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Giaccherini M, Macauda A, Orciuolo E, Rymko M, Gruenpeter K, Dumontet C, Raźny M, Moreno V, Buda G, Beider K, Varkonyi J, Avet-Loiseau H, Martinez-Lopez J, Marques H, Watek M, Sarasquete ME, Andersen V, Karlin L, Suska A, Kruszewski M, Abildgaard N, Dudziński M, Butrym A, Nagler A, Vangsted AJ, Kadar K, Waldemar T, Jamroziak K, Jacobsen SEH, Ebbesen LH, Taszner M, Mazur G, Lesueur F, Pelosini M, Garcia-Sanz R, Jurczyszyn A, Demangel D, Reis RM, Iskierka-Jażdżewska E, Markiewicz M, Gemignani F, Subocz E, Zawirska D, Druzd-Sitek A, Stępień A, Alonso MH, Sainz J, Canzian F, Campa D. Genetically determined telomere length and multiple myeloma risk and outcome. Blood Cancer J 2021; 11:74. [PMID: 33854038 PMCID: PMC8046773 DOI: 10.1038/s41408-021-00462-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/01/2021] [Accepted: 03/11/2021] [Indexed: 12/16/2022] Open
Abstract
Telomeres are involved in processes like cellular growth, chromosomal stability, and proper segregation to daughter cells. Telomere length measured in leukocytes (LTL) has been investigated in different cancer types, including multiple myeloma (MM). However, LTL measurement is prone to heterogeneity due to sample handling and study design (retrospective vs. prospective). LTL is genetically determined; genome-wide association studies identified 11 SNPs that, combined in a score, can be used as a genetic instrument to measure LTL and evaluate its association with MM risk. This approach has been already successfully attempted in various cancer types but never in MM. We tested the "teloscore" in 2407 MM patients and 1741 controls from the International Multiple Myeloma rESEarch (IMMeNSE) consortium. We observed an increased risk for longer genetically determined telomere length (gdTL) (OR = 1.69; 95% CI 1.36-2.11; P = 2.97 × 10-6 for highest vs. lowest quintile of the score). Furthermore, in a subset of 1376 MM patients we tested the relationship between the teloscore and MM patients survival, observing a better prognosis for longer gdTL compared with shorter gdTL (HR = 0.93; 95% CI 0.86-0.99; P = 0.049). In conclusion, we report convincing evidence that longer gdTL is a risk marker for MM risk, and that it is potentially involved in increasing MM survival.
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Affiliation(s)
| | - Angelica Macauda
- Department of Biology, University of Pisa, Pisa, Italy.,Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Enrico Orciuolo
- Haematology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marcin Rymko
- Department of Hematology, Copernicus Hospital, Torun, Poland
| | - Karolina Gruenpeter
- Department of Haematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Malgorzata Raźny
- Department of Hematology, Rydygier Specialistic Hospital, Cracow, Poland
| | - Victor Moreno
- Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), IDIBELL, CIBERESP and Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Gabriele Buda
- Haematology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Katia Beider
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Hervé Avet-Loiseau
- Laboratory for Genomics in Myeloma, Institut Universitaire du Cancer and University Hospital, Centre de Recherche en Cancerologie de Toulouse, Toulouse, France
| | | | - Herlander Marques
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal and ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Marzena Watek
- Department of Hematology, Holy Cross Cancer Center, Kielce, Poland.,Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | - Vibeke Andersen
- Department of Biochemistry, University Hospital of Southern Jutland, Sønderborg, Denmark.,IRS-Center Soenderjylland, University Hospital of Southern Jutland, Aabenraa, Denmark
| | | | - Anna Suska
- Department of Hematology, Jagiellonian University Medical College, Krakow, Poland
| | - Marcin Kruszewski
- Department of Hematology, University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Niels Abildgaard
- Department of Hematology, Odense University Hospital, Odense, Denmark
| | - Marek Dudziński
- Department of Hematology, Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, Rzeszow, Poland
| | - Aleksandra Butrym
