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Vainer N, Rotbain Curovic V, Niemann CU, Slager SL, Rotbain EC. Understanding the interplay between chronic lymphocytic leukemia and type 2 diabetes. Expert Rev Hematol 2024; 17:617-629. [PMID: 39041465 DOI: 10.1080/17474086.2024.2383417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 07/18/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION Comorbidities play an important role in the management of chronic lymphocytic leukemia (CLL) and may influence survival and treatment outcomes. Considering the aging general population and increasing incidence of type 2 diabetes (T2D), a comprehensive understanding of the interplay between CLL and T2D is essential for optimizing care and outcomes. AREAS COVERED We present current knowledge on co-existing CLL and T2D including prevalence, shared etiology and risk factors and how the conditions and treatment hereof may influence the outcome of one another. A literature search was performed using PubMed with the cutoff date on 1 February 2024. EXPERT OPINION The increased mortality observed in persons with CLL who have co-existing T2D is partially ascribed to infections, prompting physicians managing individuals with both conditions to consider closer monitoring during instances of infection and individualized prophylaxis. People with CLL and T2D should be managed for CLL in accordance with the international working group on CLL criteria, and we recommend that physicians exercise particular care not to delay treatment for these individuals. Multidisciplinary approaches with involvement of several specialties may be required for optimal supportive care of co-occurring T2D and CLL.
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Affiliation(s)
- Noomi Vainer
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Hematology Group, Danish Cancer Institute, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Carsten Utoft Niemann
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Susan L Slager
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Emelie Curovic Rotbain
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Hematology Group, Danish Cancer Institute, Copenhagen, Denmark
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Frost E, Hofmann JN, Huang WY, Frazer-Abel AA, Deane KD, Berndt SI. Serum levels of B-cell activating factor are associated with a reduced risk of chronic lymphocytic leukemia. Blood Cancer J 2024; 14:132. [PMID: 39112445 PMCID: PMC11306784 DOI: 10.1038/s41408-024-01106-7] [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: 04/09/2024] [Revised: 07/03/2024] [Accepted: 07/16/2024] [Indexed: 08/10/2024] Open
Abstract
IMPACT Immune dysregulation is thought to contribute to chronic lymphocytic leukemia (CLL) risk, but biological mechanisms are unclear. We discovered that increased serum levels of B-cell activating factor (BAFF), an important regulator of B-cell maturation, were associated with a decreased risk of CLL, even >10 years after blood draw. Our findings suggest that BAFF could be a useful biomarker to assess risk among individuals at high risk, such as those with monoclonal b-cell lymphocytosis.
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Affiliation(s)
- Eleanor Frost
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Jonathan N Hofmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Ashley A Frazer-Abel
- Department of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Kevin D Deane
- Department of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
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3
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Halmágyi SR, Ungureanu L, Trufin II, Apostu AP, Șenilă SC. Melanoma as Subsequent Primary Malignancy in Hematologic Cancer Survivors-A Literature Review. J Clin Med 2024; 13:4501. [PMID: 39124768 PMCID: PMC11313577 DOI: 10.3390/jcm13154501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/28/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
The occurrence of second primary malignancies is becoming increasingly important among cancer survivors. Melanoma, an aggressive neoplasm originating from the melanocytes, is responsible for most skin cancer-related deaths. This review aims to explore the risk of melanoma occurrence as a second primary cancer after the most common subtypes of hematologic neoplasia, a malignant disease originating from myeloid or lymphocytic cell lineages. Chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL) are among the most associated subtypes with melanoma development. We also discuss the underlying hypotheses that may explain the associations between these malignancies and the impact of melanoma on survival. The review emphasizes the importance of increasing awareness of melanoma risk in hematologic cancer survivors, as it can lead to prompt recognition, improved skin surveillance, and better survival outcomes.
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Affiliation(s)
- Salomea-Ruth Halmágyi
- Clinical Hospital of Infectious Diseases, 400000 Cluj-Napoca, Romania; (S.-R.H.); (I.-I.T.); (A.P.A.)
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Loredana Ungureanu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Ioana-Irina Trufin
- Clinical Hospital of Infectious Diseases, 400000 Cluj-Napoca, Romania; (S.-R.H.); (I.-I.T.); (A.P.A.)
| | - Adina Patricia Apostu
- Clinical Hospital of Infectious Diseases, 400000 Cluj-Napoca, Romania; (S.-R.H.); (I.-I.T.); (A.P.A.)
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Simona Corina Șenilă
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
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Donat-Vargas C, Kogevinas M, Benavente Y, Costas L, Campo E, Castaño-Vinyals G, Fernandez-Tardon G, Llorca J, Gómez-Acebo I, Aragonés N, Pollan M, Casabonne D, Villanueva CM. Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: a Multicase-Control Study in Spain (MCC-Spain). JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:47-57. [PMID: 37726507 PMCID: PMC10907291 DOI: 10.1038/s41370-023-00600-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Chronic lymphocytic leukemia (CLL) etiology is poorly understood, and carcinogenic chemicals in drinking and recreational water are candidates. OBJECTIVE To evaluate the association between drinking-water exposure to trihalomethanes (THMs) and nitrate as well as lifetime swimming pool attendance and CLL. METHODS During 2010-2013, hospital-based CLL cases and population-based controls were recruited in Spain, providing information on residential histories, type of water consumed and swimming pool attendance. Average THMs and nitrate levels in drinking water were linked to lifetime water consumption. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models. RESULTS Final samples for residential tap water analyses and swimming pool attendance analyses were 144 cases/1230 controls and 157 cases/1240 controls, respectively. Mean (SD) values for average lifetime residential brominated THMs and chloroform in tap water (μg/L), and ingested nitrate (mg/day) were 48.1 (35.6), 18.5 (6.7) and 13.7 (9.6) respectively in controls; and 72.9 (40.7), 17.9 (5.4), and 14.1 (8.8) in CLL cases. For each 10 μg/L increase of brominated THMs and chloroform lifetime-average levels, the ORs (95% CI) were 1.22 (1.14, 1.31) and 0.54 (0.34, 0.87), respectively. For each 5 mg/day increase of ingested nitrate, the OR of CLL was 0.91 (0.80, 1.04). The OR of lifetime pool users (vs. non-users) was 2.38 (1.61, 3.52). Upon performing annual frequency of attending pools analysis through categorization, the second and third categories showed an ORs of 2.36 (1.49, 3.72) and 2.40 (1.51, 3.83), respectively, and P-trend of 0.001. IMPACT STATEMENT This study identifies an association of long-term exposure to THMs in drinking water, at concentrations below the regulatory thresholds and WHO guidelines, and swimming pool attendance, with chronic lymphocytic leukemia (CLL). These unprecedented findings are highly relevant since CLL is an incurable cancer with still unknown etiology and because the widespread exposure to chlorination by-products that remain in drinking and recreational water worldwide. Despite the demonstrated carcinogenicity in animals of several chlorination by-products, little is known about their potential risks on human health. This study makes a significant contribution to the search for environmental factors involved in the etiology of CLL and to the evidence of the health impact of these high prevalent water contaminants.
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Affiliation(s)
- Carolina Donat-Vargas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unit of Cardiovascular and Nutritional Epidemiology, Intitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Yolanda Benavente
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908, L'Hospitalet de Llobregat, Spain
| | - Laura Costas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908, L'Hospitalet de Llobregat, Spain
| | - Elias Campo
- Haematopathology Section, Hospital Clınic of Barcelona, Institut d'Investigaciones Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Centrode Investigacion Biomedica en Red de Cancer (CIBERONC), Barcelona, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Guillermo Fernandez-Tardon
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Health Research Institute of Asturias, ISPA, Oviedo, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Faculty of Medicine, University of Cantabria, Santander, Spain
| | - Inés Gómez-Acebo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Faculty of Medicine, University of Cantabria, Santander, Spain
- IDIVAL. Instituto de Investigación Sanitaria Valdecilla, 39011, Santander, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Marina Pollan
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Delphine Casabonne
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908, L'Hospitalet de Llobregat, Spain
| | - Cristina M Villanueva
- ISGlobal, Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
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Baratè C, Sanna A, Benedetti E, Bocchia M, Capochiani E, Danesi R, Moretti S, Occhini U, Santini S, Galimberti S, Gozzetti A. Real-life diagnostic and therapeutic approach to CLL: a 2022 update from an expert panel in Tuscany. Clin Exp Med 2023; 23:4251-4264. [PMID: 37979127 DOI: 10.1007/s10238-023-01244-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
A panel of chronic lymphocytic leukemia (CLL) experts from Tuscany propose a real-life diagnostic and therapeutic approach CLL that considers the role of genomic and somatic prognostic factors in risk stratification and treatment decisions. Safety and efficacy of new agents has been demonstrated now not only in clinical trials but also in many real-world series. The BTK inhibitors, ibrutinib and acalabrutinib, and BH3 mimetic venetoclax are now indicated as first-line therapy and chemoimmunotherapy can be spared to the majority of CLL patients, thus preventing unnecessary hematological and non-hematological toxicity and second primary tumors. For treatment, FISH for 17 p and P53 mutational status are essential. IGHV mutation can be done at diagnosis or before treatment. Echography is the gold standard radiological investigation in CLL, at both diagnosis and response evaluation. Chemotherapy is virtually abandoned. Age, genetic risk, and patient comorbidities have to be carefully evaluated for treatment decision. With the availability of different drugs, there is a need for a uniform and shared approach in daily therapeutic choice. The proposed approach is based on current evidence and guidelines as well as results from clinical trials and daily clinical experience.
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Affiliation(s)
- Claudia Baratè
- Department of Clinical and Experimental Medicine, UO Hematology, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.
| | - Alessandro Sanna
- Hematology Unit, Department of Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
| | - Edoardo Benedetti
- Department of Clinical and Experimental Medicine, UO Hematology, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
- Italian School of Basic and Emergency Ultrasound (SIUMB), Pisa, Italy
| | - Monica Bocchia
- Hematology Unit, Azienda USL, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | - Enrico Capochiani
- Hematology Unit, Department of Internal Medicine, Toscana Nord Ovest, Leghorn, Italy
| | - Romano Danesi
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | | | | | | | - Sara Galimberti
- Department of Clinical and Experimental Medicine, UO Hematology, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Alessandro Gozzetti
- Hematology Unit, Azienda USL, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
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6
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Kolijn PM, Langerak AW. Immune dysregulation as a leading principle for lymphoma development in diverse immunological backgrounds. Immunol Lett 2023; 263:46-59. [PMID: 37774986 DOI: 10.1016/j.imlet.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/28/2023] [Accepted: 08/10/2023] [Indexed: 10/01/2023]
Abstract
Lymphoma is a heterogeneous group of malignancies arising from lymphocytes, which poses a significant challenge in terms of diagnosis and treatment due to its diverse subtypes and underlying mechanisms. This review aims to explore the shared and distinct features of various forms of lymphoma predisposing conditions, with a focus on genetic, immunological and molecular aspects. While diseases such as autoimmune disorders, inborn errors of immunity and iatrogenic immunodeficiencies are biologically and immunologically distinct, each of these diseases results in profound immune dysregulation and a predisposition to lymphoma development. Interestingly, the increased risk is often skewed towards a particular subtype of lymphoma. Patients with inborn errors of immunity in particular present with extreme forms of lymphoma predisposition, providing a unique opportunity to study the underlying mechanisms. External factors such as chronic infections and environmental exposures further modulate the risk of lymphoma development. Common features of conditions predisposing to lymphoma include: persistent inflammation, recurrent DNA damage or malfunctioning DNA repair, impaired tumor surveillance and viral clearance, and dysregulation of fundamental cellular processes such as activation, proliferation and apoptosis. Our growing understanding of the underlying mechanisms of lymphomagenesis provides opportunities for early detection, prevention and tailored treatment of lymphoma development.
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Affiliation(s)
- P Martijn Kolijn
- Laboratory Medical Immunology, Department of Immunology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Anton W Langerak
- Laboratory Medical Immunology, Department of Immunology, Erasmus Medical Center, Rotterdam, the Netherlands.
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7
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Frost E, Hofmann JN, Huang WY, Parks CG, Frazer-Abel AA, Deane KD, Berndt SI. Antinuclear Antibodies Are Associated with an Increased Risk of Diffuse Large B-Cell Lymphoma. Cancers (Basel) 2023; 15:5231. [PMID: 37958403 PMCID: PMC10647241 DOI: 10.3390/cancers15215231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/15/2023] Open
Abstract
Immune dysregulation is thought to increase the risk of non-Hodgkin lymphoma (NHL), but the evidence varies by subtype. We evaluated whether antinuclear antibodies (ANA), double-stranded DNA antibodies (anti-dsDNA), and extractable nuclear antigen antibodies (anti-ENA) were associated with the risk of common NHL subtypes in a nested case-control study. The autoantibodies were tested in serum collected years prior to NHL diagnosis in 832 cases and 809 controls from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Logistic regression was used to determine odds ratios (ORs) and 95% confidence intervals (95% CI) for the association with NHL risk. No association was observed between ANA positivity and NHL risk overall (OR: 1.18, 95% CI: 0.88-1.58); however, ANA positivity was associated with an increased risk of diffuse large B-cell lymphoma (DLBCL) (OR: 1.83, 95% CI: 1.15-2.91), with 19.7% of cases and 12.2% of controls testing positive. The presence of either anti-ENA or anti-dsDNA was associated with an increased risk of NHL (OR: 2.93, 95% CI: 1.18-7.28), particularly DLBCL (OR: 3.51, 95% CI: 1.02-12.0) and marginal zone lymphoma (OR: 8.86, 95% CI: 1.26-62.0). Our study demonstrates that autoantibodies are associated with an elevated risk of DLBCL, providing support for autoimmunity as a risk factor.
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Affiliation(s)
- Eleanor Frost
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jonathan N. Hofmann
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Christine G. Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health and Department of Health and Human Services, Research Triangle Park, Durham, NC 27709, USA
| | - Ashley A. Frazer-Abel
- Department of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO 80045, USA
| | - Kevin D. Deane
- Department of Medicine, University of Colorado Anschutz Medical Campus, Denver, CO 80045, USA
| | - Sonja I. Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
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8
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Broccia G, Carter J, Ozsin-Ozler C, De Matteis S, Cocco P. Epidemiology of Chronic Lymphocytic Leukemia in Sardinia, Italy (1974-2003). Exp Hematol 2023; 125-126:37-44. [PMID: 37567460 DOI: 10.1016/j.exphem.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023]
Abstract
Several reports have described a worldwide increasing incidence of chronic lymphocytic leukemia (CLL) dating back seven to eight decades. Although genetic susceptibility would be an implausible explanation, the determinants of this upward trend and its spatial coordinates are poorly understood. We explored CLL incidence in Sardinia, Italy, using a validated database including the 1700 CLL cases diagnosed during 1974-2003. We applied Bayesian methods to map the CLL probability by administrative unit and Poisson regression analysis to investigate socioeconomic and environmental determinants adjusting by possible confounders. The standardized (Standard European population) incidence rate for the Sardinian population over the study period was 5.1 per 100,000 (95% confidence interval [CI] 4.9-5.3), increased annually by 5.8% (95% CI 5.7-6.0) consistently by sex and age, and was more noticeable in urban areas. Five administrative units exceeded the 95% posterior probability of an elevated CLL incidence: these were rural areas spread over the regional territory, not suggestive of spatial clustering. The Poisson regression analysis showed that the risk was elevated in urban areas (RR = 1.11, 95% CI 1.05-1.17), among residents ≥ 30 km from the nearest hospital (RR = 1.09, 95% CI 1.06-1.12), and with the local prevalence of cork harvesting (RR = 1.62, 95% CI 1.12-2.34). Our results suggest that better access to health care facilities and improvements in diagnostic efficacy might have generated the observed upward trend in CLL incidence, along with contributing environmental factors.
