Effect of Genetic Polymorphisms Related to Folate and Homocysteine Metabolism In the Etiology of Recurrent Miscarriages

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5136-5136
Author(s):  
Elvira Maria Guerra-Shinohara ◽  
Kelma Cordeiro da Silva Giusti ◽  
Nathalia Sierra Monteiro ◽  
Robson José Lazaro ◽  
Fernanda Midori Seino ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Folic Acid ◽  
Conflicts Of Interest ◽  
Conditional Logistic Regression ◽  
The Body ◽  
Methionine Synthase ◽  
Folic Acid Deficiency ◽  
Recurrent Miscarriages ◽  
History Of ◽  
Total Homocysteine

Abstract Abstract 5136 Introduction: Folic acid deficiency has been associated with obstetric complications such as preeclampsia, placental abruption and recurrent miscarriages (RM). Folic acid is a methyl group donating in various reactions. Low concentrations of 5,10-methylenetetrahydrofolate, the cofactor of enzyme thymidylate synthase, decrease the synthesis of thymidylate, which results in increased ratio deoxyuridylate monophosphate/deoxytimidylate monophosphate (dUMP/dTMP) and increased incorporation of deoxyuridylate triphosphate (dUTP) to DNA. The removal of dUTP by DNA-glycosylase can cause permanent damage to DNA, which may lead to apoptosis or increase the risk of developing cancer. Polymorphisms in genes of enzymes (MTHFR - methylene tetrahydrofolate reductase, MTR - methionine synthase and MTRR - methionine synthase reductase) and also in the gene of the reduced folate carrier (RFC1) were related to reduced folate and increased total homocysteine concentrations and have been associated as risk factors for RM. Material and Methods: 171 women with a history of three or more recurrent miscarriages and 95 healthy women with no history of abortion and having two or more normal babies were included. Weight and height of women were obtained and the body mass index (BMI) was calculated. The presence of antibodies (ANA and anti-DNA) was evaluated using immunofluorescence kits. The genotypes of the polymorphisms MTHFR c. 677C>T, MTR c. 2756A>G and RFC1 c.80G>A were obtained by PCR-RFLP, while genotyping for polymorphisms MTRR c. 66A>G and MTHFR c. 1298A>C was made by real time PCR. Multivariate logistic regression model (forward conditional) was used to obtain the odds ratio and its 95% confidence intervals of having MR (dependent variable). The independent variables were: quartiles of BMI, age range, positive ANA (titer of 1/40), positive anti-DNA (titre 1/10), genotypes for the MTHFR c. 677C>T, MTHFR c.1298A>C, MTR c. 2756A>G, MTRR c. 66A>G and RFC1 c. 80G>A. Results: No differences between the groups were observed for serum total homocysteine or allele frequencies for MTHFR c. 677C>T, MTHFR c. 1298A>C, MTR c. 2756A>G and RFC1 c.80G>A polymorphisms. In a conditional logistic regression analysis the risk of RM was significantly associated with BMI OR [95% CI] = 1.40 [1.02, 1.93] per quartile increase in BMI), positive anti-DNA OR [95% CI] = 7.24 [0.92, 57.25], positive ANA OR [95% CI] = 2.48 [1.21, 5.08], and AA genotype for MTRR c. 66A>G polymorphism (OR [95% CI] = 2.19 [1.16, 4.12]. Conclusion: The etiology of RM is multifactorial and it is associated with increasing of BMI, presence of autoantibodies and AA genotype for MTRR c. 66A>G polymorphism. Disclosures: No relevant conflicts of interest to declare.

scholarly journals A case of anencephaly in an Unbooked Primipara diagnosed at 35 weeks gestation

2021 ◽  
Vol 12 (2) ◽  
pp. 555-558
Author(s):  
Awopola Ibiebelem Jumbo ◽  
Esther Ijeoma Nonye-Enyidah
Keyword(s):  
Folic Acid ◽  
Rural Communities ◽  
Antenatal Care ◽  
Rural Areas ◽  
Psychological Trauma ◽  
Reproductive Age ◽  
University Teaching ◽  
Diagnostic Tools ◽  
Folic Acid Deficiency ◽  
History Of