- Department of Internal Diseases, Occupational Medicine, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Arnold Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | | | - Tomczak Waldemar
- Department of Haemato-oncology and Bone Marrow Transplantation and Department of Internal Medicine in Nursing, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Jamroziak
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | | | - Michał Taszner
- Department of Hematology and Transplantology Medical University of Gdansk, Gdańsk, Poland
| | - Grzegorz Mazur
- Department of Internal Diseases, Occupational Medicine, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Fabienne Lesueur
- Inserm, U900, Institut Curie, PSL University, Mines ParisTech, Paris, France
| | - Matteo Pelosini
- U.O. Dipartimento di Ematologia, Azienda USL Toscana Nord Ovest, Livorno, Italy, currently Ospedale Santa Chiara, Pisa, Italy
| | - Ramon Garcia-Sanz
- Hematology Department, University Hospital of Salamanca, CIBERONC, Salamanca, Spain
| | - Artur Jurczyszyn
- Department of Hematology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Rui Manuel Reis
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal and ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | | | - Miroslaw Markiewicz
- Department of Hematology, Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, Rzeszow, Poland
| | | | - Edyta Subocz
- Department of Hematology, Military Institute of Medicine, Warsaw, Poland
| | - Daria Zawirska
- Department of Haematology, University Hospital in Cracow, Cracow, Poland
| | - Agnieszka Druzd-Sitek
- Department of Lymphoid Malignancies, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Anna Stępień
- Laboratory of Clinical and Transplant Immunology and Genetics, Copernicus Memorial Hospital, Łódź, Poland
| | - M Henar Alonso
- Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), IDIBELL, CIBERESP and Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Juan Sainz
- Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain.,Hematology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Daniele Campa
- Department of Biology, University of Pisa, Pisa, Italy
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Melaiu O, Macauda A, Sainz J, Calvetti D, Facioni MS, Maccari G, Ter Horst R, Netea MG, Li Y, Grząśko N, Moreno V, Jurczyszyn A, Jerez A, Watek M, Varkonyi J, Garcia-Sanz R, Kruszewski M, Dudziński M, Kadar K, Jacobsen SEH, Mazur G, Andersen V, Rybicka M, Zawirska D, Raźny M, Zaucha JM, Ostrovsky O, Iskierka-Jazdzewska E, Reis RM, Stępień A, Beider K, Nagler A, Druzd-Sitek A, Marques H, Martìnez-Lopez J, Lesueur F, Avet-Loiseau H, Vangsted AJ, Krawczyk-Kulis M, Butrym A, Jamroziak K, Dumontet C, Vogel U, Rymko M, Pelosini M, Subocz E, Szombath G, Sarasquete ME, Silvestri R, Morani F, Landi S, Campa D, Canzian F, Gemignani F. Common gene variants within 3'-untranslated regions as modulators of multiple myeloma risk and survival. Int J Cancer 2020; 148:1887-1894. [PMID: 33152124 DOI: 10.1002/ijc.33377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 12/12/2022]
Abstract
We evaluated the association between germline genetic variants located within the 3'-untranlsated region (polymorphic 3'UTR, ie, p3UTR) of candidate genes involved in multiple myeloma (MM). We performed a case-control study within the International Multiple Myeloma rESEarch (IMMEnSE) consortium, consisting of 3056 MM patients and 1960 controls recruited from eight countries. We selected p3UTR of six genes known to act in different pathways relevant in MM pathogenesis, namely KRAS (rs12587 and rs7973623), VEGFA (rs10434), SPP1 (rs1126772), IRF4 (rs12211228) and IL10 (rs3024496). We found that IL10-rs3024496 was associated with increased risk of developing MM and with a worse overall survival of MM patients. The variant allele was assayed in a vector expressing eGFP chimerized with the IL10 3'-UTR and it was found functionally active following transfection in human myeloma cells. In this experiment, the A-allele caused a lower expression of the reporter gene and this was also in agreement with the in vivo expression of mRNA measured in whole blood as reported in the GTEx portal. Overall, these data are suggestive of an effect of the IL10-rs3024496 SNP on the regulation of IL10 mRNA expression and it could have clinical implications for better characterization of MM patients in terms of prognosis.
