinov
- Division of Dermatology, McGill University, Montreal, QC
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12
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Turro J, Singh P, Sarao MS, Tadepalli S, Cheriyath P. Adult Burkitt lymphoma- an Island between lymphomas and leukemias. J Community Hosp Intern Med Perspect 2019; 9:25-28. [PMID: 30788071 PMCID: PMC6374956 DOI: 10.1080/20009666.2019.1574545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 01/18/2019] [Indexed: 11/09/2022] Open
Abstract
Background: Burkitt lymphoma is a rare, aggressive and rapidly fatal, B-cell non-Hodgkin’s lymphoma. It has an incidence of 0.4/100,000 age-adjusted to the USA standard population. Here we describe the case of a 77-year-old patient who presented with Burkitt lymphoma. Case: A 77-year-old male presented to his primary care physician with fatigue and listlessness and was referred to the hospital with a white blood cell count (WBC)-23.7 K/uL (neutrophils 37%, lymphocyte 11%, blasts 9%) and platelets-19 K/uL. During his stay in the hospital, repeat investigations revealed WBC-29.9 K/uL (neutrophils 22%, lymphocyte 27%, atypical lymphocytes 5%, blasts 20%) and platelets-10 K/uL with no evidence of mucosal bleeds, neck or abdominal masses or generalized lymphadenopathy. Bone marrow aspirate revealed the presence of MYC rearrangements (8q24) on flow cytometry and fluorescent in-situ hybridization (FISH), indicative but not typical of BL. He was transfused with platelets due to a rapidly deteriorating platelet count and episodes of epistaxis. He was discharged after four days with a plan of outpatient chemotherapy over a period of 4 months. An Ommaya reservoir was placed in the right ventricle for intrathecal chemotherapy. After four months of chemotherapy, computerized tomography of the chest, abdomen, and pelvis confirmed remission. A magnetic resonance imaging of the brain a month after completion of chemotherapy revealed metastatic lymphoma in the temporal, parietal and occipital lobes. He was discharged to hospice for palliative care. Conclusion: Unconventional presentations, as seen in our case of a leukemia-like picture in the absence of a bulky disease, are the quagmire that might delay aggressive management and result in poorer outcomes.
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Affiliation(s)
- James Turro
- Department of Internal Medicine, Hackensack Meridian Health- Ocean Medical Centre, Brick, NJ, USA
| | - Pratiksha Singh
- Department of Internal Medicine, Hackensack Meridian Health- Ocean Medical Centre, Brick, NJ, USA
| | - Manbeer Singh Sarao
- Department of Internal Medicine, Hackensack Meridian Health- Ocean Medical Centre, Brick, NJ, USA
| | - Satish Tadepalli
- Department of Internal Medicine, Hackensack Meridian Health- Ocean Medical Centre, Brick, NJ, USA
| | - Pramil Cheriyath
- Department of Internal Medicine, Hackensack Meridian Health- Ocean Medical Centre, Brick, NJ, USA
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13
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Karimi P, Birmann BM, Anderson LA, McShane CM, Gadalla SM, Sampson JN, Mbulaiteye SM. Risk factors for Burkitt lymphoma: a nested case-control study in the UK Clinical Practice Research Datalink. Br J Haematol 2018; 181:505-514. [PMID: 29676453 DOI: 10.1111/bjh.15229] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 02/16/2018] [Indexed: 02/06/2023]
Abstract
Burkitt lymphoma (BL) occurs as three subtypes: endemic BL, immunosuppression-related BL and sporadic BL. Descriptive studies of BL age-specific incidence patterns have suggested multimodal peaks near 10, 40 and 70 years of age, but the risk factors for BL at different ages are unknown. We investigated risk factors for BL in the United Kingdom among 156 BL cases and 608 matched BL-free controls identified in the Clinical Practice Research Datalink (CPRD) between 1992 and 2016. Associations with pre-diagnostic body mass index, cigarette smoking, alcohol consumption, hepatitis, Epstein-Barr virus (EBV), human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS), malaria, allergic and autoimmune conditions, and prednisone use were evaluated. Overall, we identified inverse associations between smoking and BL risk, and positive associations between prior EBV infection, HIV/AIDS and prescription or use of prednisone with BL risk. In age-group stratified analyses, BL was associated with malaria exposure (vs. no exposure, odds ratio [OR] 8·00, 95% confidence interval [CI] 1·46-43·7) among those aged 20-59 years old and with hepatitis infection (vs. no infection, OR 3·41, 95% CI 1·01-11·5) among those aged 60+ years old. The effects of EBV, malaria, HIV/AIDS, prednisone and hepatitis on BL remained significant in mutually-adjusted age-group-specific analyses. No risk factors were associated with childhood BL. We report novel associations for BL in non-endemic settings.