Background: Anencephaly is a rare but lethal congenital anomaly of the neural tube. Ideally, the diagnosis is made early in pregnancy and the pregnancy is usually terminated. This is to prevent avoidable complications during pregnancy and childbirth as well as the accompanying psychological trauma from late intrauterine foetal death or death during the neonatal period. Objective: To report a case of anencephaly in an unbooked primipara at 35 weeks gestation. Methods: The case note of the patient and how she was managed were reviewed. A relevant review of the literature on the subject was also done. Case report: Mrs A.N was a 22year old unbooked G3P1+1 who was referred to the Rivers State University Teaching Hospital (RSUTH) on the 4th of September, 2021 with a three-day history of bleeding per vaginam and an ultrasound scan report of an absent cranium and club foot at 35weeks gestation. She resided in a rural area and was on herbal medication in the index pregnancy. She did not receive routine antenatal medications and had no family history of congenital malformations. She had an induction of labour at presentation and delivered a severely asphyxiated male anencephalic baby weighing 2.0kg. The baby died 9minutes after delivery. Conclusion: Anencephaly is a lethal anomaly that is associated with folic acid deficiency. Despite available diagnostic tools, most women in rural areas lack access to antenatal care and will have a late diagnosis and increased morbidity. Thus, there is a need to improve access to antenatal care for women in rural communities, as well as supplement food with folic acid for women in the reproductive age group.

scholarly journals Hyperhomocysteinemia in recurrent pregnancy loss and the effect of folic acid and vitamin B12 on homocysteine levels: a prospective analysis

2017 ◽  
Vol 6 (6) ◽  
pp. 2258 ◽  
Author(s):  
Indrani Mukhopadhyay ◽  
V. Pruthviraj ◽  
Rao P. S. ◽  
Manash Biswas
Keyword(s):  
Folic Acid ◽  
Vitamin B12 ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
The Body ◽  
Vitamin Supplementation ◽  
Vitamin B ◽  
History Of ◽  
A Prospective Study

Background: Recurrent pregnancy loss (RPL) affects about 5% of women. High levels of homocysteine, termed hyperhomocysteinemia, have been implicated in a number of pathologic processes in the venous and arterial vascular systems. Hyperhomocysteinemia in pregnant women has been associated with deep venous thrombosis, recurrent miscarriage, abruption placentae, preeclampsia, neural tube defects, and fetal growth restriction. This study aims at determining association between hyperhomocysteinemia and recurrent pregnancy loss and also association of folic acid (vitamin B 9) and vitamin B 12 with hyperhomocysteinemia (HHCY), in reducing its levels in the body and thus preventing obstetric complications.Methods: A prospective study of pregnant mothers booked at our hospital over a period of two years with history of unexplained RPL were included in the study and their serum homocysteine levels were assessed. Hyperhomocysteinemia (>12 micromol/l) patients were treated with folic acid and vitamin B12 supplements and homocysteine levels were assessed again, post treatment.Results: Out of the 100 patients who were assessed, 32% of RPL patients had hyperhomocysteinemia. Folic acid and VitB12 supplementation reduced homocysteine levels and this was found to be statistically significant.Conclusions: Hyperhomocysteinemia is associated with RPL. Vitamin supplementation to those with hyperhomocysteinemia, decreases homocysteine levels.

scholarly journals Risk factors of primary open-angle glaucoma: the first case-control hospital-based study in Vietnam

2019 ◽  
Author(s):  
Anh Van Bui ◽  
Tung Thanh Hoang ◽  
Ngoc Bich Nguyen ◽  
Anh Kim Le ◽  
Jennifer L. Patnaik
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Open Angle ◽  
Over The Counter ◽  
Vietnamese Population ◽  
History Of

Abstract Purpose: To identify risk factors for primary open-angle glaucoma (POAG) in a Vietnamese population. Methods: A matched case-control study was conducted at Vietnam National Institute of Ophthalmology. Cases were patients clinically diagnosed with POAG. Controls were caregivers of patients with other eye diseases, free from any ocular and systemic abnormalities, and were selected and then matched with the cases by gender and age. Cases and controls were examined by a glaucoma specialist to confirm presence or absence of POAG. Data on demographic, ophthalmic and medical conditions were collected via interview at time of examination. Associations between POAG and potential factors were examined by univariate conditional logistic regression analysis (OR – Odd Ratios) and multivariate conditional logistic regression (AOR – Adjusted Odd Ratios) with level of significance is 0.05. Results: In total, 128 cases with POAG and 128 controls were recruited. Multivariate conditional (fixed-effects) logistic regression analysis resulted in several significant risk factors, including hypertension AOR =4.7 (95% CI: 1.8–12.0; p=0.002); family history of glaucoma AOR = 6.4 (95% CI: 1.3 – 32.2; p = 0.026); over–the–counter eye medication AOR = 3.1 (95% CI: 1.5 – 6.5; p = 0.006), and a protective role for marriage AOR = 0.2 (95% CI: 0.1 – 0.7; p = 0.006) and weekly exercise AOR = 0.3 (95% CI: 0.1 – 0.8; p = 0.021). Conclusions: Hypertension, family history of glaucoma and over–the–counter eye medication were risk factors while marriage and weekly exercise were protective factors for POAG in Vietnamese population.