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Affiliation(s)
- Giorgio Broccia
- Department of Haematology and Bone Marrow Transplants, Hospital A. Businco, Cagliari, Sardinia, Italy
| | | | - Cansu Ozsin-Ozler
- Department of Paediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Pierluigi Cocco
- Centre for Occupational and Environmental Health, Division of Public Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK.
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9
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Nannini DR, Cortese R, Egwom P, Palaniyandi S, Hildebrandt GC. Time to relapse in chronic lymphocytic leukemia and DNA-methylation-based biological age. Clin Epigenetics 2023; 15:81. [PMID: 37165442 PMCID: PMC10170738 DOI: 10.1186/s13148-023-01496-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) is a mature B cell neoplasm with a predilection for older individuals. While previous studies have identified epigenetic signatures associated with CLL, whether age-related DNA methylation changes modulate CLL relapse remains elusive. In this study, we examined the association between epigenetic age acceleration and time to CLL relapse in a publicly available dataset. DNA methylation profiling of 35 CLL patients prior to initiating chemoimmunotherapy was performed using the Infinium HumanMethylation450 BeadChip. Four epigenetic age acceleration metrics (intrinsic epigenetic age acceleration [IEAA], extrinsic epigenetic age acceleration [EEAA], PhenoAge acceleration [PhenoAA], and GrimAge acceleration [GrimAA]) were estimated from blood DNA methylation levels. Linear, quantile, and logistic regression and receiver operating characteristic curve analyses were conducted to assess the association between each epigenetic age metric and time to CLL relapse. EEAA (p = 0.011) and PhenoAA (p = 0.046) were negatively and GrimAA (p = 0.040) was positively associated with time to CLL relapse. Simultaneous assessment of EEAA and GrimAA in male patients distinguished patients who relapsed early from patients who relapsed later (p = 0.039). No associations were observed with IEAA. These findings suggest epigenetic age acceleration prior to chemoimmunotherapy initiation is associated with time to CLL relapse. Our results provide novel insight into the association between age-related DNA methylation changes and CLL relapse and may serve has biomarkers for treatment relapse, and potentially, treatment selection.
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Affiliation(s)
- Drew R Nannini
- Department of Internal Medicine, School of Medicine, University of Missouri at Columbia, MA408 Medical Science Building, Columbia, MO, 65212, USA.
| | - Rene Cortese
- Department of Child Health and Department of Obstetrics, Gynecology, and Women's Health, School of Medicine, University of Missouri at Columbia, Columbia, MO, 65212, USA
- Ellis Fischel Cancer Center, University of Missouri at Columbia, Columbia, MO, 65212, USA
| | - Peter Egwom
- Department of Internal Medicine, School of Medicine, University of Missouri at Columbia, MA408 Medical Science Building, Columbia, MO, 65212, USA
| | - Senthilnathan Palaniyandi
- Ellis Fischel Cancer Center, University of Missouri at Columbia, Columbia, MO, 65212, USA
- Division of Hematology and Medical Oncology, School of Medicine, University of Missouri at Columbia, Columbia, MO, 65212, USA
| | - Gerhard C Hildebrandt
- Ellis Fischel Cancer Center, University of Missouri at Columbia, Columbia, MO, 65212, USA
- Division of Hematology and Medical Oncology, School of Medicine, University of Missouri at Columbia, Columbia, MO, 65212, USA
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10
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Kleinstern G, Slager SL. The inherited genetic contribution and polygenic risk score for risk of CLL and MBL: a narrative review. Leuk Lymphoma 2023; 64:788-798. [PMID: 36576061 PMCID: PMC10121840 DOI: 10.1080/10428194.2022.2157215] [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: 11/04/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 12/29/2022]
Abstract
Chronic lymphocytic leukemia (CLL) is a neoplasm of B-cells in the blood and monoclonal B-cell lymphocytosis (MBL) is a precursor state to CLL. This narrative review provides an overview of the genetic studies that identified 43 common variants associated with risk of CLL among individuals of European ancestry. Emerging studies found that ∼50% of these variants are associated with MBL risk. Moreover, the polygenic risk score (PRS) calculated from these CLL variants has been shown to be a robust predictor for both CLL and MBL risk among European ancestry individuals but a weak predictor among African ancestry individuals. By summarizing these genetic studies, we conclude that additional studies are needed in other race/ethnic populations to identify race-specific susceptibility variants, that functional studies are needed to validate the biological mechanisms of the variants, and that the clinical utility of the PRS is limited until preventive strategies for CLL are developed.
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Affiliation(s)
- Geffen Kleinstern
- School of Public Health, University of Haifa, Haifa, Israel
- Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Susan L Slager
- Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
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Rhee J, Birmann BM, De Roos AJ, Epstein MM, Martinez-Maza O, Breen EC, Magpantay LI, Levin LI, Visvanathan K, Hosgood HD, Rohan TE, Smoller SW, Bassig BA, Qi L, Shu XO, Koh WP, Zheng W, Yuan JM, Weinstein SJ, Albanes D, Lan Q, Rothman N, Purdue MP. Circulating immune markers and risks of non-Hodgkin lymphoma subtypes: A pooled analysis. Int J Cancer 2023; 152:865-878. [PMID: 36151863 PMCID: PMC9812887 DOI: 10.1002/ijc.34299] [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: 02/05/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 01/07/2023]
Abstract
Although prediagnostic circulating concentrations of the immune activation markers soluble CD27 (sCD27), sCD30 and chemokine ligand-13 (CXCL13) have been associated with non-Hodgkin lymphoma (NHL) risk, studies have been limited by sample size in associations with NHL subtypes. We pooled data from eight nested case-control studies to investigate subtype-specific relationships for these analytes. Using polytomous regression, we calculated odds ratios (ORs) with 95% confidence intervals (CIs) relating study-specific analyte tertiles to selected subtypes vs controls (n = 3310): chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; n = 623), diffuse large B cell lymphoma (DLBCL; n = 621), follicular lymphoma (FL; n = 398), marginal zone lymphoma (MZL; n = 138), mantle cell lymphoma (MCL; n = 82) and T cell lymphoma (TCL; n = 92). We observed associations with DLBCL for elevated sCD27 [OR for third vs first tertile (ORT3 ) = 2.2, 95% CI = 1.6-3.1], sCD30 (ORT3 = 2.0, 95% CI = 1.6-2.5) and CXCL13 (ORT3 = 2.3, 95% CI = 1.8-3.0). We also observed associations with sCD27 for CLL/SLL (ORT3 = 3.3, 95% CI = 2.4-4.6), MZL (ORT3 = 7.7, 95% CI = 3.0-20.1) and TCL (ORT3 = 3.4, 95% CI = 1.5-7.7), and between sCD30 and FL (ORT3 = 2.7, 95% CI = 2.0-3.5). In analyses stratified by time from phlebotomy to case diagnosis, the sCD27-TCL and all three DLBCL associations were equivalent across both follow-up periods (<7.5, ≥7.5 years). For other analyte-subtype comparisons, associations were stronger for the follow-up period closer to phlebotomy, particularly for indolent subtypes. In conclusion, we found robust evidence of an association between these immune markers and DLBCL, consistent with hypotheses that mechanisms related to immune activation are important in its pathogenesis. Our other findings, particularly for the rarer subtypes MZL and TCL, require further investigation.
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Affiliation(s)
- Jongeun Rhee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, 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
| | - Anneclaire J. De Roos
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Mara M. Epstein
- Department of Medicine and the Meyers Health Care Institute, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Otoniel Martinez-Maza
- Department of Microbiology, Immunology & Molecular Genetics, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA AIDS Institute, Los Angeles, CA, USA
- Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Elizabeth C. Breen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Larry I. Magpantay
- UCLA AIDS Institute, Los Angeles, CA, USA
- Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lynn I. Levin
- Statistics and Epidemiology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Kala Visvanathan
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - H. Dean Hosgood
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Thomas E. Rohan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sylvia W. Smoller
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Bryan A. Bassig
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Formerly at the U.S. National Cancer Institute. This author is currently employed by the U.S. Centers for Disease Control and Prevention, National Center for Health Statistics. All work on this study by the author was conducted while employed by the National Cancer Institute
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore 117609, Singapore
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie J. Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Mark P. Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Erdal H, Ciftciler R, Tuncer SC, Özcan O. Evaluation of dynamic thiol-disulfide homeostasis and ischemia-modified albumin levels in patients with chronic lymphocytic leukemia. J Investig Med 2023; 71:62-66. [PMID: 36038148 DOI: 10.1136/jim-2022-002568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 01/21/2023]
Abstract
This is the first study to evaluate both the dynamic thiol-disulfide homeostasis and ischemia-modified albumin (IMA) levels in patients with chronic lymphocytic leukemia (CLL). Twenty-nine patients with CLL and 20 controls were included in the study. The dynamic thiol-disulfide balance was determined by the newly developed colorimetric method by Erel. IMA levels were determined by the cobalt binding test. We found that total antioxidant status levels were lower while total oxidant status (TOS) and oxidative stress index (OSI) levels were significantly higher in patients with CLL than controls. Moreover, native and total thiol levels were found to be statistically significant between the study and control groups (p<0.001), whereas no statistically significant difference was noted for IMA levels (p=0.365). A negative correlation was observed between native and total thiol levels, leukocyte, lymphocyte, and TOS. Total bilirubin showed positive correlation with direct bilirubin and alkaline phosphatase. In addition, IMA levels showed a positive correlation with OSI. This study highlights measurement of native and total thiol and IMA levels in patients with CLL for the first time. Dynamic thiol-disulfide homeostasis may contribute in the pathophysiological mechanism, and follow-up to disease in patients with CLL.
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Affiliation(s)
- Huseyin Erdal
- Medical Genetics, Aksaray University, Aksaray, Turkey
| | | | | | - Oguzhan Özcan
- Biochemistry, Hatay Mustafa Kemal University, Hatay, Turkey
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Luo J, Craver A, Bahl K, Stepniak L, Moore K, King J, Zhang Y, Aschebrook-Kilfoy B. Etiology of non-Hodgkin lymphoma: A review from epidemiologic studies. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:226-234. [PMID: 39036553 PMCID: PMC11256700 DOI: 10.1016/j.jncc.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/20/2022] [Accepted: 08/07/2022] [Indexed: 11/24/2022] Open
Abstract
Non-Hodgkin lymphoma (NHL) contributes to significant cancer burden and mortality globally. In recent years, much insight into the causes of NHL has been gained by evaluating global differences through international collaboration and data pooling. NHL comprises different subtypes that are known to behave differently, exhibit different prognoses, and start in distinct cell types (B-cell, T-cell, and NK-cell, predominantly), and there is increasing evidence that NHL subtypes have different etiologies. Classification of NHL can be complex, with varying subtype frequencies, and is a consideration when evaluating geographic differences. Because of this, international pooling of well-executed epidemiologic studies has conferred power to evaluate NHL by subtype and confidence with minimal misclassification. Given the decreasing burden in some regions while cases rise in Asia, and especially China, this report focuses on a review of the established etiology of NHL from the epidemiologic literature in recent decades, highlighting work from China. Topics covered include demographic patterns and genetic determinants including family history of NHL, as well as infection and immunosuppression, lifestyle, environment, and certain occupational exposures contributing to increased disease risk.
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Affiliation(s)
- Jiajun Luo
- Institute for Population and Precision Health, University of Chicago, Chicago, United States of America
- Comprehensive Cancer Center, University of Chicago, Chicago, United States of America
| | - Andrew Craver
- Institute for Population and Precision Health, University of Chicago, Chicago, United States of America
| | - Kendall Bahl
- Institute for Population and Precision Health, University of Chicago, Chicago, United States of America
| | - Liz Stepniak
- Institute for Population and Precision Health, University of Chicago, Chicago, United States of America
| | - Kayla Moore
- Institute for Population and Precision Health, University of Chicago, Chicago, United States of America
| | - Jaime King
- Institute for Population and Precision Health, University of Chicago, Chicago, United States of America
| | - Yawei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Briseis Aschebrook-Kilfoy
- Institute for Population and Precision Health, University of Chicago, Chicago, United States of America
- Comprehensive Cancer Center, University of Chicago, Chicago, United States of America
- Department of Public Health Sciences, University of Chicago, Chicago, United States of America
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14
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Liang Z, Liu J, Jin H, Teng Y, Xu S, Yan W, Zhu Y. Potential Correlation Between Eczema and Hematological Malignancies Risk: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:912136. [PMID: 35847819 PMCID: PMC9277696 DOI: 10.3389/fmed.2022.912136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/30/2022] [Indexed: 11/21/2022] Open
Abstract
Background Eczema characterized by itch, sleeplessness, and adverse effects on quality of life is associated with a risk of hematological malignancies. However, there is a controversy pertaining to whether this association implies a greater or lesser risk of hematological cancers. We aimed to explore the link between eczema and hematological malignancies risk. Methods We systematically searched PubMed and Embase databases from their inception to February 17, 2022. Two reviewers independently screened articles, extracted data and assessed study quality, respectively. The odds ratios and 95% confidence intervals (CIs) were pooled by using fixed or random-effects models. Results 29 studies involving 2,521,574 participants examined the contribution of eczema to hematological malignancies. We found that eczema significantly increased the risk of Hodgkin's lymphoma (1.44; 95% CI, 1.07–1.95), myeloma (1.15; 95% CI, 1.04–1.28), and significantly decreased the risk of lymphocytic leukemia (0.91; 95% CI, 0.84–0.99); however, it is not significantly associated with Non-Hodgkin's lymphoma, and myelocytic leukemia. Conclusion Eczema has been shown to be associated with the risk of hematological cancer, this association still needs to be verified in large randomized controlled trials. Systematic Review Registration https://inplasy.com/, INPLASY202260097.
