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Smedby KE, Sampson JN, Turner JJ, Slager SL, Maynadié M, Roman E, Habermann TM, Flowers CR, Berndt SI, Bracci PM, Hjalgrim H, Weisenburger DD, Morton LM. Medical history, lifestyle, family history, and occupational risk factors for mantle cell lymphoma: the InterLymph Non-Hodgkin Lymphoma Subtypes Project. J Natl Cancer Inst Monogr 2015; 2014:76-86. [PMID: 25174028 DOI: 10.1093/jncimonographs/lgu007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The etiology of mantle cell lymphoma (MCL), a distinctive subtype accounting for 2%-10% of all non-Hodgkin lymphoma, is not known. METHODS We investigated associations with self-reported medical history, lifestyle, family history, and occupational risk factors in a pooled analysis of 557 patients with MCL and 13766 controls from 13 case-control studies in Europe, North America, and Australia. Odds ratios (ORs) and 95% confidence intervals (CIs) associated with each exposure were examined using multivariate logistic regression models. RESULTS The median age of the MCL patients was 62 years and 76% were men. Risk of MCL was inversely associated with history of hay fever (OR = 0.63, 95% CI = 0.48 to 0.82), and the association was independent of other atopic diseases and allergies. A hematological malignancy among first-degree relatives was associated with a twofold increased risk of MCL (OR = 1.99, 95% CI = 1.39 to 2.84), which was stronger in men (OR = 2.21, 95% CI = 1.44 to 3.38) than women (OR = 1.61, 95% CI = 0.82 to 3.19). A modestly increased risk of MCL was also observed in association with ever having lived on a farm (OR = 1.40, 95% CI = 1.03 to 1.90). Unlike some other non-Hodgkin lymphoma subtypes, MCL risk was not statistically significantly associated with autoimmune disorders, tobacco smoking, alcohol intake, body mass index, or ultraviolet radiation. CONCLUSIONS The novel observations of a possible role for atopy and allergy and farm life in risk of MCL, together with confirmatory evidence of a familial link, suggest a multifactorial etiology of immune-related environmental exposures and genetic susceptibility. These findings provide guidance for future research in MCL etiology.
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Affiliation(s)
- Karin E Smedby
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
| | - Joshua N Sampson
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Jennifer J Turner
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Susan L Slager
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Marc Maynadié
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Eve Roman
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Thomas M Habermann
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Christopher R Flowers
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Sonja I Berndt
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Paige M Bracci
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Henrik Hjalgrim
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Dennis D Weisenburger
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Lindsay M Morton
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
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