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Affiliation(s)
- Parisa Karimi
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Brenda M Birmann
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lesley A Anderson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Charlene M McShane
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Shahinaz M Gadalla
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joshua N Sampson
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sam M Mbulaiteye
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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14
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Mukhtar F, Boffetta P, Risch HA, Park JY, Bubu OM, Womack L, Tran TV, Zgibor JC, Luu HN. Survival predictors of Burkitt's lymphoma in children, adults and elderly in the United States during 2000-2013. Int J Cancer 2017; 140:1494-1502. [PMID: 28006853 DOI: 10.1002/ijc.30576] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/21/2016] [Accepted: 12/08/2016] [Indexed: 02/05/2023]
Abstract
Burkitt's Lymphoma (BL) has three peaks of occurrence, in children, adults and elderly, at 10, 40 and 70 years respectively. To the best of our knowledge, no study has been conducted to assess predictors of survival in the three age groups. We hypothesized that survival predictors may differ by age group. We, therefore, sought to determine survival predictors for BL in these three groups: children (<15 years of age), adults (40-70 years of age) and elderly (>70 years of age). Using the Surveillance, Epidemiology, and End Results (SEER) database covering the years 2000-2013, we identified 797 children, 1,994 adults and 757 elderly patients newly diagnosed with BL. We used adjusted Cox proportional hazards regression models to determine prognostic factors for survival for each age group. Five-year relative survival in BL for children, adults and elderly were 90.4, 47.8 and 28.9%, respectively. Having at least Stage II disease and multiple primaries were associated with higher mortality in the elderly group. In adults, multiple primaries, Stage III or IV disease, African American race and bone marrow primary were associated with increased mortality whereas Stage IV disease and multiple primaries were associated with worse outcome in children. These findings demonstrate commonalities and differences in predictors of survival that may have implications for management of BL patients.
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Affiliation(s)
- Fahad Mukhtar
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Paolo Boffetta
- Icahn School of Medicine, Mount Sinai School of Medicine, Tisch Cancer Institute, New York, NY
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT.,Yale Cancer Center, New Haven, CT
| | - Jong Y Park
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612
| | - Omonigho M Bubu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Lindsay Womack
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Thuan V Tran
- Vietnam National Cancer Hospital, Hanoi, Vietnam.,Vietnam National Institute for Cancer Control, Hanoi, Vietnam
| | - Janice C Zgibor
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Hung N Luu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL.,Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
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15
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Affiliation(s)
- Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - William F Anderson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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16
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Mbulaiteye SM, Morton LM, Sampson JN, Chang ET, Costas L, de Sanjosé S, Lightfoot T, Kelly J, Friedberg JW, Cozen W, Marcos-Gragera R, Slager SL, Birmann BM, Weisenburger DD. Medical history, lifestyle, family history, and occupational risk factors for sporadic Burkitt lymphoma/leukemia: the Interlymph Non-Hodgkin Lymphoma Subtypes Project. J Natl Cancer Inst Monogr 2015; 2014:106-14. [PMID: 25174031 DOI: 10.1093/jncimonographs/lgu003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The etiologic role of medical history, lifestyle, family history, and occupational risk factors in sporadic Burkitt lymphoma (BL) is unknown, but epidemiologic and clinical evidence suggests that risk factors may vary by age. METHODS We investigated risk factors for sporadic BL in 295 cases compared with 21818 controls in a pooled analysis of 18 case-control studies in the International Lymphoma Epidemiology Consortium (InterLymph). Cases were defined to include typical BL or Burkitt-like lymphoma. Odds ratios (ORs) and 95% confidence intervals (CIs) for associations were calculated separately for younger (<50 years) and older (≥ 50 years) BL using multivariate logistic regression. RESULTS Cases included 133 younger BL and 159 older BL (age was missing for three cases) and they were evenly split between typical BL (n = 147) and Burkitt-like lymphoma (n = 148). BL in younger participants was inversely associated with a history of allergy (OR = 0.58; 95% CI = 0.32 to 1.05), and positively associated with a history of eczema among individuals without other atopic conditions (OR = 2.54; 95% CI = 1.20 to 5.40), taller height (OR = 2.17; 95% CI = 1.08 to 4.36), and employment as a cleaner (OR = 3.49; 95% CI = 1.13 to 10.7). BL in older participants was associated with a history of hepatitis C virus seropositivity (OR = 4.19; 95% CI = 1.05 to 16.6) based on three exposed cases. Regardless of age, BL was inversely associated with alcohol consumption and positively associated with height. CONCLUSIONS Our data suggest that BL in younger and older adults may be etiologically distinct.