scholarly journals IVIG-Induced Abrupt Hemolysis in Neurological Conditions

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4991-4991 ◽  
Author(s):  
Juskaran Chadha ◽  
Randy L. Levine ◽  
Omer Ilyas
Keyword(s):  
Folic Acid ◽  
Vitamin B12 ◽  
Hemolytic Anemia ◽  
Conflicts Of Interest ◽  
Type A ◽  
Blood Type ◽  
Lower Extremity Weakness ◽  
Autoimmune Conditions ◽  
History Of ◽  
Work Up

Background Immunoglobulin (IVIG) is used to treat autoimmune conditions, but there are reports of brisk hemolysis within 48 hours (hrs) of treatment due to anti-A isohemogglutinins(1). Despite these reports, hemolysis remains an unrecognized side effect of IVIG. Methods We presented a series of 3 cases of IVIG-induced hemolysis in patients with autoimmune neurological disorders. In the investigative phase, we traced the cases to a common IVIG lot number. The sample was tested to determine the anti-A titer levels. Case Studies (See Table 1) Case 1 75-year-old man presented with SOB and dysarthria from myasthenia gravis (MG). He received IVIG for 4 days. He developed a hemolytic anemia with 3 g drop in hemoglobin (Hb) 48 hours later. He needed a pRBC transfusion and folic acid. Case 2 59-year-old female with history of MG treated with IVIG at another hospital until 3 months earlier in crisis, with SOB and dysphagia. She received IVIG for 5 days and rituximab. She improved and was discharged, but returned to the ER 7 days later with SOB. Her Hb fell to 8.0 g/dL from 13 g/dL on last admission. She required a pRBC transfusion, folic acid, and vitamin B12 with improvement of SOB. Case 3 20-year-old female admitted for lower extremity weakness, diagnosed with presumed syndrome (GBS). She received IVIG for 4 days. On the 5th day, her Hb fell from 15 g/dL to 9 g/dL. She began prednisone, folic acid, and vitamin B12 with improvement in her Hb. Conclusions Although acute hemolysis is well described in the literature, it is under recognized, as exemplified by the first two cases. Their initial SOB was due to MG, so when SOB recurred, they were misdiagnosed with recurrent MG. A hemolytic anemia was later suspected, and a work up revealed a positive DAT. The initial eluate was negative against type O panel cells, suggesting a drug related hemolysis. It was only when the eluate was tested against type A cells that the etiology became clear. The third patient's hemolytic reaction was then rapidly identified. These cases remind us to consider IVIG induced anti-A hemolysis in patients who are blood type A and AB, and to evaluate the eluate against the appropriate reagent cells. These patients should receive specific IVIG that is low in anti-A isohemagglutinins. Since the second patient did not hemolyze from earlier exposure to IVIG, she likely received a low titer product. Disclosures No relevant conflicts of interest to declare.

Folates: Modern Pregnant Health Support

2020 ◽  
pp. 37-42
Author(s):  
M.V. Khaitovich ◽  
Keyword(s):  
Folic Acid ◽  
Physiological Role ◽  
Chemical Compounds ◽  
The Body ◽  
Folic Acid Deficiency ◽  
Vitamin B9 ◽  
Acid Deficiency ◽  
Health Support ◽  
Spinach Leaves

Folates (folic acid-based chemical compounds) got their name from the Latin “folio” - “leaf”, since they were first synthesized from spinach leaves, in which vitamin B9 is found in maximum quantities. As an important cofactor in carbon metabolism, folates are involved in the most important metabolic processes in the body, in particular, they play a key role in the synthesis of nucleotides and DNA replication. The article provides information on the physiological role of folates, their metabolism and its genetic aspects. The clinical significance of folate deficiency is examined, their sources and doses are described, and the interaction of folic acid and drugs is highlighted. Keywords: folate, metabolism, folic acid deficiency, pregnancy.