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Affiliation(s)
- Zuohui Liang
- Department of Dermatology and Venereology, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Jie Liu
- Department of Dermatology and Venereology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hongxia Jin
- Department of Intense Care Unit, Ziyang Hospital of Traditional Chinese Medicine, Ziyang, China
| | - Yirong Teng
- Department of General Medicine, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Shuangyan Xu
- Department of Dermatology and Venereology, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Weimin Yan
- Department of Dermatology and Venereology, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Yun Zhu
- Department of Dermatology and Venereology, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
- Department of Dermatology and Venereology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
- *Correspondence: Yun Zhu ; orcid.org/0000-0003-2691-6220
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15
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Blansky D, Fazzari M, Mantzaris I, Rohan T, Dean Hosgood H. Racial and ethnic differences in all-cause mortality among Hispanics diagnosed with follicular lymphoma and chronic lymphocytic leukemia in the Bronx, NY. Cancer Causes Control 2022; 33:137-147. [PMID: 34677741 PMCID: PMC9737328 DOI: 10.1007/s10552-021-01507-0] [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: 05/06/2021] [Accepted: 10/06/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Research suggests better survival among Hispanics with diffuse large B-cell lymphoma (DLBCL) compared to non-Hispanic Whites (NHW); however, less is known about racial/ethnic survival differences in follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL). METHODS We identified incident FL and CLL cases diagnosed between 2005 and 2016 at Montefiore Medical Center in the Bronx, NY. Cox proportional hazards regression assessed the association between race/ethnicity and all-cause mortality among FL and CLL separately. RESULTS Of the 201 FL patients, 39.3% were NHW, 19.4% non-Hispanic Black (NHB), and 41.3% Hispanic, with a similar distribution among CLL patients. After adjusting for International Prognostic Index factors, sex, and chemotherapy, Hispanics with FL had lower all-cause mortality compared to NHWs (HR = 0.22; 95% CI 0.08-0.63), similar to prior DLBCL findings. All-cause mortality did not differ between NHBs and NHWs for FL or by any race/ethnicity for CLL. CONCLUSION In our diverse, urban population, we found that Hispanic diagnosed with FL had lower all-cause mortality compared to NHWs. We found no significant difference in all-cause mortality between Hispanics and NHWs diagnosed with CLL. Our study adds to the growing literature on racial and ethnic differences in survival among Hispanics with hematologic malignancies.
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Affiliation(s)
- Deanna Blansky
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.
| | - Melissa Fazzari
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | | | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA
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16
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17
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Ko BS, Chen LJ, Huang HH, Chen HM, Hsiao FY. Epidemiology, treatment patterns and survival of chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) in Taiwan, 2006-2015. Int J Clin Pract 2021; 75:e14258. [PMID: 33884738 DOI: 10.1111/ijcp.14258] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/16/2021] [Indexed: 12/22/2022] Open
Abstract
AIM/OBJECTIVE Chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) is one of the most frequent types of leukaemia/lymphoma in adults in Western countries. However, there are few studies regarding its epidemiology and treatment patterns in Asian countries. METHODS To investigate CLL/SLL in Asian populations, we identified CLL/SLL patients diagnosed during 2006 to 2015 from the Taiwan Cancer Registry Database and estimated the incidence. Further, patients diagnosed during 2008 to 2015 were included for the analysis of treatment patterns and survivals. Treatments for CLL/SLL were retrieved from the Taiwan's National Health Insurance Research Database and survival data from the National Death Registry. RESULTS In total, 1497 patients who were older than 20 years and had newly diagnosed CLL/SLL during 2006-2015 were identified. The age-standardized incidence rates of CLL/SLL (0.36 per 100 000 persons in 2006, and 0.54 in 2015) increased during the 10-year period. The sex ratio was ranged from 1.21 to 2.63 with male predominant during 2006 and 2015. For the analysis of treatment patterns (n = 1236), 72.8% patients received chemotherapies. The median duration between the diagnosis and start of treatments was 27 days, and monotherapy of chlorambucil, bendamustine or cyclophosphamide was the most common regimen in initial treatments. The median follow-up duration for the patients receiving therapies was 29.6 months, and 45.0% patients experienced relapse or refractory. In patients with relapse/refractory CLL/SLL, 34.1% received rituximab-containing chemotherapies. Three hundred and ninety-nine (32.3%) patients received intensive treatments, and 175 (43.9%) of them received rituximab-containing chemotherapies. The 5-year overall survival (OS) rate was 61%, and age was an important prognostic factor for CLL/SLL patients. CONCLUSIONS This study is the first population-based study in Asia and provides comprehensive evidence of epidemiology, treatment patterns and survivals of CLL/SLL in an Asian population.
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Affiliation(s)
- Bor-Sheng Ko
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Hematological Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Li-Ju Chen
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan
| | - Huai-Hsuan Huang
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ho-Min Chen
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan
- School of Pharmacy, National Taiwan University, Taipei, Taiwan
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
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18
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Consumption of Ultra-Processed Food and Drinks and Chronic Lymphocytic Leukemia in the MCC-Spain Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105457. [PMID: 34065213 PMCID: PMC8160774 DOI: 10.3390/ijerph18105457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 01/30/2023]
Abstract
Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults in Western countries. Its etiology is largely unknown but increasing incidence rates observed worldwide suggest that lifestyle and environmental factors such as diet might play a role in the development of CLL. Hence, we hypothesized that the consumption of ultra-processed food and drinks (UPF) might be associated with CLL. Data from a Spanish population-based case-control study (MCC-Spain study) including 230 CLL cases (recruited within three years of diagnosis) and 1634 population-based controls were used. The usual diet during the previous year was collected through a validated food frequency questionnaire and food and drink consumption was categorized using the NOVA classification scheme. Logistic regression models adjusted for potential confounders were used. Overall, no association was reported between the consumption of UPF and CLL cases (OR per each 10% increase of the relative contribution of UPF to total dietary intake = 1.09 (95% CI: 0.94; 1.25)), independently of the Rai stage at diagnosis. However, when analyses were restricted to cases diagnosed within <1 year (incident), each 10% increment in the consumption of UPF was associated with a 22% higher odds ratio of CLL (95% CI: 1.02, 1.47) suggesting that the overall results might be affected by the inclusion of prevalent cases, who might have changed their dietary habits after cancer diagnosis. Given the low number of cases in the subgroup analyses and multiple tests performed, chance findings cannot totally be ruled out. Nonetheless, positive associations found in CLL incident cases merit further research, ideally in well-powered studies with a prospective design.
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Lerro CC, Hofmann JN, Andreotti G, Koutros S, Parks CG, Blair A, Albert PS, Lubin JH, Sandler DP, Beane Freeman LE. Dicamba use and cancer incidence in the agricultural health study: an updated analysis. Int J Epidemiol 2021; 49:1326-1337. [PMID: 32357211 DOI: 10.1093/ije/dyaa066] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The herbicide dicamba has been commonly used agriculturally and residentially. Recent approval of genetically engineered dicamba-resistant crops is expected to lead to increased dicamba use, and there has been growing interest in potential human health effects. A prior analysis in the Agricultural Health Study (AHS) suggested associations between dicamba and colon and lung cancer. We re-evaluated dicamba use in the AHS, including an additional 12 years and 2702 exposed cancers. METHODS The AHS is a prospective cohort of pesticide applicators in Iowa and North Carolina. At enrollment (1993-1997) and follow-up (1999-2005), participants reported dicamba use. Exposure was characterized by cumulative intensity-weighted lifetime days, including exposure lags of up to 20 years. We estimated relative risks (RR) and 95% confidence intervals (CI) using multivariable Poisson regression for incident cancers diagnosed from enrollment through 2014/2015. RESULTS Among 49 922 applicators, 26 412 (52.9%) used dicamba. Compared with applicators reporting no dicamba use, those in the highest quartile of exposure had elevated risk of liver and intrahepatic bile duct cancer (nexposed = 28, RRQ4 = 1.80, CI: 1.26-2.56, Ptrend < 0.001) and chronic lymphocytic leukaemia (CLL, nexposed = 93, RRQ4 = 1.20, CI: 0.96-1.50, Ptrend = 0.01) and decreased risk of myeloid leukaemia (nexposed = 55, RRQ4 = 0.73, CI: 0.51-1.03, Ptrend = 0.01). The associations for liver cancer and myeloid leukaemia remained after lagging exposure of up to 20 years. CONCLUSIONS With additional follow-up and exposure information, associations with lung and colon cancer were no longer apparent. In this first evaluation of liver and intrahepatic bile duct cancer, there was an association with increasing use of dicamba that persisted across lags of up to 20 years.
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Affiliation(s)
- Catherine C Lerro
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Jonathan N Hofmann
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Gabriella Andreotti
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Stella Koutros
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Paul S Albert
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Jay H Lubin
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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20
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Slager SL, Lanasa MC, Marti GE, Achenbach SJ, Camp NJ, Abbasi F, Kay NE, Vachon CM, Cerhan JR, Johnston JB, Call TG, Rabe KG, Kleinstern G, Boddicker NJ, Norman AD, Parikh SA, Leis JF, Banerji V, Brander DM, Glenn M, Ferrajoli A, Curtin K, Braggio E, Shanafelt TD, McMaster ML, Weinberg JB, Hanson CA, Caporaso NE. Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families. Blood 2021; 137:2046-2056. [PMID: 33512457 PMCID: PMC8057266 DOI: 10.1182/blood.2020006322] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 11/14/2020] [Indexed: 12/21/2022] Open
Abstract
Chronic lymphocytic lymphoma (CLL) has one of the highest familial risks among cancers. Monoclonal B-cell lymphocytosis (MBL), the precursor to CLL, has a higher prevalence (13%-18%) in families with 2 or more members with CLL compared with the general population (5%-12%). Although, the rate of progression to CLL for high-count MBLs (clonal B-cell count ≥500/µL) is ∼1% to 5%/y, no low-count MBLs have been reported to progress to date. We report the incidence and natural history of MBL in relatives from CLL families. In 310 CLL families, we screened 1045 relatives for MBL using highly sensitive flow cytometry and prospectively followed 449 of them. MBL incidence was directly age- and sex-adjusted to the 2010 US population. CLL cumulative incidence was estimated using Kaplan-Meier survival curves. At baseline, the prevalence of MBL was 22% (235/1045 relatives). After a median follow-up of 8.1 years among 449 relatives, 12 individuals progressed to CLL with a 5-year cumulative incidence of 1.8%. When considering just the 139 relatives with low-count MBL, the 5-year cumulative incidence increased to 5.7%. Finally, 264 had no MBL at baseline, of whom 60 individuals subsequently developed MBL (2 high-count and 58 low-count MBLs) with an age- and sex-adjusted incidence of 3.5% after a median of 6 years of follow-up. In a screening cohort of relatives from CLL families, we reported progression from normal-count to low-count MBL to high-count MBL to CLL, demonstrating that low-count MBL precedes progression to CLL. We estimated a 1.1% annual rate of progression from low-count MBL, which is in excess of that in the general population.
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Affiliation(s)
- Susan L Slager
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Mark C Lanasa
- Department of Medicine, Duke University, Duke Cancer Institute, Durham, NC
| | - Gerald E Marti
- Lymphoid Malignancies Section, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Sara J Achenbach
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Nicola J Camp
- Department of Internal Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT
| | - Fatima Abbasi
- Center for Biologics Research and Evaluation, Food and Drug Administration, Silver Springs, MD
| | - Neil E Kay
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Celine M Vachon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - James B Johnston
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Timothy G Call
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Kari G Rabe
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | - Aaron D Norman
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Sameer A Parikh
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Jose F Leis
- Department of Hematology and Oncology, Mayo Clinic, Phoenix, AZ
| | - Versha Banerji
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Biochemistry and Medical Genetics, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Danielle M Brander
- Department of Medicine, Duke University, Duke Cancer Institute, Durham, NC
| | - Martha Glenn
- Department of Internal Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT
| | - Alessandra Ferrajoli
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Karen Curtin
- Department of Internal Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT
| | - Esteban Braggio
- Department of Hematology and Oncology, Mayo Clinic, Phoenix, AZ
| | - Tait D Shanafelt
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - Mary L McMaster
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - J Brice Weinberg
- Department of Medicine, Duke University, Duke Cancer Institute, Durham, NC
- Department of Immunology, Duke University Medical Center, Durham, NC
- Durham Veterans Affairs Medical Center, Durham, NC; and
| | - Curtis A Hanson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
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21
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Thandra KC, Barsouk A, Saginala K, Padala SA, Barsouk A, Rawla P. Epidemiology of Non-Hodgkin's Lymphoma. Med Sci (Basel) 2021; 9:medsci9010005. [PMID: 33573146 PMCID: PMC7930980 DOI: 10.3390/medsci9010005] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/24/2022] Open
Abstract
Non-Hodgins’s lymphoma (NHL) is the most common hematological malignancy worldwide, accounting for nearly 3% of cancer diagnoses and deaths. NHL is the seventh most prevalent cancer and has the sixth highest mortality among cancers in the US. NHL accounts for 4% of US cancer diagnoses, and incidence has increased 168% since 1975 (while survival has improved 158%). NHL is more common among men, those >65 years old, and those with autoimmune disease or a family history of hematological malignancies. NHL is a heterogenous disease, with each subtype associated with different risk factors. Marginal zone lymphoma (MZL) is strongly associated with Sjogren’s syndrome (SS) and Hashimoto’s thyroiditis, while peripheral T-cell lymphoma (PTCL) is most associated with celiac disease. Occupational exposures among farm workers or painters increases the risk of most of the common subtypes. Prior radiation treatment, obesity, and smoking are most highly associated with diffuse large B-cell lymphoma (DLBCL), while breast implants have been rarely associated with anaplastic large cell lymphoma (ALCL). Infection with Epstein–Barr Virus (EBV) is strongly associated with endemic Burkitts lymphoma. HIV and human herpes virus 8 (HHV-8), is predisposed to several subtypes of DLBCL, and human T-cell lymphoma virus (HTLV-1) is a causative agent of T-cell lymphomas. Obesity and vitamin D deficiency worsen NHL survival. Atopic diseases and alcohol consumption seem to be protective against NHL.