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Affiliation(s)
| | - Angelica Macauda
- Department of Biology, University of Pisa, Pisa, Italy.,Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Juan Sainz
- Genomic Oncology Area, GENYO. Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain.,Hematology Department, Virgen de las Nieves University Hospital, Granada, Spain.,Department of Medicine, University of Granada, Granada, Spain
| | - Diego Calvetti
- Department of Biology, University of Pisa, Pisa, Italy.,Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Rob Ter Horst
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Mihai G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.,Department for Immunology and Metabolism, Life and Medical Sciences Institute (LIMES), University of Bonn, Bonn, Germany
| | - Yang Li
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.,Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Victor Moreno
- Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), IDIBELL, CIBERESP and Department of Clinical Sciences, Faculty of Medicine, University of Barcelona. Hospitalet de Llobregat, Barcelona, Spain
| | - Artur Jurczyszyn
- Department of Hematology, Cracow University Hospital, Cracow, Poland
| | - Andrés Jerez
- Hematology and Medical Oncology Department, University Hospital Morales Meseguer, IMIB, Murcia, Spain
| | | | - Judit Varkonyi
- 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Ramon Garcia-Sanz
- Department of Hematology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, IBSAL, Salamanca, Spain
| | | | - Marek Dudziński
- Department of Hematology, Specialist District Hospital, Rzeszow, Poland
| | - Katalin Kadar
- 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | | | - Grzegorz Mazur
- Department of Internal Diseases, Hypertension and Occupational Medicine, Medical University, Wroclaw, Poland
| | - Vibeke Andersen
- Research Unit of Molecular Diagnostics and Clinical Research, Laboratory Center, Hospital of Southern Jutland, Aabenraa, Denmark.,Institute of Regional Health Research, and Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Malwina Rybicka
- Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland
| | - Daria Zawirska
- Department of Hematology, Cracow University Hospital, Cracow, Poland
| | | | | | - Olga Ostrovsky
- Hematology Division Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | - Rui Manuel Reis
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | - Anna Stępień
- Laboratory of Clinical and Transplant Immunology and Genetics, Copernicus Memorial Hospital, Lodz, Poland
| | - Katia Beider
- Hematology Division Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Nagler
- Hematology Division Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Agnieszka Druzd-Sitek
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie Memorial Institute and Oncology Centre Warsaw, Warsaw, Poland
| | - Herlander Marques
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Joaquin Martìnez-Lopez
- Department of Hematology, Hospital Universitario 12 de Octubre, Complutense School of Medicine, CNIO, Madrid, Spain
| | - Fabienne Lesueur
- Institut Curie, Paris, France.,PSL Research University, Paris, France.,Inserm, Paris, France.,Mines Paris Tech, Fontainebleau, France
| | - Hervé Avet-Loiseau
- Hematology, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Annette Juul Vangsted
- Department of Haematology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Malgorzata Krawczyk-Kulis
- Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland
| | - Aleksandra Butrym
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Medical University, Wrocław, Poland
| | - Krzysztof Jamroziak
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | - Ulla Vogel
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Marcin Rymko
- Department of Hematology, Copernicus Hospital, Torun, Poland
| | - Matteo Pelosini
- U.O. Dipartimentale di Ematologia, Azienda USL Toscana Nord Ovest, Livorno, Italy
| | - Edyta Subocz
- Department of Hematology, Military Institute of Medicine, Warsaw, Poland
| | - Gergely Szombath
- 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Maria Eugenia Sarasquete
- Department of Hematology, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, IBSAL, Salamanca, Spain
| | | | | | - Stefano Landi
- Department of Biology, University of Pisa, Pisa, Italy