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Affiliation(s)
- Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Ellen T Chang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Laura Costas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Silvia de Sanjosé
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Tracy Lightfoot
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Jennifer Kelly
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Jonathan W Friedberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Wendy Cozen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Rafael Marcos-Gragera
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Susan L Slager
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Brenda M Birmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Dennis D Weisenburger
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health Bethesda, MD (SMM, LMM, JNS); Center for Epidemiology and Computational Biology, Health Sciences Practice, Exponent, Inc, Menlo Park, CA, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER Epidemiologia y Salud Publica, Barcelona, Spain (LC, SdS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JK, JWF); Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA (WC); Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute, Catalan Institute of Oncology-Girona, Girona, Spain (RM-G); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (BMB); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
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17
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Rosenberg PS, Check DP, Anderson WF. A web tool for age-period-cohort analysis of cancer incidence and mortality rates. Cancer Epidemiol Biomarkers Prev 2014; 23:2296-302. [PMID: 25146089 DOI: 10.1158/1055-9965.epi-14-0300] [Citation(s) in RCA: 287] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Age-period-cohort (APC) analysis can inform registry-based studies of cancer incidence and mortality, but concerns about statistical identifiability and interpretability, as well as the learning curves of statistical software packages, have limited its uptake. METHODS We implemented a panel of easy-to-interpret estimable APC functions and corresponding Wald tests in R code that can be accessed through a user-friendly Web tool. RESULTS Input data for the Web tool consist of age-specific numbers of events and person-years over time, in the form of a rate matrix of paired columns. Output functions include model-based estimators of cross-sectional and longitudinal age-specific rates, period and cohort rate ratios that incorporate the overall annual percentage change (net drift), and estimators of the age-specific annual percentage change (local drifts). The Web tool includes built-in examples for teaching and demonstration. User data can be input from a Microsoft Excel worksheet or by uploading a comma-separated-value file. Model outputs can be saved in a variety of formats, including R and Excel. CONCLUSIONS APC methodology can now be carried out through a freely available user-friendly Web tool. The tool can be accessed at http://analysistools.nci.nih.gov/apc/. IMPACT The Web tool can help cancer surveillance researchers make important discoveries about emerging cancer trends and patterns.
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Affiliation(s)
- Philip S Rosenberg
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland.