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Affiliation(s)
- Krishna C. Thandra
- Department of Pulmonary and Critical Care Medicine, Sentara Virginia Beach General Hospital, Virginia Beach, VA 23455, USA
- Correspondence: ; Tel.: +1-757-481-2515
| | - Adam Barsouk
- Sidney Kimmel Cancer Center, Jefferson University, Philadelphia, PA 19107, USA;
| | - Kalyan Saginala
- Plains Regional Medical Group Internal Medicine, Clovis, NM 88101, USA;
| | - Sandeep Anand Padala
- Department of Medicine, Nephrology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Alexander Barsouk
- Hematologist-Oncologist, Allegheny Health Network, Pittsburgh, PA 15212, USA;
| | - Prashanth Rawla
- Department of Medicine, Sovah Health, Martinsville, VA 24112, USA;
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22
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Tracking the Genetic Susceptibility Background of B-Cell Non-Hodgkin's Lymphomas from Genome-Wide Association Studies. Int J Mol Sci 2020; 22:ijms22010122. [PMID: 33374413 PMCID: PMC7795678 DOI: 10.3390/ijms22010122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/10/2020] [Accepted: 12/18/2020] [Indexed: 12/31/2022] Open
Abstract
B-cell non-Hodgkin’s lymphoma (NHL) risk associations had been mainly attributed to family history of the disease, inflammation, and immune components including human leukocyte antigen (HLA) genetic variations. Nevertheless, a broad range of genome-wide association studies (GWAS) have shed light into the identification of several genetic variants presumptively associated with B-cell NHL etiologies, survival or shared genetic risk with other diseases. The present review aims to overview HLA structure and diversity and summarize the evidence of genetic variations, by GWAS, on five NHL subtypes (diffuse large B-cell lymphoma DLBCL, follicular lymphoma FL, chronic lymphocytic leukemia CLL, marginal zone lymphoma MZL, and primary central nervous system lymphoma PCNSL). Evidence indicates that the HLA zygosity status in B-cell NHL might promote immune escape and that genome-wide significance variants can give biological insight but also potential therapeutic markers such as WEE1 in DLBCL. However, additional studies are needed, especially for non-DLBCL, to replicate the associations found to date.
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23
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Zhong C, Franklin M, Wiemels J, McKean-Cowdin R, Chung NT, Benbow J, Wang SS, Lacey JV, Longcore T. Outdoor artificial light at night and risk of non-Hodgkin lymphoma among women in the California Teachers Study cohort. Cancer Epidemiol 2020; 69:101811. [PMID: 33002844 PMCID: PMC7710554 DOI: 10.1016/j.canep.2020.101811] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/07/2020] [Accepted: 09/04/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Outdoor artificial light at night (ALAN) has been implicated in a growing number of adverse health outcomes. ALAN is believed to disrupt circadian rhythms and has been associated with increased inflammation, one of the hallmarks of cancer. We examined the association between outdoor ALAN and a cancer strongly associated with autoimmune and inflammatory conditions, non-Hodgkin lymphoma (NHL), in the prospective California Teachers Study cohort. METHODS Outdoor ALAN was assigned to participant addresses at study baseline (1995-96) through use of the New World Atlas of Artificial Night Sky Brightness. Among 105,937 women followed from 1995 to 2015, linkage to the California Cancer Registry identified 873 incident cases of NHL. Age-stratified Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % confidence intervals (95 %CI) for overall NHL and the most common NHL subtypes; diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Multivariate analyses adjusted for previously reported subtype specific covariates (e.g. body mass index (BMI) for DLBCL). RESULTS Compared to the lowest quintile, participants residing in the highest quintile of outdoor ALAN at baseline were more likely to develop NHL (HR = 1.32, 95 %CI = 1.07-1.63), and, in particular, DLBCL (HR = 1.87, 95 %CI = 1.16-3.02). The elevated risk for DLBCL remained statistically significant after adjusting for age, race/ethnicity, BMI, and socioeconomic status (DLBCL:HR = 1.87, 95 %CI = 1.16-3.02, NHL:HR = 1.32, 95 %CI = 1.07-1.63). There was no association between ALAN and FL or CLL/SLL. CONCLUSION DLBCL risk was elevated among women residing in neighborhoods with greater outdoor ALAN. Future research in circadian disruption and DLBCL may clarify potential biological processes implicated in this association.
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Affiliation(s)
- Charlie Zhong
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, United States; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
| | - Meredith Franklin
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Joseph Wiemels
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Roberta McKean-Cowdin
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Nadia T Chung
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Jennifer Benbow
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Sophia S Wang
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - James V Lacey
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Travis Longcore
- Institute of the Environment and Sustainability, University of California, Los Angeles, Los Angeles, CA, United States
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24
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Garcin LM, Gelot A, Gomez RR, Gusto G, Boutron-Ruault MC, Kvaskoff M, Severi G, Besson C. Pigmentary traits, sun exposure, and risk of non-Hodgkin's lymphoma/chronic lymphocytic leukemia: A study within the French E3N prospective cohort. Cancer Med 2020; 10:297-304. [PMID: 33219744 PMCID: PMC7826467 DOI: 10.1002/cam4.3586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/09/2020] [Accepted: 10/14/2020] [Indexed: 11/13/2022] Open
Abstract
To investigate whether risk factors for keratinocyte carcinomas (KCs), namely pigmentary traits and sun exposure, are associated with risk of non‐Hodgkin's lymphomas (NHL) and chronic lymphocytic leukemia (CLL). E3N is a prospective cohort of French women aged 40–65 years at inclusion in 1990. Cancer data were collected at baseline and updated every 2–3 years. Hazard Ratios (HRs) and 95% confidence intervals (CIs) for associations between pigmentary traits and sun exposure, and risk of CLL/NHL were estimated using Cox models. With a median follow‐up of 24 years, 622 incident cases of CLL/NHL were ascertained among the 92,097 included women. The presence of nevi was associated with CLL/NHL risk: HR for “many or very many nevi” relative to “no nevi”: 1.56 [1.15; 2.11]. Such association with number of nevi appears to be mostly limited to risk of CLL: HR for “many or very many nevi”: 3.00 [1.38; 6.52]; versus 1.32 [0.94; 1.84] for NHL. Women whose skin was highly sensitive to sunburn also had a higher risk of CLL: HR = 1.96 [1.21; 3.18], while no increase in risk of NHL was observed. Skin or hair color, number of freckles, and average daily ultraviolet (UV) dose during spring and summer in location of residence at birth or at inclusion (kJ/m2) were not associated with CLL/NHL risk. Some pigmentary traits (presence of nevi and skin sensitivity), but not sun exposure, were associated with CLL/NHL. These observations suggest that CLL may share some constitutional risk factors with keratinocyte cancers.
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Affiliation(s)
- Louis-Marie Garcin
- Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Hematology-Oncology Department, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Amandine Gelot
- CESP, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, INSERM, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Roselyn-Rima Gomez
- CESP, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, INSERM, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Gaëlle Gusto
- CESP, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, INSERM, Villejuif, France.,Gustave Roussy, Villejuif, France
| | | | - Marina Kvaskoff
- CESP, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, INSERM, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- CESP, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, INSERM, Villejuif, France.,Gustave Roussy, Villejuif, France.,Departement of Statistics, Computer Science and Applications (DISIA), University of Florence, Florence, Italy
| | - Caroline Besson
- Hematology-Oncology Department, Centre Hospitalier de Versailles, Le Chesnay, France.,CESP, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, INSERM, Villejuif, France
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25
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Blansky D, Mantzaris I, Rohan T, Hosgood HD. Influence of Rurality, Race, and Ethnicity on Non-Hodgkin Lymphoma Incidence. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2020; 20:668-676.e5. [PMID: 32605898 PMCID: PMC7976043 DOI: 10.1016/j.clml.2020.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Exposure to lymphomagens vary by geography. The extent to which these contribute to racial and ethnic disparities in non-Hodgkin lymphoma (NHL) incidence is not well understood. We sought to evaluate the association between urban-rural status and racial and ethnic disparities in the 3 major NHL subtypes: diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), and chronic lymphocytic leukemia (CLL). PATIENTS AND METHODS We used data on NHL incidence from 21 Surveillance, Epidemiology, and End Results (SEER) population-based registries for the period 2000 to 2016. Population characteristics were compared by NHL subtype and urban-rural status, using rural-urban continuum codes from the US Department of Agriculture. Incidence rate ratios were calculated, and Poisson regression was used to assess the association between incidence and rurality. RESULTS A total of 136,197 DLBCL, 70,882 FL, and 120,319 CLL incident cases aged ≥ 20 years were reported. The majority of DLBCL patients were non-Hispanic white (73.5%), with 11.9% Hispanic and 7.3% non-Hispanic black, with a similar distribution observed in FL and CLL. Adjusting for age, sex, and family poverty, we found increased DLBCL incidence among Hispanics in increasingly urban areas compared to rural areas (rural incidence rate ratio [IRR] = 1.00; nonmetropolitan urban IRR = 1.32, 95% CI 1.16, 1.51; metropolitan urban IRR = 1.55, 95% CI 1.36, 1.76). Among non-Hispanic blacks, urban areas, relative to rural areas, were associated with increased CLL incidence (IRR = 1.48; 95% CI 1.27, 1.72). CONCLUSION Urban-rural incidence patterns suggest that environmental exposures in urban areas associated with DLBCL and CLL pathogenesis may disproportionately affect Hispanics and non-Hispanic blacks.
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Affiliation(s)
- Deanna Blansky
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
| | - Ioannis Mantzaris
- Department of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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26
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Al-Khatib SM, Abdo N, Al-Eitan LN, Al-Mistarehi AHW, Zahran DJ, Kewan TZ. LTA, LEP, and TNF-a Gene Polymorphisms are Associated with Susceptibility and Overall Survival of Diffuse Large B-Cell lymphoma in an Arab Population: A Case-Control Study. Asian Pac J Cancer Prev 2020; 21:2783-2791. [PMID: 32986381 PMCID: PMC7779465 DOI: 10.31557/apjcp.2020.21.9.2783] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Indexed: 01/08/2023] Open
Abstract
Objective: In this study, we aimed to explore the relationship between five selected proinflammatory and immune-mediated genes (TNF rs1800629G>A, rs361525G>A, rs1799964T>C, LTA rs1800683G>A, rs909253A>G, TNFAIP8 rs1042541C>T, LEPR rs1327118G>C, and LEP rs2167270G>A) and the risk and overall survival of DLBCL patients within the Jordanian Arab population. Methods: One hundred twenty-five patients (125) diagnosed with DLBCL at the King Abdullah University Hospital (KAUH) between 2013 and 2018 and 238 healthy cancer-free control subjects with similar geographic and ethnic backgrounds to the patients were included in the study. Genomic DNA was extracted from the formalin-fixed paraffin-embedded tissues of the subjects and from peripheral blood samples of the controls. The Sequenom MassARRAY® sequencer system (iPLEX GOLD) was used. The analyses included assessments of population variability and survival. Results: Our study showed significant differences in the distribution of the studied polymorphisms of DLBCL between the patients and controls for TNF rs1800629G>A, LTA rs909253 G>A and LEP rs2167270 G>A. TNF rs1800629G>A (p = 0.01), in which the G allele harbors a higher risk of DLBCL (GG and GA genotypes when compared with AA genotype) (p = 0.044). The LTA rs909253 A>G polymorphism is associated with a higher risk of DLBCL in the allelic model (p = .004). LEP rs2167270 G>A polymorphism is associated with a decreased risk of DLBCL in the recessive mode models (p = .03). Subjects with the dominant model for TNF-a rs1799964 (TT genotype in comparison with the combined TT/TC genotype) and patients with the homozygous genotype (GG) of rs361525 have better overall survival rates. Conclusion: Our results confirmed the diversity and the heterogeneity of the disease. Although the study has a limitation because of its relatively small size, it clearly emphasizes the significance of ancestry and genetic composition as the determinants of DLBCL risk and behavior.
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Affiliation(s)
- Sohaib M Al-Khatib
- Department of Pathology and Laboratory Medicine Jordan University of Science and Technology Irbid, Jordan
| | - Nour Abdo
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Laith N Al-Eitan
- Department of Biotechnology and Genetic Engineering, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed W Al-Mistarehi
- Department of Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Deeb Jamil Zahran
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Tariq Zuheir Kewan
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.,Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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27
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Moubadder L, McCullough LE, Flowers CR, Koff JL. Linking Environmental Exposures to Molecular Pathogenesis in Non-Hodgkin Lymphoma Subtypes. Cancer Epidemiol Biomarkers Prev 2020; 29:1844-1855. [PMID: 32727723 DOI: 10.1158/1055-9965.epi-20-0228] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/27/2020] [Accepted: 07/20/2020] [Indexed: 12/24/2022] Open
Abstract
Non-Hodgkin lymphoma comprises a heterogeneous group of hematologic malignancies, with about 60 subtypes that arise via various pathogenetic mechanisms. Although establishing etiology for specific NHL subtypes has been historically difficult given their relative rarity, environmental exposures have been repeatedly implicated as risk factors across many subtypes. Large-scale epidemiologic investigations have pinpointed chemical exposures in particular, but causality has not been established, and the exact biologic mechanisms underpinning these associations are unclear. Here we review chemical exposures that have been associated with development of NHL subtypes and discuss their biologic plausibility based on current research.
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Affiliation(s)
- Leah Moubadder
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Lauren E McCullough
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Christopher R Flowers
- Department of Lymphoma & Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jean L Koff
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
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28
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Occupational Exposure to Pesticides and Chronic Lymphocytic Leukaemia in the MCC-Spain Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145174. [PMID: 32709095 PMCID: PMC7400560 DOI: 10.3390/ijerph17145174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/29/2020] [Accepted: 07/05/2020] [Indexed: 12/28/2022]
Abstract
We aimed to study the association between occupational exposure to pesticides and chronic lymphocytic leukemia (CLL) in Spain. Occupational exposure to pesticides (four insecticides, four herbicides and two fungicides) was evaluated using a job-exposure matrix for the Spanish population (MatEmESp) among 302 CLL cases and 1567 population controls in five regions of Spain, 2010–2013. Cumulative exposure scores (CES) were obtained by summing across the exposed jobs the product of prevalence, intensity and duration of exposure to each active substance. Principal components analysis (PCA) and logistic regression models adjusted for age, sex, region, education and occupational exposure to solvents were used. Around 20% of controls and 29% of cases were exposed to one or more pesticides. Compared to non-exposed, subjects in the highest tertile (3rd tertile) of CES of insecticides, herbicides, fungicides were more likely to have CLL [OR (95% CI), P-trend; 2.10 (1.38; 3.19), 0.002; 1.77 (1.12; 2.80), 0.12; and 1.67 (1.06; 2.64), 0.10, respectively). Following PCA, the first component (PC1, explaining 70% of the variation) equally led by seven active substances (the insecticide pyrethrin, all herbicides, all fungicides) was associated with a 26% higher odds of having CLL for 1-standard deviation increase in PC1 (95% CI: 1.14 to 1.40). These results confirm previous associations between CLL and exposure to pesticides and provide additional evidence by application groups and active substance. However, more research is needed to disentangle independent effects of individual active substances.
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29
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Bispo JAB, Pinheiro PS, Kobetz EK. Epidemiology and Etiology of Leukemia and Lymphoma. Cold Spring Harb Perspect Med 2020; 10:cshperspect.a034819. [PMID: 31727680 DOI: 10.1101/cshperspect.a034819] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Available evidence suggests that the incidence of leukemia and lymphoma tends to be higher in highly developed regions of the world and among Whites in the United States. Temporal trends in incidence are dynamic and multifactorial; for instance, the incidence of non-Hodgkin's lymphoma increased around the turn of the century, in part because of the acquired immune deficiency syndrome (AIDS) epidemic. Most leukemias and lymphomas are sporadic and the specific etiology remains elusive. Still, research shows that these malignancies often develop in the context of genetic abnormalities, immunosuppression, and exposure to risk factors like ionizing radiation, carcinogenic chemicals, and oncogenic viruses. The prognosis varies by subtype, with poorer survival outcomes for acute leukemias among adults, and more favorable outcomes for Hodgkin's lymphoma. At a time when specific prevention efforts targeting these malignancies are nonexistent, there is a great need to ensure equitable access to diagnostic services and treatments worldwide.