Risk Factors for Inpatient Acute Venous Thromboembolism (VTE) Despite Thromboprophylaxis.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2248-2248
Author(s):  
Tzu-Fei Wang ◽  
Catherine A Wong ◽  
Paul Milligan ◽  
Mark S Thoelke ◽  
Keith F Woeltje ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Venous Thromboembolism ◽  
Conflicts Of Interest ◽  
Conditional Logistic Regression ◽  
Hospital Setting ◽  
Care Facility ◽  
Conditional Logistic Regression Model ◽  
Term Care ◽  
Pooled Data

Abstract Abstract 2248 Background: Venous thromboembolism (VTE) is the most common preventable cause of morbidity and mortality in the hospital. Adequate thromboprophylaxis has reduced the rate of hospital-acquired VTE by 50–70%; however, some inpatients still develop VTE despite thromboprophylaxis. Predictors associated with thromboprophylaxis failure are undefined. Objectives: We aimed to identify risk factors for VTE despite use of inpatient thromboprophylaxis. Patients/Methods: We used a case-control study to determine independent predictors of inpatient VTE. We matched 94 cases discharged from the BJC HealthCare system from January 1st, 2010 to May 31st, 2011who developed in-hospital VTE despite thromboprophylaxis (including either pharmacological or mechanical prophylaxis or both) to 272 controls without VTE. Matching was done by hospital, age, and date of discharge. Two thirds of the sample was used as derivation model, while one third was used for validation. We used multivariate conditional logistic regression on the derivation sample to develop a VTE prediction model and validated the model. We repeated conditional logistic regression on the pooled data. Results: Age and sex were well-matched. Mean age was 62.8 years-old in the VTE group and 63.2 years-old in the no-VTE group. Forty-three percent were female in the VTE group, while 49% were female in the no-VTE group. Using conditional logistic regression model in the pooled data, we identified five independent risk factors for in-hospital VTE: hospitalization for cranial surgery (Odds ratio [OR] 16.1, 95% confidence interval [CI] 3.2–80.4, p<0.001), hospitalization in a critical care unit (OR 3.0, 95% CI 1.5–5.9, p=0.002), admission leukocyte count > 13 × 103/mm3(OR 2.7, 95% CI 1.4–5.1, p=0.003), presence of an indwelling central venous catheter (OR 2.5, 95% CI 1.3–4.7, p=0.007), and admission from a long-term care facility (OR 2.1, 95% CI 1.0–4.2, p=0.04). Conclusions: In the hospital setting, we derived and validated five risk factors associated with the development of VTE despite thromboprophylaxis. Clinicians should be vigilant for VTE in these patients and ensure that they have aggressive VTE prophylaxis. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Misdiagnosed Frontal_Transethmoidal Meningoencephalocele : Case Report

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Enas Hamed Al-Fattani, Tariq Abdulfattah Al-Jammal, Tariq Ah
Keyword(s):  
Folic Acid ◽  
Nasal Obstruction ◽  
Healthcare Providers ◽  
Middle Turbinate ◽  
Complete Healing ◽  
Folic Acid Deficiency ◽  
Nasal Tissue ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Study

To enhance awareness of healthcare providers for any baby comes with persistence unilateral nasal obstruction, and take care for him. Methods: A report of rare case for a child presented with an internal nasal mass with maternal history of folic acid deficiency Results:  The diagnosis of transethmoidal encephalocele was confirmed by a computed tomography (CT) and magnetic resonance imaging(MRI). Craniotomy excision and duroplasty, assisted with endonasal endoscopic excision and repair of skull base defect by middle turbinate graft were done. Nasal tissue was taken for Histological examination which confirmed the diagnosis of an encephalocele within the nasal cavity. The patient had recovered with complete healing of grafts with no recurrence and follow up CT after 6 months was normal. Conclusion:   The general physicians and pediatricians must put in consideration any baby with unilateral persistence nasal obstruction which can be frontal-transethmoidal meningocele +/- encephalocele . Taking folic acid or food rich of folate during pregnancy can help in reduction of neural tube defects prevalence.  Radiological imaging (CT +/- MRI) study should be done for every Pediatric case presenting with an intranasal mass before any surgical intervention or an invasive intranasal procedure.

scholarly journals Unspecified pain and other soft tissue disorders following electrical injuries: a register-based matched cohort study