| | - David P Check
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland
| | - William F Anderson
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland
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18
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Mbulaiteye SM, Pullarkat ST, Nathwani BN, Weiss LM, Rao N, Emmanuel B, Lynch CF, Hernandez B, Neppalli V, Hawes D, Cockburn MG, Kim A, Williams M, Altekruse S, Bhatia K, Goodman MT, Cozen W. Epstein-Barr virus patterns in US Burkitt lymphoma tumors from the SEER residual tissue repository during 1979-2009. APMIS 2013; 122:5-15. [PMID: 23607450 DOI: 10.1111/apm.12078] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 02/18/2013] [Indexed: 11/28/2022]
Abstract
Burkitt lymphoma (BL) occurs at all ages, but the patterns of Epstein-Barr virus (EBV) positivity in relation to human immunodeficiency virus (HIV), immunoprofiles and age have not been fully explored. BL tissues from residual tissue repositories, and two academic centers in the United States were examined by expert hematopathologists for morphology, immunohistochemistry, MYC rearrangement, EBV-encoded RNA (EBER), and diagnosed according to the 2008 WHO lymphoma classification. Analysis was done using frequency tables, Chi-squared statistics, and Student's t-test. Of 117 cases examined, 91 were confirmed as BL. The age distribution was 26%, 15%, 19%, and 29% for 0-19, 20-34, 35-59, 60+ years, and missing in 11%. MYC rearrangement was found in 89% and EBER positivity in 29% of 82 cases with results. EBER positivity varied with age (from 13% in age group 0-19 to 55% in age group 20-34, and fell to 25% in age group 60+ years, p = 0.08); with race (56% in Blacks/Hispanics vs 21% in Whites/Asians/Pacific Islanders, p = 0.006); and by HIV status (64% in HIV positive vs 22% in HIV negative cases, p = 0.03). EBER positivity was demonstrated in about one-third of tumors and it was strongly associated with race and HIV status, and marginally with age-group.
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Affiliation(s)
- Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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19
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Mbulaiteye SM, Clarke CA, Morton LM, Gibson TM, Pawlish K, Weisenburger DD, Lynch CF, Goodman MT, Engels EA. Burkitt lymphoma risk in U.S. solid organ transplant recipients. Am J Hematol 2013; 88:245-50. [PMID: 23386365 PMCID: PMC3608801 DOI: 10.1002/ajh.23385] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 12/17/2012] [Accepted: 12/20/2012] [Indexed: 01/07/2023]
Abstract
Case reports of Burkitt lymphoma (BL) in transplant recipients suggest that the risk is markedly elevated. Therefore, we investigated the incidence of BL in 203,557 solid organ recipients in the U.S. Transplant Cancer Match Study (1987-2009) and compared it with the general population using standardized incidence ratios. We also assessed associations with demographic and clinical characteristics, and treatments used to induce therapeutic immunosuppression. BL incidence was 10.8 per 100,000 person-years, representing 23-fold (95% confidence interval (CI) 19-28) greater risk than in the general population, and it peaked 3-8 years after the time of transplantation. In adjusted analyses, BL incidence was higher in recipients transplanted when <18 vs. ≥35 years (incidence rate ratio [IRR] 3.49, 95% CI 2.08-5.68) and in those transplanted with a liver (IRR 2.91, 95% CI 1.68-5.09) or heart (IRR 2.39, 95% CI 1.30-4.31) compared with kidney. BL incidence was lower in females than males (IRR 0.45, 95% CI 0.28-0.71), in blacks than whites (IRR 0.33, 95% CI 0.12-0.74), in those with a baseline Epstein-Barr virus (EBV)-seropositive versus EBV-seronegative status (IRR 0.34, 95% CI 0.13-0.93), and in those treated with azathioprine (IRR 0.56, 95% CI 0.34-0.89) or corticosteroids (IRR 0.48, 95% CI 0.29-0.82). Tumors were EBV-positive in 69% of 32 cases with results. EBV positivity was 90% in those aged <18 years and 59% in those aged 18+ years. In conclusion, BL risk is markedly elevated in transplant recipients, and it is associated with certain demographic and clinical features. EBV was positive in most but not all BL cases with results.