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Affiliation(s)
- Jordan A Baeker Bispo
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida 33136, USA
| | - Paulo S Pinheiro
- Sylvester Comprehensive Cancer Center and Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida 33136, USA
| | - Erin K Kobetz
- Sylvester Comprehensive Cancer Center and Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida 33136, USA
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30
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Leak SA, Mmbaga LG, Mkwizu EW, Mapendo PJ, Henke O. Hematological malignancies in East Africa-Which cancers to expect and how to provide services. PLoS One 2020; 15:e0232848. [PMID: 32374771 PMCID: PMC7202623 DOI: 10.1371/journal.pone.0232848] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/22/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa (SSA) has an increasing non-communicable disease burden. Tanzania has an incidence of more than 35,000 cancer cases per year with an 80% mortality rate. Hematological malignancies account for 10% of these cases. The numbers will double within the next 10 years due to demographic changes, better diagnostic capabilities and life style changes. Kilimanjaro Christian Medical Centre established a Cancer Care Centre (CCC) in December 2016 for a catchment area of 15 million people in Northern Tanzania. This article aims to display the hematological diagnosis and characteristics of the patients as well as to describe the advancements of hematologic services in a low resource setting. METHODS A cross-sectional analysis of all hematological malignancies at CCC from December 2016 to May 2019 was performed and a narrative report provides information about diagnostic means, treatment and the use of synergies. RESULTS A total of 209 cases have been documented, the most common malignancies were NHL and MM with 44% and 20%. 36% of NHL cases, 16% of MM cases and 63% of CML cases were seen in patients under the age of 45. When subcategorized, CLL/SLL cases had a median age was 56.5, 51 years for those with other entities of NHL. Sexes were almost equally balanced in all NHL groups while clear male predominance was found in HL and CML. DISCUSSION Malignancies occur at a younger age and higher stages than in Western countries. It can be assumed that infections play a key role herein. Closing the gap of hematologic services in SSA can be achieved by adapting and reshaping existing infrastructure and partnering with international organizations.
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Affiliation(s)
- Steven Alan Leak
- Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Lilian Gasper Mmbaga
- Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Elifuraha Wilson Mkwizu
- Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Priscus John Mapendo
- Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Oliver Henke
- Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
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31
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The Impact of IL-6 and IL-10 Gene Polymorphisms in Diffuse Large B-Cell Lymphoma Risk and Overall Survival in an Arab Population: A Case-Control Study. Cancers (Basel) 2020; 12:cancers12020382. [PMID: 32046104 PMCID: PMC7072608 DOI: 10.3390/cancers12020382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/10/2020] [Accepted: 02/05/2020] [Indexed: 11/22/2022] Open
Abstract
B-cell lymphomas can be classified as Hodgkin and non-Hodgkin lymphomas. Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin Lymphoma (NHL). The incidence of NHL is variable and affected by age, gender, racial, and geographic factors. There is strong evidence that the immune-regulatory cytokines have a major role in hematologic malignancies. In this study, we analyzed the relationship between seven single nucleotide polymorphisms (SNPs) in two selected cytokines (IL-6 rs1800795G > C, rs1800796G > C, rs1800797G > A, IL-10 rs1800871G > A, rs1800872G > T, rs1800890A > T, rs1800896T > C) and the risk and overall survival of DLBCL patients in a Jordanian Arab population. One hundred and twenty-five DLBCL patients diagnosed at King Abdullah University Hospital (KAUH) from the period 2013–2018 and 238 matched healthy controls were included in the study. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissues. Genotyping of the genetic polymorphisms was conducted using a sequencing protocol. Our study showed no significant differences in the distribution of all studied polymorphisms of DLBCL between patients and controls. The IL-6 rs1800797 was the only SNP to show significant survival results, DLBCL subjects with the codominant model (GG/AG/AA) genotypes and recessive model (AA genotype in comparison with the combined GG/GA genotype) had worse overall survival (p = 0.028 and 0.016, respectively).
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Moore A, Kane E, Wang Z, Panagiotou OA, Teras LR, Monnereau A, Wong Doo N, Machiela MJ, Skibola CF, Slager SL, Salles G, Camp NJ, Bracci PM, Nieters A, Vermeulen RCH, Vijai J, Smedby KE, Zhang Y, Vajdic CM, Cozen W, Spinelli JJ, Hjalgrim H, Giles GG, Link BK, Clavel J, Arslan AA, Purdue MP, Tinker LF, Albanes D, Ferri GM, Habermann TM, Adami HO, Becker N, Benavente Y, Bisanzi S, Boffetta P, Brennan P, Brooks-Wilson AR, Canzian F, Conde L, Cox DG, Curtin K, Foretova L, Gapstur SM, Ghesquières H, Glenn M, Glimelius B, Jackson RD, Lan Q, Liebow M, Maynadie M, McKay J, Melbye M, Miligi L, Milne RL, Molina TJ, Morton LM, North KE, Offit K, Padoan M, Patel AV, Piro S, Ravichandran V, Riboli E, de Sanjose S, Severson RK, Southey MC, Staines A, Stewart C, Travis RC, Weiderpass E, Weinstein S, Zheng T, Chanock SJ, Chatterjee N, Rothman N, Birmann BM, Cerhan JR, Berndt SI. Genetically Determined Height and Risk of Non-hodgkin Lymphoma. Front Oncol 2020; 9:1539. [PMID: 32064237 PMCID: PMC6999122 DOI: 10.3389/fonc.2019.01539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/19/2019] [Indexed: 02/02/2023] Open
Abstract
Although the evidence is not consistent, epidemiologic studies have suggested that taller adult height may be associated with an increased risk of some non-Hodgkin lymphoma (NHL) subtypes. Height is largely determined by genetic factors, but how these genetic factors may contribute to NHL risk is unknown. We investigated the relationship between genetic determinants of height and NHL risk using data from eight genome-wide association studies (GWAS) comprising 10,629 NHL cases, including 3,857 diffuse large B-cell lymphoma (DLBCL), 2,847 follicular lymphoma (FL), 3,100 chronic lymphocytic leukemia (CLL), and 825 marginal zone lymphoma (MZL) cases, and 9,505 controls of European ancestry. We evaluated genetically predicted height by constructing polygenic risk scores using 833 height-associated SNPs. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for association between genetically determined height and the risk of four NHL subtypes in each GWAS and then used fixed-effect meta-analysis to combine subtype results across studies. We found suggestive evidence between taller genetically determined height and increased CLL risk (OR = 1.08, 95% CI = 1.00-1.17, p = 0.049), which was slightly stronger among women (OR = 1.15, 95% CI: 1.01-1.31, p = 0.036). No significant associations were observed with DLBCL, FL, or MZL. Our findings suggest that there may be some shared genetic factors between CLL and height, but other endogenous or environmental factors may underlie reported epidemiologic height associations with other subtypes.
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Affiliation(s)
- Amy Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Eleanor Kane
- Department of Health Sciences, University of York, York, United Kingdom
| | - Zhaoming Wang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, United States
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Orestis A. Panagiotou
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, United States
- Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI, United States
| | - Lauren R. Teras
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, United States
| | - Alain Monnereau
- Epidemiology of Childhood and Adolescent Cancers Group, Inserm, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
- Université Paris Descartes, Paris, France
- Registre des hémopathies malignes de la Gironde, Institut Bergonié, Bordeaux, France
| | - Nicole Wong Doo
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Mitchell J. Machiela
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Christine F. Skibola
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, United States
| | - Susan L. Slager
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Gilles Salles
- Department of Hematology, Hospices Civils de Lyon, Lyon, France
- Department of Hematology, Université Lyon-1, Lyon, France
- Equipe Experimental and Clinical Models of Lymphomagenesis, Cancer Research Center of Lyon, Institut National de Santé et de la Recherche Médicale UMR1052 Pierre Benite, Lyon, France
| | - Nicola J. Camp
- Division of Hematology and Hematologic Malignancies, Department of Internal Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Paige M. Bracci
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Alexandra Nieters
- Center for Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg im Breisgau, Germany
| | - Roel C. H. Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Joseph Vijai
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Karin E. Smedby
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Hematology Center, Karolinska University Hospital, Stockholm, Sweden
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Claire M. Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Wendy Cozen
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Norris Comprehensive Cancer Center, USC Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - John J. Spinelli
- Cancer Control Research, BC Cancer, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Henrik Hjalgrim
- Division of Health Surveillance and Research, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Graham G. Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Brian K. Link
- Department of Internal Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States
| | - Jacqueline Clavel
- Epidemiology of Childhood and Adolescent Cancers Group, Inserm, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
- Université Paris Descartes, Paris, France
| | - Alan A. Arslan
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, United States
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, United States
- Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY, United States
| | | | - Lesley F. Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Giovanni M. Ferri
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Thomas M. Habermann
- Division of General Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
| | - Nikolaus Becker
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Yolanda Benavente
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Barcelona, Spain
| | - Simonetta Bisanzi
- Regional Cancer Prevention Laboratory, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Paul Brennan
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Angela R. Brooks-Wilson
- Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center, Heidelberg, Germany
| | - Lucia Conde
- Bill Lyons Informatics Centre, UCL Cancer Institute, University College London, London, United Kingdom
| | - David G. Cox
- INSERM U1052, Cancer Research Center of Lyon, Centre Léon Bérard, Lyon, France
| | - Karen Curtin
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and MF MU, Brno, Czechia
| | - Susan M. Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, United States
| | - Hervé Ghesquières
- Equipe Experimental and Clinical Models of Lymphomagenesis, Cancer Research Center of Lyon, Institut National de Santé et de la Recherche Médicale UMR1052 Pierre Benite, Lyon, France
- Department of Hematology, Centre Léon Bérard, Lyon, France
| | - Martha Glenn
- Department of Internal Medicine, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Rebecca D. Jackson
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, Columbus, OH, United States
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Mark Liebow
- Division of General Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, United States
| | - Marc Maynadie
- INSERM U1231, Registre des Hémopathies Malignes de Côte d'Or, University of Burgundy and Dijon University Hospital, Dijon, France
| | - James McKay
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Mads Melbye
- Division of Health Surveillance and Research, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Unit, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Roger L. Milne
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Thierry J. Molina
- Department of Pathology, AP-HP, Necker Enfants malades, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Lindsay M. Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Kari E. North
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Center for Genome Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kenneth Offit
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Marina Padoan
- CPO-Piemonte and Unit of Medical Statistics and Epidemiology, Department Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Alpa V. Patel
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, United States
| | - Sara Piro
- Environmental and Occupational Epidemiology Unit, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Vignesh Ravichandran
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Elio Riboli
- School of Public Health, Imperial College London, London, United Kingdom
| | - Silvia de Sanjose
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Barcelona, Spain
| | - Richard K. Severson
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, United States
| | - Melissa C. Southey
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony Staines
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Carolyn Stewart
- Clinical Genetics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Ruth C. Travis
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Stephanie Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Tongzhang Zheng
- Department of Epidemiology, Brown School of Public Health, Providence, RI, United States
| | - Stephen J. Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Nilanjan Chatterjee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Brenda M. Birmann
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - James R. Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Sonja I. Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
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Solans M, Romaguera D, Gracia-Lavedan E, Molinuevo A, Benavente Y, Saez M, Marcos-Gragera R, Costas L, Robles C, Alonso E, de la Banda E, Gonzalez-Barca E, Llorca J, Rodriguez-Suarez MM, Lozano-Lorca M, Aymerich M, Campo E, Gimeno-Vázquez E, Castaño-Vinyals G, Aragonés N, Pollán M, Kogevinas M, de Sanjose S, Amiano P, Casabonne D. Adherence to the 2018 WCRF/AICR cancer prevention guidelines and chronic lymphocytic leukemia in the MCC-Spain study. Cancer Epidemiol 2019; 64:101629. [PMID: 31756676 DOI: 10.1016/j.canep.2019.101629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/28/2019] [Accepted: 10/31/2019] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Preventable risk factors for chronic lymphocytic leukemia (CLL) remain largely unknown. The aim of this study was to evaluate the association between adherence to nutrition-based guidelines for cancer prevention and CLL, in the MCC-Spain case-control study. METHODS A total of 318 CLL cases and 1293 population-based controls were included in the present study. The World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) score based on the 2018 recommendations for cancer prevention (on body fatness, physical activity, and diet) was constructed. We used logistic regression analysis adjusting for potential confounders. RESULTS Individuals in the highest tertile of the WCRF/AICR score had an odds ratio for CLL of 1.25 (95 % CI 0.91; 1.73) compared with individuals with low adherence (p-trend = 0.172). Each point increment in the score was associated with an OR for CLL of 1.06 (95 % CI 0.91; 1.23). Analyses by severity of disease did not show significant heterogeneity of effects. CONCLUSION Overall, our results do not support an association between the WCRF/AICR score and CLL, yet we might have been limited by statistical power and study design to detect modest associations. Further research, ideally with a prospective design, long follow-up, and including additional lymphoma subtypes, is warranted to confirm the impact of composite healthy lifestyle behaviors on lymphoma risk.
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Affiliation(s)
- Marta Solans
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003, Girona, Spain; Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, 17004, Girona, Spain
| | - Dora Romaguera
- Balearic Islands Health Research Institute (IdISBa), University Hospital Son Espases, 07120, Palma de Mallorca, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain; ISGlobal, 08003, Barcelona, Spain
| | - Esther Gracia-Lavedan
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain
| | - Amaia Molinuevo
- Public Health Division of Gipuzkoa, BioDonostia Research Institute, 20014, San Sebastian, Spain
| | - Yolanda Benavente
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908, Hospitalet De Llobregat, Spain
| | - Marc Saez
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003, Girona, Spain
| | - Rafael Marcos-Gragera
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, 17003, Girona, Spain; Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, 17004, Girona, Spain
| | - Laura Costas
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908, Hospitalet De Llobregat, Spain
| | - Claudia Robles
- Unit of information and interventions in infections and cancer (UNIC-I&I), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908, Hospitalet de Llobregat, Spain
| | - Esther Alonso
- Department of Patology, Hospital Universitari de Bellvitge, IDIBELL, 08907, L'Hospitalet de Llobregat, Spain
| | - Esmeralda de la Banda
- Department of Patology, Hospital Universitari de Bellvitge, IDIBELL, 08907, L'Hospitalet de Llobregat, Spain
| | - Eva Gonzalez-Barca
- Hematology, IDIBELL, Catalan Institute of Oncology, 08908, L'Hospitalet de Llobregat, Spain
| | - Javier Llorca
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Universidad de Cantabria - IDIVAL, 39011, Santander, Spain
| | - Marta Maria Rodriguez-Suarez
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; IUOPA, University of Oviedo, ISPA-FINBA, 33003, Oviedo, Spain
| | - Macarena Lozano-Lorca
- Dpto. de Medicina Preventiva y Salud Pública. Universidad de Granada, 18071, Granada, Spain; Instituto de Investigación Biosanitaria de Granada.ibs, 18012, Granada, Spain
| | - Marta Aymerich
- Hematopathology Unit, Pathology Department, Hospital Clínic, University of Barcelona, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), 08008, Barcelona, Spain
| | - Elias Campo
- Hematopathology Unit, Pathology Department, Hospital Clínic, University of Barcelona, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), 08008, Barcelona, Spain; Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - Eva Gimeno-Vázquez
- Hematology Department, Hematology Department. Grup de Recerca Clínica Aplicada en Neoplàsies Hematològiques, Cancer Research Programme, IMIM-Hospital del Mar, 08003, Barcelona, Spain
| | - Gemma Castaño-Vinyals
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain
| | - Nuria Aragonés
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, 28035, Madrid, Spain
| | - Marina Pollán
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, 28029, Madrid, Spain
| | - Manolis Kogevinas
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), 08003, Barcelona, Spain
| | - Silvia de Sanjose
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908, Hospitalet De Llobregat, Spain; PATH, Reproductive Health, Seattle, United States
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Public Health Division of Gipuzkoa, BioDonostia Research Institute, 20014, San Sebastian, Spain
| | - Delphine Casabonne
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908, Hospitalet De Llobregat, Spain.