| | - Daniele Campa
- Department of Biology, University of Pisa, Pisa, Italy
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
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3
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Macauda A, Calvetti D, Maccari G, Hemminki K, Försti A, Goldschmidt H, Weinhold N, Houlston R, Andersen V, Vogel U, Buda G, Varkonyi J, Sureda A, Martinez Lopez J, Watek M, Butrym A, Sarasquete ME, Dudziński M, Jurczyszyn A, Druzd-Sitek A, Kruszewski M, Subocz E, Petrini M, Iskierka-Jażdżewska E, Raźny M, Szombath G, Marques H, Zawirska D, Chraniuk D, Halka J, Hove Jacobsen SE, Mazur G, García Sanz R, Dumontet C, Moreno V, Stępień A, Beider K, Pelosini M, Manuel Reis R, Krawczyk-Kulis M, Rymko M, Avet-Loiseau H, Lesueur F, Grząśko N, Ostrovsky O, Jamroziak K, Vangsted AJ, Jerez A, Tomczak W, Zaucha JM, Kadar K, Sainz J, Nagler A, Landi S, Gemignani F, Canzian F. Identification of miRSNPs associated with the risk of multiple myeloma. Int J Cancer 2016; 140:526-534. [DOI: 10.1002/ijc.30465] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 08/24/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Angelica Macauda
- Department of Biology; University of Pisa; Pisa Italy
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Diego Calvetti
- Department of Biology; University of Pisa; Pisa Italy
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Giuseppe Maccari
- The Pirbright Institute, Pirbright; Woking Surrey GU24 0NF United Kingdom
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Asta Försti
- Division of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Hartmut Goldschmidt
- Department of Internal Medicine V; University of Heidelberg; Heidelberg Germany
| | - Niels Weinhold
- Department of Internal Medicine V; University of Heidelberg; Heidelberg Germany
| | - Richard Houlston
- Division of Genetics and Epidemiology; The Institute of Cancer Research; London United Kingdom
| | - Vibeke Andersen
- Institute of Regional Health Research, and Institute of Molecular Medicine, Faculty of Health Sciences, University of Southern Denmark; Odense Denmark
- Research Unit of Molecular Diagnostics and Clinical Research, Laboratory Center, Hospital of Southern Jutland; Aabenraa Denmark
| | - Ulla Vogel
- National Research Centre for the Working Environment; Copenhagen DK-2100 Denmark
| | - Gabriele Buda
- UO Hematology, Department of Internal and Experimental Medicine; University of Pisa; Pisa Italy
| | - Judit Varkonyi
- Department of Hematology; Semmelweis University; Budapest Hungary
| | - Anna Sureda
- Department of Hematology; Catalan Institute of Oncology (ICO) and IDIBELL; Barcelona Spain
| | - Joaquin Martinez Lopez
- Department of Hematology; Hospital Universitario 12 de Octubre, Complutense School of Medicine, CNIO; Madrid Spain
| | | | | | | | - Marek Dudziński
- Department of Hematology; Specialist District Hospital; Rzeszow Poland
| | - Artur Jurczyszyn
- Department of Hematology; Cracow University Hospital; Cracow Poland
| | - Agnieszka Druzd-Sitek
- Department of Lymphoid Malignancies Maria Sklodowska-Curie Memorial Institute and Oncology Centre Warsaw; Warsaw Poland
| | | | - Edyta Subocz
- Department of Hematology; Military Institute of Medicine; Warsaw Poland
| | - Mario Petrini
- UO Hematology, Department of Internal and Experimental Medicine; University of Pisa; Pisa Italy
| | | | | | - Gergely Szombath
- Department of Hematology; Semmelweis University; Budapest Hungary
| | - Herlander Marques
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho; Braga Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga Portugal
| | - Daria Zawirska
- Department of Hematology; Cracow University Hospital; Cracow Poland
| | | | - Janusz Halka
- Department of Hematology; Military Institute of Medicine; Warsaw Poland
| | | | - Grzegorz Mazur
- Department of Internal Diseases, Hypertension and Occupational Medicine; Medical University; Wroclaw Poland
| | - Ramón García Sanz
- Department of Hematology; University Hospital of Salamanca; Salamanca Spain
| | - Charles Dumontet
- INSERM UMR 1052/CNRS 5286, Université Claude Bernard Lyon I; Lyon 69622 France
| | - Victor Moreno
- Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), IDIBELL, CIBERESP and Department of Clinical Sciences, Faculty of Medicine; University of Barcelona; Barcelona Spain
| | - Anna Stępień