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Affiliation(s)
- Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
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20
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Rosenberg PS, Wilson KL, Anderson WF. Are incidence rates of adult leukemia in the United States significantly associated with birth cohort? Cancer Epidemiol Biomarkers Prev 2012; 21:2159-66. [PMID: 23064005 DOI: 10.1158/1055-9965.epi-12-0910] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Leukemia is a common cancer among U.S. adults but there are few established risk factors. If leukemia risks are substantially influenced by exposures that vary in prevalence across generations, then population incidence rates should vary significantly by birth cohort. However, prior studies have not examined leukemia birth cohort effects using contemporary data and methods. METHODS We used incidence data from the National Cancer Institute's Surveillance, Epidemiology and End Results Program from 1992 through 2009 for adults 25-84 years old and age period cohort models to estimate incidence rate ratios according to birth cohort for acute myeloid leukemia (AML), acute lymphoid leukemia (ALL), chronic myeloid leukemia (CML), and chronic lymphoid leukemia (CLL). RESULTS Leukemia incidence varied significantly between birth cohorts for each major leukemia type in men and women except female AMLs; changes on the order of 1% per birth year or 20% per generation were observed. The most significant birth cohort signatures were observed for CLLs and AMLs in men, which were decreasing and increasing, respectively, in cohorts born since 1946. CONCLUSIONS Our results support the hypothesis that adult leukemia risks are significantly modulated by environmental and lifestyle exposures. IMPACT A number of well-established (smoking, certain chemicals, radiation) and newly recognized (obesity) leukemia risk factors are modifiable; ultimately, efforts to promote healthy lifestyles might also help reduce incidence rates of adult leukemia.
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Affiliation(s)
- Philip S Rosenberg
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Executive Plaza South, Room 8022, Rockville, MD 20852, USA.
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21
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Mbulaiteye SM, Anderson WF, Ferlay J, Bhatia K, Chang C, Rosenberg PS, Devesa SS, Parkin DM. Pediatric, elderly, and emerging adult-onset peaks in Burkitt's lymphoma incidence diagnosed in four continents, excluding Africa. Am J Hematol 2012; 87:573-8. [PMID: 22488262 PMCID: PMC3358448 DOI: 10.1002/ajh.23187] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 02/29/2012] [Indexed: 11/08/2022]
Abstract
Burkitt's lymphoma (BL) in the general population and immunosuppressed persons with AIDS in the United States was characterized by three age-specific incidence peaks near 10, 40, and 70 years. We hypothesized that BL from different geographical areas may exhibit pediatric, adult, and elderly age incidence peaks. We investigated this hypothesis using data on 3,403 cases obtained from the International Agency for Research on Cancer (1963-2002). Data from Africa were sparse or incomplete, and thus were excluded. Age-standardized rates (ASRs) and age-specific incidence rates were calculated, supplemented with the calculations performed using age-period-cohort (APC) models. The ASR rose 5.3% (95% confidence interval [CI], 5.0-5.6) per year in males and 4.6% (95% CI, 4.5-4.8) in females. The ASR increased gradually in children, steeply in adults and most rapidly in the elderly both in males and in females. Overall, BL male/female ASR ratio was 2.5, but it declined from 3.1 (95% CI, 3.0-3.3) for pediatric BL to 2.3 (95% CI, 2.2-2.4) for adult BL and 1.5 (95% CI, 1.4-1.6) for elderly BL. Age-specific incidence peaks occurred near 10 and 70 years in all regions and periods. A peak near 40 years of age emerged in the mid-1990s, particularly in men. Findings using APC models confirmed those based on the standard analyses. Our findings, based on the international BL cases, support our hypothesis that BL is multimodal and that BL peaks at different ages may be clues to differences in the etiology and/or biology of BL at those ages.
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Affiliation(s)
- Sam M Mbulaiteye
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health/DHHS, Rockville, MD 20892, USA.
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22
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Mwamba PM, Mwanda WO, Busakhala N, Strother RM, Loehrer PJ, Remick SC. AIDS-Related Non-Hodgkin's Lymphoma in Sub-Saharan Africa: Current Status and Realities of Therapeutic Approach. LYMPHOMA 2012; 2012:10.1155/2012/904367. [PMID: 24205439 PMCID: PMC3817848 DOI: 10.1155/2012/904367] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Today AIDS-related non-Hodgkin's lymphoma (AR-NHL) is a significant cause of morbidity and mortality in HIV-infected patients the world over, and especially in sub-Saharan Africa. While the overall incidence of AR-NHL since the emergence of combination antiretroviral therapy (cART) era has declined, the occurrence of this disease appears to have stabilized. In regions of the world where access to cART is challenging, the impact on disease incidence is less clear. In the resource-rich environment it is clinically well recognized that it is no longer appropriate to consider AR-NHL as a single disease entity and rather treatment of AIDS lymphoma needs to be tailored to lymphoma subtype. While intensive therapeutic strategies in the resource-rich world are clearly improving outcome, in AIDS epicenters of the world and especially in sub-Saharan Africa there is a paucity of data on treatment and outcomes. In fact, only one prospective study of dose-modified oral chemotherapy and limited retrospective studies with sufficient details provide a window into the natural history and clinical management of this disease. The scarcities and challenges of treatment in this setting provide a backdrop to review the current status and realities of the therapeutic approach to AR-NHL in sub-Saharan Africa. More pragmatic and risk-adapted therapeutic approaches are needed.