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Stranska K, Plevova K, Skuhrova Francova H, Skabrahova H, von Jagwitz-Biegnitz M, Radova L, Panovska A, Hrobkova S, Brychtova Y, Urbanova R, Smolej L, Simkovic M, Zuchnicka J, Mohammadova L, Spacek M, Mayer J, Pospisilova S, Doubek M. Profiling of biological and environmental risk factors in immunogenetic subgroups of chronic lymphocytic leukemia - Czech national study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 164:425-434. [PMID: 31558845 DOI: 10.5507/bp.2019.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/04/2019] [Indexed: 11/23/2022] Open
Abstract
AIMS This is a nation-wide survey of chronic lymphocytic leukemia (CLL) patients at six large hematology centers in the Czech Republic. The aim was to identify specific populations, social, and health characteristics of CLL subgroups divided according to the immunogenetic features of their B cell receptors (BCRs) and clonality. PATIENTS AND METHODS Questionnaires directed to specific health, social, and environmental conditions were collected in a cohort of 573 CLL patients. For these patients, immunoglobulin heavy chain gene rearrangements were also analyzed in order to gain information about their clonality, IGHV mutational status, and the presence of stereotyped BCRs. Data extracted from the questionnaires were analyzed statistically in the context of immunogenetic features of the cohort. RESULTS There were no statistically significant differences in the data collected in the survey between patients with mutated and patients with unmutated IGHV. However, patients with oligoclonal CLL reported health conditions such as hypercholesterolemia, hypertension, herpes simplex, tumors, and also, separately, CLL in 1st degree relatives, more often than their monoclonal counterparts. In patients with stereotyped BCRs, we found more frequent alcohol consumption and gastric infections in subset #1 cases and frequent cholecystectomies and familial CLL in subset #2 cases. CONCLUSION To the best of our knowledge, this study is the first to investigate CLL immunogenetic features and clonality in the context of epidemiological data. We reported statistically significant associations suggesting the influence of certain health and social conditions on a number of clonal populations expanding in CLL and also on characteristic BCR features, especially stereotypy.
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Affiliation(s)
- Kamila Stranska
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Karla Plevova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Hana Skuhrova Francova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Hana Skabrahova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Magdalena von Jagwitz-Biegnitz
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lenka Radova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Anna Panovska
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Stanislava Hrobkova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Yvona Brychtova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Renata Urbanova
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | | | | | - Jana Zuchnicka
- Department of Hematooncology, University Hospital Ostrava, Czech Republic
| | - Lekaa Mohammadova
- Department of Hematology and Oncology, University Hospital Pilsen, Czech Republic
| | | | - Jiri Mayer
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Sarka Pospisilova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Michael Doubek
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology, Masaryk University, Brno, Czech Republic
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Clay-Gilmour AI, Rishi AR, Goldin LR, Greenberg-Worisek AJ, Achenbach SJ, Rabe KG, Maurer MJ, Kay NE, Shanafelt TD, Call TG, Brice Weinberg J, Camp NJ, Cerhan JR, Leis J, Norman A, Murray DL, Vincent Rajkumar S, Caporaso NE, Landgren O, McMaster ML, Slager SL, Vachon CM. Association of elevated serumfree light chains with chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis. Blood Cancer J 2019; 9:59. [PMID: 31383849 PMCID: PMC6683199 DOI: 10.1038/s41408-019-0220-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 05/06/2019] [Indexed: 02/08/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) and its precursor, monoclonal B-cell lymphocytosis (MBL), are heritable. Serumfree light-chain (sFLC) measures are a prognostic factor for CLL, but their role in susceptibility to CLL is not clear. We investigated differences between sFLC measurements in pre-treatment serum from five groups to inform the association of sFLC with familial and sporadic CLL: (1) familial CLL (n = 154), (2) sporadic CLL (n = 302), (3) familial MBL (n = 87), (4) unaffected first-degree relatives from CLL/MBL families (n = 263), and (5) reference population (n = 15,396). The percent of individuals having elevated monoclonal and polyclonal sFLCs was compared using age-stratified and age- and sex-adjusted logistic regression models. In age groups >50 years, monoclonal sFLC elevations were increased in sporadic and familial CLL cases compared to the reference population (p's < 0.05). However, there were no statistically significant differences in sFLC monoclonal or polyclonal elevations between familial and sporadic CLL cases (p's > 0.05). Unaffected relatives and MBL cases from CLL/MBL families, ages >60 years, showed elevated monoclonal sFLC, compared to the reference population (p's < 0.05). This is the first study to demonstrate monoclonal sFLC elevations in CLL cases compared to controls. Monoclonal sFLC levels may provide additional risk information in relatives of CLL probands.
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Affiliation(s)
- Alyssa I Clay-Gilmour
- Division of Epidemiology, Department of Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Abdul R Rishi
- Department of Internal Medicine, Mercy Hospital, St. Louis, MO, USA
| | - Lynn R Goldin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | | | - Sara J Achenbach
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kari G Rabe
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Matthew J Maurer
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Neil E Kay
- Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Tait D Shanafelt
- Stanford University Medical Center, Department of Medicine/Hematology, Stanford, CA, USA
| | - Timothy G Call
- Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - Nicola J Camp
- Department of Medicine, University of Utah and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - James R Cerhan
- Division of Epidemiology, Department of Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jose Leis
- Division of Medical Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Aaron Norman
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - David L Murray
- Laboratory Medicine and Pathology, College of Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Ola Landgren
- Myeloma Service, Division of Hematologic Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Mary L McMaster
- Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Susan L Slager
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Celine M Vachon
- Division of Epidemiology, Department of Health Sciences, Mayo Clinic, Rochester, MN, USA.
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36
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Cerhan JR, Kane E, Vajdic CM, Linet MS, Monnereau A, Bernstein L, de Sanjose S, Chiu BCH, Spinelli JJ, Dal Maso L, Zhang Y, Larrabee BR, Cozen W, Smith AG, Clavel J, Serraino D, Zheng T, Holly EA, Weisenberger DD, Slager SL, Bracci PM. Blood transfusion history and risk of non-Hodgkin lymphoma: an InterLymph pooled analysis. Cancer Causes Control 2019; 30:889-900. [PMID: 31165419 PMCID: PMC6613988 DOI: 10.1007/s10552-019-01188-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/18/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE To conduct a pooled analysis assessing the association of blood transfusion with risk of non-Hodgkin lymphoma (NHL). METHODS We used harmonized data from 13 case-control studies (10,805 cases, 14,026 controls) in the InterLymph Consortium. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression, adjusted for study design variables. RESULTS Among non-Hispanic whites (NHW), history of any transfusion was inversely associated with NHL risk for men (OR 0.74; 95% CI 0.65-0.83) but not women (OR 0.92; 95% CI 0.83-1.03), pheterogeneity = 0.014. Transfusion history was not associated with risk in other racial/ethnic groups. There was no trend with the number of transfusions, time since first transfusion, age at first transfusion, or decade of first transfusion, and further adjustment for socioeconomic status, body mass index, smoking, alcohol use, and HCV seropositivity did not alter the results. Associations for NHW men were stronger in hospital-based (OR 0.56; 95% CI 0.45-0.70) but still apparent in population-based (OR 0.84; 95% CI 0.72-0.98) studies. CONCLUSIONS In the setting of a literature reporting mainly null and some positive associations, and the lack of a clear methodologic explanation for our inverse association restricted to NHW men, the current body of evidence suggests that there is no association of blood transfusion with risk of NHL.
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Affiliation(s)
- James R Cerhan
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Eleanor Kane
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, AGSM Building, Level 1 (G27), UNSW, Kensington, NSW, 2052, Australia
| | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive Room 7E452, Bethesda, MD, 20892-9778, USA
| | - Alain Monnereau
- Registre des Hémopathies Malignes de la Gironde, Institut Bergonié, University of Bordeaux, Inserm, Team EPICENE, UMR 1219, 33000, Paris, France
- Epidemiology of Childhood and Adolescent Cancers Group, Inserm, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
| | - Leslie Bernstein
- Department of Population Sciences, Beckman Research Institute of City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA
| | - Silvia de Sanjose
- Cancer Epidemiology Research Programme, |IDIBELL | CIBERESP| Institut Català d'Oncologia, Barcelona, Spain
| | - Brian C-H Chiu
- Department of Public Health Sciences, University of Chicago, 5841 S. Maryland Ave, MC 2000, Chicago, IL, 60637, USA
| | - John J Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - L Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Yawei Zhang
- Section of Surgical Outcomes and Epidemiology, Department of Surgery, Yale School of Medicine, 60 College Street, New Haven, CT, 06520, USA
| | - Beth R Larrabee
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Wendy Cozen
- Departments of Preventive Medicine and Pathology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Alexandra G Smith
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Jacqueline Clavel
- Epidemiology of Childhood and Adolescent Cancers Group, Inserm, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
- Université Paris Descartes, Paris, France
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Tongzhang Zheng
- Department of Epidemiology, Brown School of Public Health, Providence, RI, 02912, USA
| | - Elizabeth A Holly
- Dept of Epidemiology and Biostatistics, University of California San Francisco, 3333 California Street, Suite 280, San Francisco, CA, 94118, USA
| | - Dennis D Weisenberger
- Department of Pathology, City of Hope Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Susan L Slager
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Paige M Bracci
- Dept of Epidemiology and Biostatistics, University of California San Francisco, 3333 California Street, Suite 280, San Francisco, CA, 94118, USA
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Park HY, Hong YC, Lee K, Koh J. Vitamin D status and risk of non-Hodgkin lymphoma: An updated meta-analysis. PLoS One 2019; 14:e0216284. [PMID: 31034511 PMCID: PMC6488072 DOI: 10.1371/journal.pone.0216284] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 04/17/2019] [Indexed: 01/11/2023] Open
Abstract
Purpose This meta-analysis aimed to extensively investigate the association between various measures of vitamin D status and non-Hodgkin lymphoma (NHL) and its subtypes. Methods We searched MEDLINE (PubMed), Embase, and the Cochrane Library in February 2018. Two authors independently reviewed and selected articles based on predetermined criteria. Results A total of 30 studies with 56,458 NHL cases were finally selected, with 24, 9, and 3 studies on sunlight/ultraviolet radiation (UVR) exposure, dietary intake, and serum/plasma 25-hydroxyvitamin D levels, respectively. Significant protective effects of overall sunlight/UVR exposure on NHL and subtypes were observed, with summary relative risks (RRs) ranging from 0.67–0.80 (RR for NHL = 0.80; 95% confidence interval [CI]: 0.71–0.90) among subjects with high exposure compared to those with low exposure. The results were consistent with various classifications of sunlight/UVR exposure. In contrast, when exposure measures of dietary vitamin D intake (RR for NHL = 1.03; 95% CI: 0.90–1.19) and serum/plasma 25-hydroxyvitamin D levels (RR for NHL = 0.97; 95% CI: 0.82–1.15) were used, risk estimates were inconsistent or non-significant for NHL and the subtypes. Conclusion While risk estimates varied by different measures of vitamin D status, a protective effect of sunlight/UVR exposure on NHL incidence was verified, across most of the tested subtypes as well as exposure categories.
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Affiliation(s)
- Hye Yin Park
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si, Gyeonggi-do, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
- * E-mail:
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Environment Health Center, Seoul National University, Seoul, Korea
| | - Kyoungho Lee
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si, Gyeonggi-do, Korea
| | - Jaewoo Koh
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si, Gyeonggi-do, Korea
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38
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von Tresckow J, Eichhorst B, Bahlo J, Hallek M. The Treatment of Chronic Lymphatic Leukemia. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 116:41-46. [PMID: 30855005 PMCID: PMC6415618 DOI: 10.3238/arztebl.2019.0041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 09/28/2017] [Accepted: 11/05/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chronic lymphocytic leukemia (CLL) mainly affects older persons and is the commonest form of leukemia, with an incidence of 6 cases per 100 000 per- sons per year. In Germany, approximately 1000 men and 850 women die of CLL each year. METHODS This review is based on pertinent publications retrieved by a selective literature search in PubMed and on the authors' scientific and clinical experience. RESULTS The diagnosis of CLL requires the detection of at least 5000 B-lymphocytes per microliter in the peripheral blood. Courses of CLL may be indolent and require no treatment, but may also be aggressive and progress rapidly. Treatment should be initiated when there is marked evidence of bone-marrow suppression or disease- related symptoms such as B symptoms or fatigue. In the past ten years, a number of targeted drugs have been introduced that can achieve a very good, long-lasting response, particularly when used in combination. The combination of chemotherapy with anti-CD20 antibodies (chemoimmunotherapy) is the standard first-line treat- ment. In younger patients without any relevant accompanying illnesses, the combi- nation of fludarabine, cyclophosphamide, and rituximab prolongs survival. Patients with comorbidities should be treated with a combination of chlorambucil and obinutuzumab. In the last few years, ibrutinib, idelalsib, and venetoclax have been approved for clinical use. These substances inhibit cellular signal transduction pathways and are being increasingly used. CONCLUSION Recent progress in the development of novel treatment options gives hope that CLL may soon be a controllable disease. Even at present, chemoimmuno- therapy can achieve a progression-free survival of more than eight years in certain genetically defined subgroups of CLL patients.