- Laboratory of Clinical and Transplant Immunology and Genetics; Copernicus Memorial Hospital; Łódź Poland
| | - Katia Beider
- Chaim Sheba Medical Center; Tel-Hashomer Ramat Gan Israel
| | - Matteo Pelosini
- Azienda USL Toscana Nord Ovest; U.O Dipartimento di Ematologia; Livorno, Italy
| | - Rui Manuel Reis
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho; Braga Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga Portugal
- Barretos Cancer Hospital; Molecular Oncology Research Center; Barretos Brazil
| | - Malgorzata Krawczyk-Kulis
- Department of Hematology and Bone marrow Transplantation; Silesian Medical University; Katowice Poland
| | - Marcin Rymko
- Department of Hematology; Copernicus Hospital; Torun Poland
| | - Hervé Avet-Loiseau
- Laboratoire d'hématologie, Pôle biologie; Institut Universitaire du Cancer de Toulouse-Oncopole 1; Avenue Irène Joliot-Curie, Toulouse 31059 France
| | - Fabienne Lesueur
- Institut Curie; 26 rue d'Ulm Paris F-75005 France
- PSL Research University; Paris F-75005 France
- Inserm, U900; Paris F-75005 France
- Mines Paris Tech; Fontainebleau, Paris F-77305 France
| | - Norbert Grząśko
- Department of Hematology; St. John's Cancer Center; Lublin Poland
| | - Olga Ostrovsky
- Chaim Sheba Medical Center; Tel-Hashomer Ramat Gan Israel
| | - Krzysztof Jamroziak
- Department of Hematology; Institute of Hematology and Transfusion Medicine; Warsaw Poland
| | - Annette J. Vangsted
- Department of Haematology, Rigshospitalet; Copenhagen University; Copenhagen Denmark
| | - Andrés Jerez
- Department of Hematology and Medical Oncology; IMIB, University Hospital Morales Meseguer; Murcia Spain
| | - Waldemar Tomczak
- Department of Hematooncology and Bone Marrow Transplantation; Medical University of Lublin; Lublin Poland
| | | | - Katalin Kadar
- Department of Hematology; Semmelweis University; Budapest Hungary
| | - Juan Sainz
- Centro Pfizer, Universidad de Granada, Junta de Andalucía de Genómica e Investigación Oncológica (GENYO); Granada Spain
| | - Arnon Nagler
- Chaim Sheba Medical Center; Tel-Hashomer Ramat Gan Israel
| | - Stefano Landi
- Department of Biology; University of Pisa; Pisa Italy
| | | | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ); Heidelberg Germany
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Omland LH, Krarup H, Jepsen P, Georgsen J, Harritshøj LH, Riisom K, Jacobsen SEH, Schouenborg P, Christensen PB, Sørensen HT, Obel N. Mortality in patients with chronic and cleared hepatitis C viral infection: a nationwide cohort study. J Hepatol 2010; 53:36-42. [PMID: 20400197 DOI: 10.1016/j.jhep.2010.01.033] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 12/02/2009] [Accepted: 01/03/2010] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS It is unknown whether mortality differs between patients with chronic hepatitis C virus (HCV) replication and those who cleared the virus after infection. We examined the impact of chronic HCV replication on mortality among Danish patients testing positive for HCV antibodies. METHODS This nationwide cohort study focused on Danish patients with at least one HCV RNA measurement available after testing positive for HCV antibodies between 1996 and 2005. To capture long-term prognosis, eligible patients needed to be alive 1year after HCV RNA assessment. We estimated mortality rate ratios (MRRs) using Cox regression (for overall mortality) and subdistribution hazard ratios (SDHRs) for cause-specific mortality, controlling for gender, age, comorbidity, calendar period, alcohol abuse, injection drug use, and income. RESULTS Of the 6292 patients under study, 63% had chronic HCV-infection and 37% had cleared the virus. Five-year survival was 86% (95% confidence interval (CI): 84-87%) in the chronic HCV group and 92% (95% CI: 91-94%) in the cleared HCV group. Chronic HCV-infection was associated with higher overall mortality (MRR: 1.55, 95% CI: 1.28-1.86) and liver-related death (SDHR: 2.42, 95% CI: 1.51-3.88). Chronic HCV-infection greatly increased the risk of death from primary liver cancer (SDHR: 16.47, 95% CI: 2.24-121.00). CONCLUSIONS Patients with chronic HCV-infection are at higher risk of death than patients who cleared the infection. The substantial association found between chronic HCV-infection and death from primary liver cancer supports early initiation of antiviral treatment in chronically HCV-infected patients.
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