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Affiliation(s)
- Peter M. Mwamba
- Section Haematology and Blood Transfusion, Department of Human Pathology University of Nairobi College of Health Sciences Nairobi, Kenya
| | - Walter O. Mwanda
- Section Haematology and Blood Transfusion, Department of Human Pathology University of Nairobi College of Health Sciences Nairobi, Kenya
| | - NaftaliW. Busakhala
- Departments of Oncology and Pharmacology Moi University School of Medicine Eldoret, Kenya
| | | | - Patrick J. Loehrer
- Melvin and Bren Simon Cancer Center Indiana University, Indianapolis, IN, USA
| | - Scot C. Remick
- Mary Babb Randolph Cancer Center West Virginia University, Morgantown, WV, USA
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23
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Rosenberg PS, Anderson WF. Age-period-cohort models in cancer surveillance research: ready for prime time? Cancer Epidemiol Biomarkers Prev 2011; 20:1263-8. [PMID: 21610223 PMCID: PMC3132831 DOI: 10.1158/1055-9965.epi-11-0421] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Standard descriptive methods for the analysis of cancer surveillance data include canonical plots based on the lexis diagram, directly age-standardized rates (ASR), estimated annual percentage change (EAPC), and joinpoint regression. The age-period-cohort (APC) model has been used less often. Here, we argue that it merits much broader use. First, we describe close connections between estimable functions of the model parameters and standard quantities such as the ASR, EAPC, and joinpoints. Estimable functions have the added value of being fully adjusted for period and cohort effects, and generally more precise. Second, the APC model provides the descriptive epidemiologist with powerful new tools, including rigorous statistical methods for comparative analyses, and the ability to project the future burden of cancer. We illustrate these principles by using invasive female breast cancer incidence in the United States, but these concepts apply equally well to other cancer sites for incidence or mortality.
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Emmanuel B, Kawira E, Ogwang MD, Wabinga H, Magatti J, Nkrumah F, Neequaye J, Bhatia K, Brubaker G, Biggar RJ, Mbulaiteye SM. African Burkitt lymphoma: age-specific risk and correlations with malaria biomarkers. Am J Trop Med Hyg 2011; 84:397-401. [PMID: 21363976 DOI: 10.4269/ajtmh.2011.10-0450] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
African Burkitt lymphoma is an aggressive B-cell, non-Hodgkin lymphoma linked to Plasmodium falciparum malaria. Malaria biomarkers related to onset of African Burkitt lymphoma are unknown. We correlated age-specific patterns of 2,602 cases of African Burkitt lymphoma (60% male, mean ± SD age = 7.1 ± 2.9 years) from Uganda, Ghana, and Tanzania with malaria biomarkers published from these countries. Age-specific patterns of this disease and mean multiplicity of P. falciparum malaria parasites, defined as the average number of distinct genotypes per positive blood sample based on the merozoite surface protein-2 assessed by polymerase chain reaction, were correlated and both peaked between 5 and 9 years. This pattern, which was strong and consistent across regions, contrasted parasite prevalence, which peaked at 2 years and decreased slightly, and geometric mean parasite density, which peaked between 2 and 3 years and decreased sharply. Our findings suggest that concurrent infection with multiple malaria genotypes may be related to onset of African Burkitt lymphoma.
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Affiliation(s)
- Benjamin Emmanuel
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, Bethesda, MD 20852, USA.