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Affiliation(s)
- Julia von Tresckow
- Department of Internal Medicine I – Oncology, Hematology, Clinical Infectiology, Clinical Immunology, Hemostaseology, Internal Intensive Care; University Hospital Cologne, Cologne, Germany
| | - Barbara Eichhorst
- Department of Internal Medicine I – Oncology, Hematology, Clinical Infectiology, Clinical Immunology, Hemostaseology, Internal Intensive Care; University Hospital Cologne, Cologne, Germany
| | - Jasmin Bahlo
- Department of Internal Medicine I – Oncology, Hematology, Clinical Infectiology, Clinical Immunology, Hemostaseology, Internal Intensive Care; University Hospital Cologne, Cologne, Germany
| | - Michael Hallek
- Department of Internal Medicine I – Oncology, Hematology, Clinical Infectiology, Clinical Immunology, Hemostaseology, Internal Intensive Care; University Hospital Cologne, Cologne, Germany
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39
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Crespi M, Demarzo MG, Brunacci M, Pellegatta G, Ferrando F, Ballestrero A, Grillo F, Savarino V, Giannini EG. Improvement in Waldenström's Macroglobulinemia after Successful Treatment of HCV with Direct-acting Antivirals. Ann Hepatol 2018; 17:1072-1077. [PMID: 30600285 DOI: 10.5604/01.3001.0012.7208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Chronic hepatitis C (HCV) virus infection may be associated with several non-hepatic manifestations, mainly driven by chronic immune stimulation, such as mixed cryoglobulinemia and Non-Hodgkin's Lymphoma. This association has been proved by several meta-analyses and some interventional studies demonstrating that antiviral treatment may be effective in inducing HCV-associated lymphoma regression. The recent advent of direct acting antivirals (DAAs) in the therapeutic armamentarium of HCV infection made possible treatment of patients with advanced liver disease. Here we report on a rare association of a cirrhotic patient with HCV and Waldenström's Macroglobulinemia with severe cryoglobulinemia, who had already failed an interferon-based antiviral regimen, whose haematologic disease was ameliorated by HCV eradication following treatment with sofosbuvir and simeprevir with ribavirin, and where successful treatment was accompanied also by consistent improvement in liver function and parameters of portal hypertension.
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Affiliation(s)
- Mattia Crespi
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Maria Giulia Demarzo
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Matteo Brunacci
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Gaia Pellegatta
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Fabio Ferrando
- Internal Medicine and Oncology Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Alberto Ballestrero
- Internal Medicine and Oncology Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Federica Grillo
- Pathology Unit, Department of Surgical Sciences, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Vincenzo Savarino
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Edoardo G Giannini
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
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40
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Solans M, Castelló A, Benavente Y, Marcos-Gragera R, Amiano P, Gracia-Lavedan E, Costas L, Robles C, Gonzalez-Barca E, de la Banda E, Alonso E, Aymerich M, Campo E, Dierssen-Sotos T, Fernández-Tardón G, Olmedo-Requena R, Gimeno E, Castaño-Vinyals G, Aragonés N, Kogevinas M, de Sanjose S, Pollán M, Casabonne D. Adherence to the Western, Prudent, and Mediterranean dietary patterns and chronic lymphocytic leukemia in the MCC-Spain study. Haematologica 2018; 103:1881-1888. [PMID: 29954942 PMCID: PMC6278961 DOI: 10.3324/haematol.2018.192526] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/25/2018] [Indexed: 12/12/2022] Open
Abstract
Diet is a modifiable risk factor for several neoplasms but evidence for chronic lymphocytic leukemia (CLL) is sparse. Previous studies examining the association between single-food items and CLL risk have yielded mixed results, while few studies have been conducted on overall diet, reporting inconclusive findings. This study aimed to evaluate the association between adherence to three dietary patterns and CLL in the multicase-control study (MCC-Spain) study. Anthropometric, sociodemographic, medical and dietary information was collected for 369 CLL cases and 1605 controls. Three validated dietary patterns, Western, Prudent and Mediterranean, were reconstructed in the MCC-Spain data. The association between adherence to each dietary pattern and CLL was assessed, overall and by Rai stage, using mixed logistic regression models adjusted for potential confounders. High adherence to a Western dietary pattern (i.e. high intake of high-fat dairy products, processed meat, refined grains, sweets, caloric drinks, and convenience food) was associated with CLL [ORQ4 vs. Q1=1.63 (95%CI 1.11; 2.39); P-trend=0.02; OR 1-SD increase=1.19 (95%CI: 1.03; 1.37)], independently of Rai stages. No differences in the association were observed according to sex, Body Mass Index, energy intake, tobacco, physical activity, working on a farm, or family history of hematologic malignancies. No associations were observed for Mediterranean and Prudent dietary patterns and CLL. This study provides the first evidence for an association between a Western dietary pattern and CLL, suggesting that a proportion of CLL cases could be prevented by modifying dietary habits. Further research, especially with a prospective design, is warranted to confirm these findings.
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Affiliation(s)
- Marta Solans
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Spain.,Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Adela Castelló
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Yolanda Benavente
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Unit of Molecular Epidemiology and Genetic in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme (IDIBELL), Catalan Institute of Oncology, L' Hospitalet De Llobregat, Spain
| | - Rafael Marcos-Gragera
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Spain.,Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Esther Gracia-Lavedan
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Laura Costas
- Unit of Molecular Epidemiology and Genetic in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme (IDIBELL), Catalan Institute of Oncology, L' Hospitalet De Llobregat, Spain
| | - Claudia Robles
- Unit of Information and Interventions in Infections and Cancer (UNIC-I&I), Cancer Epidemiology Research Programme, (IDIBELL), Catalan Institute of Oncology, L' Hospitalet De Llobregat, Spain
| | - Eva Gonzalez-Barca
- Hematology, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Esmeralda de la Banda
- Hematology Laboratory, Department of Pathology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Esther Alonso
- Hematology Laboratory, Department of Pathology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Marta Aymerich
- Hospital Clinic de Barcelona, University of Barcelona, CIBERONC, Barcelona Spain
| | - Elias Campo
- Hospital Clinic de Barcelona, University of Barcelona, CIBERONC, Barcelona Spain
| | - Trinidad Dierssen-Sotos
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,University of Cantabria - Marqués de Valdecilla Research Institute (IDIVAL), Santander, Spain
| | - Guillermo Fernández-Tardón
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,University Institute of Oncology (IUOPA), University of Oviedo, Spain
| | - Rocio Olmedo-Requena
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Preventive Medicine and Public Health, University of Granada, Spain.,Instituto de Investigación Biosanitaria de Granada, Hospitales Universitarios de Granada, Spain
| | - Eva Gimeno
- Hematology Department, Hospital del Mar, Barcelona, Spain
| | - Gemma Castaño-Vinyals
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Nuria Aragonés
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Epidemiology Section, Public Health Division, Department of Health of Madrid, Spain
| | - Manolis Kogevinas
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Silvia de Sanjose
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Unit of Molecular Epidemiology and Genetic in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme (IDIBELL), Catalan Institute of Oncology, L' Hospitalet De Llobregat, Spain.,PATH, Reproductive Health, Seattle, WA, USA
| | - Marina Pollán
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Delphine Casabonne
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Madrid, Spain .,Unit of Molecular Epidemiology and Genetic in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme (IDIBELL), Catalan Institute of Oncology, L' Hospitalet De Llobregat, Spain
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41
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Kleinstern G, Camp NJ, Goldin LR, Vachon CM, Vajdic CM, de Sanjose S, Weinberg JB, Benavente Y, Casabonne D, Liebow M, Nieters A, Hjalgrim H, Melbye M, Glimelius B, Adami HO, Boffetta P, Brennan P, Maynadie M, McKay J, Cocco PL, Shanafelt TD, Call TG, Norman AD, Hanson C, Robinson D, Chaffee KG, Brooks-Wilson AR, Monnereau A, Clavel J, Glenn M, Curtin K, Conde L, Bracci PM, Morton LM, Cozen W, Severson RK, Chanock SJ, Spinelli JJ, Johnston JB, Rothman N, Skibola CF, Leis JF, Kay NE, Smedby KE, Berndt SI, Cerhan JR, Caporaso N, Slager SL. Association of polygenic risk score with the risk of chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis. Blood 2018; 131:2541-2551. [PMID: 29674426 PMCID: PMC5992865 DOI: 10.1182/blood-2017-11-814608] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 03/23/2018] [Indexed: 01/07/2023] Open
Abstract
Inherited loci have been found to be associated with risk of chronic lymphocytic leukemia (CLL). A combined polygenic risk score (PRS) of representative single nucleotide polymorphisms (SNPs) from these loci may improve risk prediction over individual SNPs. Herein, we evaluated the association of a PRS with CLL risk and its precursor, monoclonal B-cell lymphocytosis (MBL). We assessed its validity and discriminative ability in an independent sample and evaluated effect modification and confounding by family history (FH) of hematological cancers. For discovery, we pooled genotype data on 41 representative SNPs from 1499 CLL and 2459 controls from the InterLymph Consortium. For validation, we used data from 1267 controls from Mayo Clinic and 201 CLL, 95 MBL, and 144 controls with a FH of CLL from the Genetic Epidemiology of CLL Consortium. We used odds ratios (ORs) to estimate disease associations with PRS and c-statistics to assess discriminatory accuracy. In InterLymph, the continuous PRS was strongly associated with CLL risk (OR, 2.49; P = 4.4 × 10-94). We replicated these findings in the Genetic Epidemiology of CLL Consortium and Mayo controls (OR, 3.02; P = 7.8 × 10-30) and observed high discrimination (c-statistic = 0.78). When jointly modeled with FH, PRS retained its significance, along with FH status. Finally, we found a highly significant association of the continuous PRS with MBL risk (OR, 2.81; P = 9.8 × 10-16). In conclusion, our validated PRS was strongly associated with CLL risk, adding information beyond FH. The PRS provides a means of identifying those individuals at greater risk for CLL as well as those at increased risk of MBL, a condition that has potential clinical impact beyond CLL.
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Affiliation(s)
| | - Nicola J Camp
- Huntsman Cancer Institute and Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Lynn R Goldin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Celine M Vachon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Silvia de Sanjose
- CIBER de Epidemiología y Salud Pública, Barcelona, Spain
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Institute d'Investigacio Biomedica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Brice Weinberg
- Department of Medicine and
- Department of Immunology, Duke University Medical Center, Durham, NC
- Durham Veterans Affairs Medical Center, Durham, NC
| | - Yolanda Benavente
- CIBER de Epidemiología y Salud Pública, Barcelona, Spain
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Institute d'Investigacio Biomedica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Delphine Casabonne
- CIBER de Epidemiología y Salud Pública, Barcelona, Spain
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Institute d'Investigacio Biomedica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mark Liebow
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Alexandra Nieters
- Center for Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Baden-Württemberg, Germany
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Division of Health Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Mads Melbye
- Department of Epidemiology Research, Division of Health Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Marc Maynadie
- Registre des Hémopathies Malignes de Côte d'Or, INSERM UMR1231, Université de Bourgogne-Franche-Comté, Dijon, France
| | - James McKay
- International Agency for Research on Cancer, Lyon, France
| | - Pier Luigi Cocco
- Department of Medical Sciences and Public Health, Occupational Health Section, University of Cagliari, Monserrato, Italy
| | | | | | - Aaron D Norman
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Curtis Hanson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Dennis Robinson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Kari G Chaffee
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Angela R Brooks-Wilson
- Genome Sciences Centre, BC Cancer Agency, Vancouver, BC, Canada
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Alain Monnereau
- Registre des Hémopathies Malignes de la Gironde, Institut Bergonié, University of Bordeaux, INSERM, Team EPICENE, UMR 1219, Bordeaux, France
- Epidemiology of Childhood and Adolescent Cancers Group, INSERM, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris, France
- Université Paris Descartes, Paris, France
| | - Jacqueline Clavel
- Epidemiology of Childhood and Adolescent Cancers Group, INSERM, Center of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris, France
- Université Paris Descartes, Paris, France
| | - Martha Glenn
- Huntsman Cancer Institute and Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Karen Curtin
- Huntsman Cancer Institute and Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Lucia Conde
- UCL Cancer Institute, London, United Kingdom
| | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Wendy Cozen
- Department of Preventive Medicine and
- Norris Comprehensive Cancer Center, USC Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Richard K Severson
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - John J Spinelli
- Cancer Control Research, BC Cancer Agency, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - James B Johnston
- Department of Medical Oncology, Cancer Care Manitoba, Winnipeg, MB, Canada
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Christine F Skibola
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
| | - Jose F Leis
- Department of Hematology and Oncology, Mayo Clinic, Phoenix, AZ; and
| | - Neil E Kay
- Department of Medical Sciences and Public Health, Occupational Health Section, University of Cagliari, Monserrato, Italy
| | - Karin E Smedby
- Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Neil Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Susan L Slager
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
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Strati P, Jain N, O'Brien S. Chronic Lymphocytic Leukemia: Diagnosis and Treatment. Mayo Clin Proc 2018; 93:651-664. [PMID: 29728204 DOI: 10.1016/j.mayocp.2018.03.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/30/2018] [Accepted: 03/02/2018] [Indexed: 12/27/2022]
Abstract
The complexity of the treatment of patients with chronic lymphocytic leukemia has increased substantially over the past several years as a consequence of the advent of novel biological agents such as ibrutinib, idelalisib, and venetoclax, as well as increasingly potent anti-CD20 monoclonal antibodies. In addition, the identification of molecular predictive markers and the introduction of more sensitive and sophisticated techniques to assess minimal residual disease have allowed optimization of the use of chemoimmunotherapy and targeted therapies and may become standard of care in the future. This review summarizes the diagnosis, prognostication, and treatment of patients with chronic lymphocytic leukemia with emphasis on new prognostic and predictive factors and novel treatment strategies.
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MESH Headings
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Humans
- Immunotherapy/methods
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
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Affiliation(s)
- Paolo Strati
- Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nitin Jain
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Susan O'Brien
- Chao Family Comprehensive Cancer Center, University of California, Irvine, Orange, CA.
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Chronic lymphocytic leukemia and mantle cell lymphoma: crossroads of genetic and microenvironment interactions. Blood 2018; 131:2283-2296. [PMID: 29666114 DOI: 10.1182/blood-2017-10-764373] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/03/2018] [Indexed: 02/07/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) are 2 well-defined entities that diverge in their basic pathogenic mechanisms and clinical evolution but they share epidemiological characteristics, cells of origin, molecular alterations, and clinical features that differ from other lymphoid neoplasms. CLL and MCL are classically considered indolent and aggressive neoplasms, respectively. However, the clinical evolution of both tumors is very heterogeneous, with subsets of patients having stable disease for a long time whereas others require immediate intervention. Both CLL and MCL include 2 major molecular subtypes that seem to derive from antigen-experienced CD5+ B cells that retain a naive or memory-like epigenetic signature and carry a variable load of immunoglobulin heavy-chain variable region somatic mutations from truly unmutated to highly mutated, respectively. These 2 subtypes of tumors differ in their molecular pathways, genomic alterations, and clinical behavior, being more aggressive in naive-like than memory-like-derived tumors in both CLL and MCL. The pathogenesis of the 2 entities integrates the relevant influence of B-cell receptor signaling, tumor cell microenvironment interactions, genomic alterations, and epigenome modifications that configure the evolution of the tumors and offer new possibilities for therapeutic intervention. This review will focus on the similarities and differences of these 2 tumors based on recent studies that are enhancing the understanding of their pathogenesis and creating solid bases for new management strategies.