2021 ◽  
Author(s):  
Per Hoegh Poulsen ◽  
Ole Carstensen ◽  
Anette Kærgaard ◽  
Jesper Medom Vestergaard ◽  
Kent J. Nielsen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Soft Tissue ◽  
Cox Regression ◽  
Conditional Logistic Regression ◽  
Electrical Injury ◽  
Matched Cohort ◽  
Eye Injuries ◽  
History Of ◽  
Electrical Injuries

Abstract Objective This study investigates whether individuals who have sustained an electrical injury (EI) are diagnosed with unspecified pain or pain related to the musculoskeletal system in the years following the injury. Methods Individuals listed in Danish registers as having sustained EIs were matched for sex, age, and year of injury in a cohort study with individuals having experienced dislocations/sprains (match 1), eye injuries (match 2), and a sample of individuals with the same occupation without a history of electrical injuries (match 3). Outcomes were unspecified pain and unspecified soft tissue disorders. Conditional logistic regression and conditional Cox regression were applied. Results We identified 14,112 individuals who sustained EIs. A higher risk of both outcomes was observed for all three matches, and was highest at the 6- and 12-month follow-ups. The risk of both outcomes was considerably higher for match 3. Conclusions This study confirms that exposure to EIs increases the risk of being diagnosed with unspecified pain or unspecified soft tissue disorders both at short and long terms. Our results also showed that the risk of unspecified pain as sequelae is related to the severity of the injury.

Childhood infection experience and risk of Young Adult Hodgkin Lymphoma.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1457-1457
Author(s):  
Wendy Cozen ◽  
Ann S. Hamilton ◽  
Peng Zhao ◽  
Muhammed Towhid Salam ◽  
Dennis M. Deapen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Young Adult ◽  
Young Child ◽  
Hodgkin Lymphoma ◽  
Confidence Intervals ◽  
Conditional Logistic Regression ◽  
Oral Exposure ◽  
Increased Risk ◽  
History Of ◽  
Discordant Twin

Abstract The risk pattern of adolescent/young adult Hodgkin lymphoma (HL) is consistent with causation by a relatively late infection to a common childhood virus. However a causal virus has not yet been convincingly found. Susceptibility is known to be heritable, and a lower genetically determined interleukin-12 [IL-12] response is a risk factor. A lower IL-12 response can also be produced by diminished gastrointestinal exposure to the environmental microbiome, with resulting persistence of a Th2-skewed cytokine phenotype. We have therefore studied twin pairs discordant for HL to search for early life differences in sources of both viral and non-viral infection. HL-discordant twin pairs volunteered for the International Twin Study in ignorance of specific hypotheses. 70% of the questionnaires sent to individual twins were returned producing 188 informative pairs. The Kappa statistic was used to assess between-twin agreement. Designating the twin with HL as the case and the unaffected twin as the control, odds ratios (ORs) and 95% confidence intervals (CI) were calculated using conditional logistic regression for matched pairs. Tonsillectomy or appendectomy at least 5 years prior to diagnosis were associated respectively with a 2- and 3-fold statistically significant increase in risk. Infection with 3 or more childhood exanthems was associated with a 60% decreased risk (95% confidence intervals 0.2, 0.9). Behaviors likely to produce oral exposure to the environmental microbiome conveyed statistically significant decreases in risk (OR=0.2–0.5). A history of eczema increased risk (OR= 2.8, 95% CI= 1.0, 7.8). Kappa statistics were high (&gt;0.8) for significant findings. Our evidence supports a role for early exposure to various infections in the etiology of adolescent/young adult Hodgkin lymphoma. Table 1. History of infections, immune-related surgeries and other childhood experience at least 5 years prior to diagnosis and risk of adolescent-young adult Hodgkin Lymphoma diagnosed between 13–50 years of age in disease-discordant twin pairs from the International Twin International Twin Registry (n = 188 total pairs). Exposures Kappa1 Ratio of Exposure Discordant Pairs2 Odds Ratio3 95% CI4 1. Kappa calculated from the 93 double respondent twin pairs (pairs in whom both twins returned questionnaires) 2 Total number of twin pairs in which case-twin was exposed and the unaffected co-twin was unexposed/Total number of twin pairs in which unaffected co-twin was exposed and the case-twin was unexposed 3 Odds ratio estimated using conditional logistic regression using SAS Version 8.1 4 Confidence interval estimated using conditional logistic regression 3 or more childhood exanthems - 6/15 0.4 0.2, 0.9 Infectious mononucleosis 0.72 22/19 1.2 0.6, 2.1 Cold Sores (Herpes Simplex 1) 0.70 18/10 1.8 0.8, 3.9 Tonsillectomy 0.86 25/12 2.1 1.1, 4.1 Appendectomy 0.84 33/11 3.0 1.5, 5.9 Eczema 0.79 14/5 2.8 1.0, 7.8 Sucked pacifier/thumb/fingers more as an infant/young child? 0.87 18/34 0.5 0.3, 0.9 Put more things in mouth as an infant/young child? 0.86 10/30 0.3 0.2, 0.7