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25
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Shiels MS, Pfeiffer RM, Hall HI, Li J, Goedert JJ, Morton LM, Hartge P, Engels EA. Proportions of Kaposi sarcoma, selected non-Hodgkin lymphomas, and cervical cancer in the United States occurring in persons with AIDS, 1980-2007. JAMA 2011; 305:1450-9. [PMID: 21486978 PMCID: PMC3909038 DOI: 10.1001/jama.2011.396] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
CONTEXT Given the higher risk of AIDS-defining malignancies that include Kaposi sarcoma (KS), certain non-Hodgkin lymphomas (NHLs), and cervical cancer in persons with human immunodeficiency virus (HIV) infection, the HIV epidemic has likely contributed to the overall numbers of these cancers in the United States. OBJECTIVE To quantify the proportions of KS, AIDS-defining NHLs, and cervical cancer in the United States that occurred among persons with AIDS from 1980 to 2007. DESIGN, SETTING, AND PARTICIPANTS The HIV/AIDS Cancer Match Study (1980-2007) linked data from 16 US HIV/AIDS and cancer registries to identify cases with and without AIDS for KS, AIDS-defining NHLs (ie, diffuse large B-cell lymphoma [DLBCL], Burkitt lymphoma [BL], and central nervous system [CNS] lymphoma), and cervical cancer. Using linked data, we derived cancer rates for persons with and without AIDS. To estimate national counts, the rates were applied to national AIDS surveillance and US Census data. MAIN OUTCOME MEASURE Proportion of AIDS-defining malignancies in the United States occurring in persons with AIDS. RESULTS In the United States, an estimated 81.6% (95% confidence interval [CI], 81.2%-81.9%) of 83,252 KS cases, 6.0% (95% CI, 5.8%-6.1%) of 351,618 DLBCL cases, 19.9% (95% CI, 18.1%-21.7%) of 17,307 BL cases, 27.1% (95% CI, 26.1%-28.1%) of 27,265 CNS lymphoma cases, and 0.42% (95% CI, 0.37%-0.47%) of 375,452 cervical cancer cases occurred among persons with AIDS during 1980-2007. The proportion of KS and AIDS-defining NHLs in persons with AIDS peaked in the early 1990s (1990-1995: KS, 90.5% [95% CI, 90.2%-90.8%]; DLBCL, 10.2% [95% CI, 9.9%-10.5%]; BL, 27.8% [95% CI, 25.0%-30.5%]; and CNS lymphoma, 48.3% [95% CI, 46.7%-49.8%]; all P < .001 [compared with 1980-1989]) and then declined (2001-2007: KS, 70.5% [95% CI, 68.1%-73.0%]; DLBCL, 4.7% [95% CI, 4.3%-5.2%]; BL, 21.5% [95% CI, 17.7%-25.4%]; and CNS lymphoma, 12.9% [95% CI, 10.5%-15.3%]; all P < .001 [compared with 1990-1995]). The proportion of cervical cancers in persons with AIDS increased over time (1980-1989: 0.11% [95% CI, 0.09%-0.13%]; 2001-2007: 0.71% [95% CI, 0.51%-0.91%]; P < .001). CONCLUSIONS In the United States, the estimated proportions of AIDS-defining malignancies that occurred among persons with AIDS were substantial, particularly for KS and some NHLs. Except for cervical cancer, the proportions of AIDS-defining malignancies occurring among persons with AIDS peaked in the mid-1990s and then declined.
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Affiliation(s)
- Meredith S Shiels
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, EPS 7059, Rockville, MD 20892, USA.
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Abstract
PURPOSE OF REVIEW The success of combined antiretroviral therapy (cART) has transformed HIV infection into a survivable chronic disease in developed countries. Increasingly then, the risks of HIV associated cancers become paramount. Burkitt lymphoma is one of the cancer subtypes highly disproportionately affecting HIV infected patients. RECENT FINDINGS Recent conference proceedings appear to corroborate early reports that intensive therapy of HIV-Burkitt lymphoma is feasible and effective. An optimal approach is not defined due to the small numbers of patients in current trials and the absence of comparison studies. Moreover, as breakthroughs in the pathogenesis of lymphoma in general and Burkitt lymphoma in particular suggest that HIV infection plays a significant role, the opportunity for targeted therapy based on differences in biology are wholly untapped. SUMMARY Advances are being made in HIV-Burkitt lymphoma, but future studies need to incorporate our expanding understanding of biology to improve efficacy and reduce toxicity, preferably by integrating a biologic approach to this curable disease.