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Hallek M, Shanafelt TD, Eichhorst B. Chronic lymphocytic leukaemia. Lancet 2018; 391:1524-1537. [PMID: 29477250 DOI: 10.1016/s0140-6736(18)30422-7] [Citation(s) in RCA: 209] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 10/30/2017] [Accepted: 11/13/2017] [Indexed: 12/15/2022]
Abstract
Important advances in understanding the pathogenesis of chronic lymphocytic leukaemia in the past two decades have led to the development of new prognostic tools and novel targeted therapies that have improved clinical outcome. Chronic lymphocytic leukaemia is the most common type of leukaemia in developed countries, and the median age at diagnosis is 72 years. The criteria for initiating treatment rely on the Rai and Binet staging systems and on the presence of disease-related symptoms. For many patients with chronic lymphocytic leukaemia, treatment with chemotherapy and anti-CD20 monoclonal antibodies is the standard of care. The impressive efficacy of kinase inhibitors ibrutinib and idelalisib and the BCL-2 antagonist venetoclax have changed the standard of care in specific subsets of patients. In this Seminar, we review the recent progress in the management of chronic lymphocytic leukaemia and highlight new questions surrounding the optimal disease management.
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MESH Headings
- Adenine/analogs & derivatives
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bridged Bicyclo Compounds, Heterocyclic/therapeutic use
- Diagnosis, Differential
- Genetic Predisposition to Disease
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/etiology
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Mutation
- Piperidines
- Prognosis
- Purines/therapeutic use
- Pyrazoles/therapeutic use
- Pyrimidines/therapeutic use
- Quinazolinones/therapeutic use
- Recurrence
- Risk Factors
- Sulfonamides/therapeutic use
- Survival Analysis
- Treatment Outcome
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Affiliation(s)
- Michael Hallek
- Department of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany.
| | | | - Barbara Eichhorst
- Department of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany
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Benavente Y, Casabonne D, Costas L, Robles C, Alonso E, de la Banda E, Gonzalez-Barca E, Marcos-Gragera R, Llorca J, Tardón A, Monleon JJ, Aymerich M, Campo E, Gimeno-Vázquez E, Castaño-Vinyals G, Aragonés N, Pollán M, Kogevinas M, de Sanjosé S. Established and suggested exposures on CLL/SLL etiology: Results from the CLL-MCC-Spain study. Cancer Epidemiol 2018; 52:106-111. [PMID: 29289901 DOI: 10.1016/j.canep.2017.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 11/13/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Chronic Lymphocytic Leukemia (CLL/SLL) is the most common adult leukemia in Western countries. Although it is mostly an indolent disease it is still incurable and with limited knowledge in relation to its etiology. We aim to confirm and quantify established risk factors for CLL/SLL using a multi-center epidemiological population-based case-control study on CLL/SLL as well as to explore new exposures inconclusively associated with CLL/SLL METHODS: Using the framework provided by the large MCC-Spain case-control study, we explored established and suggested risk factors associated with CLL/SLL using data collected through a face-to-face interview. We estimated odds ratios (OR) and confidence intervals (CI) adjusted by basic confounders, in 1,845 controls from the general population and 560 CLL/SLL from 5 different Spanish regions. RESULTS Among the established risk factors, CLL/SLL cases were 3 times more likely to report first degree relatives with an hematological cancer (OR = 3.11, 95% CI 2.10 to 4.61) and nearly twice likely to have ever worked in agriculture (OR = 1.70, 95% CI = 1.34 to 2.16). New findings suggest that women with CLL/SLL were more likely to have central obesity (OR = 1.67 95% CI = 1.12 to 2.48). An inverse association was found for current alcohol consumption (p-trend<0.016) and for type II diabetes. CONCLUSION We confirmed previous established risk factors for CLL/SLL. Among the new findings, further research of central obesity as preventable exposure and the treatment for type II diabetes are warranted.
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Affiliation(s)
- Yolanda Benavente
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, IDIBELL, Institut Català d'Oncologia, 08908, L'Hospitalet De Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
| | - Delphine Casabonne
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, IDIBELL, Institut Català d'Oncologia, 08908, L'Hospitalet De Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
| | - Laura Costas
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, IDIBELL, Institut Català d'Oncologia, 08908, L'Hospitalet De Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
| | - Claudia Robles
- Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France
| | - Esther Alonso
- Hematology Laboratory, Pathology Department, Hospital Universitari de Bellvitge, 08908, L'Hospitalet De Llobregat, Barcelona, Spain
| | - Esmeralda de la Banda
- Hematology Laboratory, Pathology Department, Hospital Universitari de Bellvitge, 08908, L'Hospitalet De Llobregat, Barcelona, Spain
| | - Eva Gonzalez-Barca
- Hematology, IDIBELL, Institut Català d' Oncologia, 08908, L'Hospitalet De Llobregat, Barcelona, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), 17007, Girona, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; University of Cantabria - IDIVAL, Santander, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Oncology Institute (IUOPA), University of Oviedo, Asturias, Spain
| | - José J Monleon
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Servicio Andaluz de Salud/Universidad de Granada, 18012, Granada, Spain
| | - Marta Aymerich
- Hematopathology Unit, Pathology Department, Hospital Clínic, University of Barcelona, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), 08036, Barcelona, Spain
| | - Elías Campo
- Hematopathology Unit, Pathology Department, Hospital Clínic, University of Barcelona, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), 08036, Barcelona, Spain
| | - Eva Gimeno-Vázquez
- Department of Clinical Hematology, Hospital del Mar, Barcelona, 08003, Spain; Grup de Recerca Aplicada en Neoplasies Hematològiques-PSMAR, Barcelona, Spain
| | - Gemma Castaño-Vinyals
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Marina Pollán
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Sílvia de Sanjosé
- Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, IDIBELL, Institut Català d'Oncologia, 08908, L'Hospitalet De Llobregat, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
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Miranda-Filho A, Piñeros M, Ferlay J, Soerjomataram I, Monnereau A, Bray F. Epidemiological patterns of leukaemia in 184 countries: a population-based study. Lancet Haematol 2018; 5:e14-e24. [PMID: 29304322 DOI: 10.1016/s2352-3026(17)30232-6] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Leukaemia is a heterogeneous group of haemopoietic cancers that comprises a number of diverse and biologically distinct subgroups. We examine the leukaemia burden worldwide and highlight the distinct incidence patterns in order to elucidate explanatory factors that may support preventive measures and health resource planning. We aimed to estimate the global burden of leukaemia incidence according to the four major subtypes stratified by age and sex. METHODS In this population-based study, we assessed leukaemia incidence for the major subtypes using the Cancer Incidence in Five Continents Volume X (CI5-X), which includes data from 290 cancer registries in 68 countries covering the diagnostic period 2003-07, for all ages and both sexes. We then extracted counts and incidence rates in 184 countries for the year 2012 from IARC's GLOBOCAN database of national estimates. We calculated age-specific incidence rates per 100 000 person-years and age-standardised rates (ASRs) using the world standard population by country, sex, age group, and where applicable, by major subtypes. We excluded from all analyses registries for which the total number of leukaemia cases was less than 100 or the proportion of microscopically verified (MV%) cases was less than 80% (2572 cases). FINDINGS 717 863 cases between 2003-07 were included in this analysis. More than 350 000 new leukaemia cases were estimated in 2012. We observed substantial variation in incidence between and within world regions. The highest leukaemia incidence rates for both sexes were estimated in Australia and New Zealand (ASR per 100 000 11·3 in males and 7·2 in females), Northern America (10·5 in males and 7·2 in females), and western Europe (9·6 in males and 6·0 in females), and the lowest was in in western Africa (1·4 in males and 1·2 in females). Rates were generally higher in males than females with an overall male to female ratio of 1·4. In children, acute lymphoblastic leukaemia was the main subtype in all studied countries in both sexes, and characterised by a bimodal age-specific pattern. The subtype distribution was more diverse in adults, with a relatively higher proportion of chronic lymphocytic leukaemia in most European and North American countries, whereas rates of acute lymphoblastic leukaemia remained relatively high among adults in selected South American, Caribbean, Asian, and African populations. INTERPRETATION Geographical disparities in leukaemia might partly be explained by quality of, and access to, health systems linked to resource levels, although there is probably a role for aetiological factors, including gene-environment interactions. The observed bimodal pattern could be due to different risk factors affecting different ages, and might include a genetic component. FUNDING European Commission's FP-7 Marie Curie Actions-People-COFUND.
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Affiliation(s)
| | - Marion Piñeros
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Jacques Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Alain Monnereau
- Hematological Malignancies Registry of Gironde, Bergonie Institute, Comprehensive Cancer Centre, Bordeaux France; University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Bordeaux, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Desbiolles A, Roudier C, Goria S, Stempfelet M, Kairo C, Quintin C, Bidondo M, Monnereau A, Vacquier B. Cancer incidence in adults living in the vicinity of nuclear power plants in France, based on data from the French Network of Cancer Registries. Int J Cancer 2017; 142:899-909. [DOI: 10.1002/ijc.31116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/03/2017] [Accepted: 10/10/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Alice Desbiolles
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Candice Roudier
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Sarah Goria
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Morgane Stempfelet
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Cécile Kairo
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Cécile Quintin
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Marie‐Laure Bidondo
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
| | - Alain Monnereau
- French Network of Cancer Registries (FRANCIM) and INSERM U1219 EPICENE Team, Bordeaux France
| | - Blandine Vacquier
- Santé publique France, French National Public Health AgencySaint‐MauriceF‐94415 France
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Frenkel M, Sapire K. Complementary and Integrative Medicine in Hematologic Malignancies: Questions and Challenges. Curr Oncol Rep 2017; 19:79. [PMID: 29032389 DOI: 10.1007/s11912-017-0635-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Hematologic malignancies represent 9.7% of all cancers, making them the fourth most common type of cancer in the United States. The aggressive and complex treatments administered in hematologic malignancies result in a high burden of psychological needs. Complementary and integrative medicine (CIM) is becoming one of the options that patients use to address their distress during and after cancer treatments. It is not clear whether appropriate CIM can relieve distress in patients affected by these malignancies. This review covers the potential benefits of CIM as relates to nutrition, nutritional supplements, exercise, circadian rhythm, methods for reducing distress during bone marrow aspiration, massage therapy, and acupuncture, in treating patients with hematological malignancies. This review may provide a framework to enhance patient-doctor dialogue regarding CIM use in hematologic malignancies.
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Affiliation(s)
- Moshe Frenkel
- Department of Family Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX, USA. .,Integrative Medicine Program, Institute of Oncology, Meir Medical Center, Kfar Saba, Israel. .,, Hashoftim 1 B, 30900, Zichron Yaacov, Israel.
| | - Kenneth Sapire
- Department of Anesthesia and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Towle KM, Grespin ME, Monnot AD. Personal use of hair dyes and risk of leukemia: a systematic literature review and meta-analysis. Cancer Med 2017; 6:2471-2486. [PMID: 28925101 PMCID: PMC5633595 DOI: 10.1002/cam4.1162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/21/2017] [Accepted: 07/24/2017] [Indexed: 12/12/2022] Open
Abstract
The objective of this study was to examine the association between personal use of hair dyes and the risk of leukemia. We conducted a systematic literature review of epidemiology studies reporting leukemia‐specific cancer risks among hair dye users, and estimated the meta‐relative risk (meta‐RR) and corresponding 95% confidence interval (95% CI) of leukemia, comparing hair dye users to nonusers. When data from all 20 studies that met the inclusion criteria were combined, ever use of hair dye was associated with a nonstatistically significant increased risk of leukemia, meta‐RR = 1.09 (95% CI: 0.97–1.22). When restricted to studies that adjusted for smoking, ever use of hair dye was not associated with leukemia, meta‐RR = 0.99 (95% CI: 0.76–1.29). A statistically significant increased risk of leukemia was associated with permanent hair dye use (meta‐RR = 1.19 [95% CI: 1.07–1.33]), dark hair dye use (meta‐RR = 1.29 [95% CI: 1.11–1.50]), hair dye use among males (meta‐RR = 1.42 [95% CI: 1.01–2.00]), hair dye use pre‐1980 (meta‐RR = 1.49 [95% CI: 1.21–1.83]), and hair dye use for ≥15 years (meta‐RR = 1.35 [95% CI: 1.13–1.62]). Overall, findings suggest that ever use of hair dye is not a significant risk factor for leukemia. Certain hair dye use characteristics were associated with a statistically significant increased risk, but further research is required to determine whether these associations truly reflect a risk of leukemia due to methodological limitations in the underlying studies.
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Affiliation(s)
- Kevin M Towle
- Cardno ChemRisk, 101 2nd St. Suite 700, San Francisco, California, 94105
| | | | - Andrew D Monnot
- Cardno ChemRisk, 101 2nd St. Suite 700, San Francisco, California, 94105
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Oancea SC, Rundquist BC, Simon I, Swartz S, Zheng Y, Zhou X, Sens MA, Schwartz GG. County level incidence rates of chronic lymphocytic leukemia are associated with residential radon levels. Future Oncol 2017; 13:1873-1881. [PMID: 28835109 PMCID: PMC5618932 DOI: 10.2217/fon-2017-0165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Aim: We previously reported that incidence rates for chronic lymphocytic leukemia (CLL) among US states are significantly correlated with levels of residential radon (RR). Because these correlations could be influenced by confounding and/or misclassification among large geographic units, we reinvestigated them using smaller geographic units that better reflect exposure and disease at the individual level. Methods: We examined the relationships between CLL and RR per county in 478 counties with publicly-available data. Results: After adjustment for ultraviolet radiation, a possible risk factor for CLL, county rates for CLL and RR were significantly correlated among males and females both together and separately (p < 0.0001). Conclusion: CLL is significantly associated with RR at the county level.
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Affiliation(s)
- S Cristina Oancea
- Department of Population Health, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA
| | - Bradley C Rundquist
- Department of Geography & Geographic Information Science, University of North Dakota, College of Arts & Sciences, Grand Forks, ND 58202, USA
| | - Isaac Simon
- Department of Earth System Science & Policy, University of North Dakota, John D. Odegard School of Aerospace Sciences, Grand Forks, ND, 58202, USA
| | - Sami Swartz
- Department of Geography & Geographic Information Science, University of North Dakota, College of Arts & Sciences, Grand Forks, ND 58202, USA
| | - Yun Zheng
- Department of Pathology, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Xudong Zhou
- Department of Pathology, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Mary Ann Sens
- Department of Pathology, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, ND 58202, USA
| | - Gary G Schwartz
- Department of Population Health, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA
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