Vitamins, Minerals, and Specialty Supplements and Risk of Hematological Malignancies In the VITamins and Lifestyle (VITAL) Cohort Study

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4143-4143
Author(s):  
Filippo Milano ◽  
Roland B. Walter ◽  
Theodore M. Brasky ◽  
Emily White
Keyword(s):  
Folic Acid ◽  
Dietary Supplements ◽  
Hematological Malignancies ◽  
Conflicts Of Interest ◽  
Hematologic Malignancy ◽  
Hematologic Malignancies ◽  
Cox Proportional Hazards ◽  
Case Control Studies ◽  
History Of ◽  
Incident Cases

Abstract Abstract 4143 Introduction: The use of vitamins and dietary supplements is a common health practice in many parts of the world, in part because of the belief that they will prevent diseases, including cancer. However, results of epidemiologic studies regarding their efficacy in reducing the risk of any cancer, particularly hematologic malignancies, are inconsistent and are mostly limited to case-control studies. Materials: Participants were male and female members of the VITamins And Lifestyle (VITAL) cohort. Between 2000 and 2002, 64,839 men and women, aged 50 to 76 years, who lived in the region of Washington State covered by the Surveillance, Epidemiology, and End Results (SEER) registry, were recruited. Participants were excluded if they had any cancer prior to baseline other than non-melanoma skin cancer and were censored at the time of diagnosis of a non-hematologic malignancy during follow-up; after exclusions, there were 64,839 participants available for study. Incident cases of hematologic malignancies were identified through December 2008 by linkage to the SEER registry. Participants answered questions on the frequency (days/week), duration (years), and dose per day of their supplemental use of vitamins, including A, B3, B6, B12, C, D, E, multivitamin compounds, and folic acid; minerals, including calcium, selenium, iron, magnesium, chrome, and zinc during the 10 years before baseline. For the non-vitamin, non-mineral “specialty” supplements, garlic, ginseng, and fish oil, only frequency and duration were ascertained. Use of vitamin and mineral supplements was categorized into non-users and tertiles of use, such that the highest category was greater than could be achieved only by use of a common multivitamin (Centrum Silver). 10-year average use of specialty supplements was categorized into: non-user; low use, <4 days/week or <3 years; and high use, ≥4 days/week and ≥3 years. Multivariable-adjusted Cox proportional hazards models were used to estimate hazards ratios (HR) and 95% confidence intervals (95% CI) of the use of dietary supplements with the risk of total hematologic malignancies. Models were adjusted for age, sex, race/ethnicity (white/hispanic/other), education, smoking, self-rated health, physical activity, history of anemia in the year before baseline, and family history of leukemia or lymphoma. Results: A total of 577 case of hematological malignancies were identified including MDS [n=54], AML [n=36], myeloproliferative disorders [n=46], CLL/SLL [n=88] and other non-Hodgkin lymphomas [n=235], Hodgkin lymphomas [n=22], plasma cell disorders [n=66], mature NK/T cell neoplasms [n=17], and other entities [n=13]). None of the vitamin 10-year average intakes were associated with decreased risk of incident hematologic malignancies There was no evidence that high use of vitamins A (HR=0.79, 95% CI: 0.58–1.08; p-trend=0.28), B12 (HR=0.98, 95%CI: 0.73–1.31; p-trend=0.26), C (HR=0.97, 95% CI: 0.77–1.22; p-trend=0.99), D (HR=0.90, 95% CI: 0.62–1.31; p-trend=0.45), or folic acid (HR=1.00, 95% CI: 0.73–1.39; p-trend=0.19) was associated with the risk of blood cancer. Among specialty supplements, only high 10-year average use of garlic was significantly associated with a reduced risk of development of blood cancers (HR=0.64,95% CI: 0.42–0.98); however the association was not linear (p-trend=0.14). Conclusions: We observed no reduction in the risk of incident hematologic malignancies with dietary supplement and vitamin use with the exception of garlic when used at a high amount (≥4 days/week for ≥ 3 years). Disclosures: No relevant conflicts of interest to declare.

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