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Burkitt lymphoma: pathogenesis and immune evasion. JOURNAL OF ONCOLOGY 2010; 2010. [PMID: 20953370 PMCID: PMC2952908 DOI: 10.1155/2010/516047] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 09/02/2010] [Indexed: 12/21/2022]
Abstract
B-cell lymphomas arise at distinct stages of cellular development and maturation, potentially influencing antigen (Ag) presentation and T-cell recognition. Burkitt lymphoma (BL) is a highly malignant B-cell tumor associated with Epstein-Barr Virus (EBV) infection. Although BL can be effectively treated in adults and children, leading to high survival rates, its ability to mask itself from the immune system makes BL an intriguing disease to study. In this paper, we will provide an overview of BL and its association with EBV and the c-myc oncogene. The contributions of EBV and c-myc to B-cell transformation, proliferation, or attenuation of cellular network and immune recognition or evasion will be summarized. We will also discuss the various pathways by which BL escapes immune detection by inhibiting both HLA class I- and II-mediated Ag presentation to T cells. Finally, we will provide an overview of recent developments suggesting the existence of BL-associated inhibitory molecules that may block HLA class II-mediated Ag presentation to CD4+ T cells, facilitating immune escape of BL.
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AIDS-related Burkitt lymphoma in the United States: what do age and CD4 lymphocyte patterns tell us about etiology and/or biology? Blood 2010; 116:5600-4. [PMID: 20813897 DOI: 10.1182/blood-2010-03-275917] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Trimodal or bimodal age-specific incidence rates for Burkitt lymphoma (BL) were observed in the United States general population, but the role of immunosuppression could not be excluded. Incidence rates, rate ratios, and 95% confidence intervals for BL and other non-Hodgkin lymphoma (NHL), by age and CD4 lymphocyte count categories, were estimated using Poisson regression models using data from the United States HIV/AIDS Cancer Match study (1980-2005). BL incidence was 22 cases per 100 000 person-years and 586 for non-BL NHL. Adjusted BL incidence rate ratio among males was 1.6× that among females and among non-Hispanic blacks, 0.4× that among non-Hispanic whites, but unrelated to HIV-transmission category. Non-BL NHL incidence increased from childhood to adulthood; in contrast, 2 age-specific incidence peaks during the pediatric and adult/geriatric years were observed for BL. Non-BL NHL incidence rose steadily with decreasing CD4 lymphocyte counts; in contrast, BL incidence was lowest among people with ≤ 50 CD4 lymphocytes/μL versus those with ≥ 250 CD4 lymphocytes/μL (incidence rate ratio 0.3 [95% confidence interval = 0.2-0.6]). The bimodal peaks for BL, in contrast to non-BL NHL, suggest effects of noncumulative risk factors at different ages. Underascertainment or biological reasons may account for BL deficit at low CD4 lymphocyte counts.
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Clinical aspects and therapy of sporadic burkitt lymphoma. Mediterr J Hematol Infect Dis 2009; 1:e2009030. [PMID: 21416007 PMCID: PMC3033171 DOI: 10.4084/mjhid.2009.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Accepted: 12/23/2009] [Indexed: 11/30/2022] Open
Abstract
Burkitt’s lymphoma is a highly aggressive mature B-cell neoplasm consisting of endemic, sporadic, and immunodeficiency-associated variants, sharing many morphologic and immunophenotypic features. It is characterized by a high proliferation rate and propensity for extranodal sites such as gastrointestinal tract and reproductive organs. Brief-duration, high-intensity chemotherapy regimens including aggressive central nervous system prophylaxis have had remarkable success in the treatment of this disease in the sporadic form, with very high complete remission rate and overall survival in adults. Although Burkitt’s lymphoma is extremely chemosensitive, biologically targeted therapies should be developed, because current treatment options are suboptimal for patients with poor prognostic features or with relapsed disease.
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