Secondary Leukemia After Non-Hodgkin Lymphoma: A Systematic Review and a Meta-Analysis

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5192-5192
Author(s):  
Raffaella Marcheselli ◽  
Alessia Bari ◽  
Eliana Valentina Liardo ◽  
Luigi Marcheselli ◽  
Samantha Pozzi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hodgkin Lymphoma ◽  
Publication Bias ◽  
Observational Studies ◽  
Conflicts Of Interest ◽  
Meta Analysis ◽  
Group Analysis ◽  
Secondary Leukemia ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk

Abstract Abstract 5192 Background: The risk of second leukemia/myelodisplastic syndrome (MDS) in non-Hodgkin lymphoma (NHL) survivors has been described in several studies, but the available evidence has yielded different results. Thus, we performed a systematic review and a meta-analysis on population-based and cohort studies to provide a quantitative assessment of the risk of secondary leukemia/MDS after NHL. Aims of our research were to estimate the pooled Relative Risk (RR) of secondary leukemia/MDS and the RRs associated with impact of different therapies in particular the effect of radiation treatments. Methods: A Medline search of articles published between January 1985 and December 2010 was conducted to identify relevant observational studies. We included studies that met each of the following criteria: 1) published in English-language; 2) original papers (no reviews, comments, letters, or editorials); 3) including naïve patients with any stage of NHL; 4) investigating the risk of secondary leukemia/MDS in NHL survivors; 5) reporting RR, specified as standardized incidence ratios or data allowing such outcomes to be derived. The reference lists of the selected articles were inspected to identify additional papers. When two or more articles reported duplicate data, we included the most recently updated data or most informative study. We did not exclude papers on the base of therapeutic regimens. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Pooled RR and 95% confidence interval (CI) were calculated using random effect models. Meta-regression and tests on heterogeneity and sensitivity analysis was conducted. The publication bias was also evaluated. Results: Fifteen papers met the inclusion criteria reporting RRs for leukemia/MDS. These studies included 278,782 patients affected by NHL of which 575 presented a second leukemia/MDS. RRs ranged from 2.0–251.8 and we found a meta-RR for secondary leukemia/MDS of 8.69 (95%CI: 3.66–20.64). In addition, we evaluated the effect of therapeutic regimens and radiotherapy (RT) and/or total body irradiation (TBI) exposure, limiting the analysis to the studies that clearly described the chemotherapies (CHT) and RT and/or TBI. We found a significant increased risk of second leukemia/MDS for patients exposed to irradiation (considering studies where the % of patients treated with RT and/or TBI was >30%) in comparison with unexposed patients: meta-RR was 20.20 (95%CI: 4.65–87.89) and 6.48 (95%CI:2.41–17.39) respectively. By regression analysis we identified a significant association between RT and/or TBI and secondary leukemia/MDS (P=0.004). No publication bias was observed. Regarding CHT with alkylating agents we found a meta-RR of 9.83 (95%CI: 2.45–58.84), and in a sub-group analysis of the studies that reported informations of CHT plus RT in comparison with the studies that reported data of CHT alone we found an increased risk for the patients undergoing CHT plus RT: meta-RR 13.35 (95%CI: 1.75–19.46) and 5.83 (95%CI: 1.75–19.46) respectively. Conclusion: Our comparative analysis on the incidence of second leukemia/MDS presents several issues including the heterogeneity of NHL, the source of data, the time during which the studies were performed, the different schedule of CHT, the dose of RT used in the different period of time and the length of follow-up. Although these problems could reduce the accuracy of the meta-analysis, our results indicate that NHL treatment is associated with a significantly higher risk of second leukemia/MDS, in particular after RT and/or TBI. Disclosures: No relevant conflicts of interest to declare. Acknowledgments: the study has been supported by funds of the Italian Ministry of Education (FIRB 2011, CINECA code RBAP11TF7Z) and the Italian Association “Angela Serra per la Ricerca sul Cancro”, Modena. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Association between Oral Contraceptives and cutaneous melanoma: a systematic review and metanalysis

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Giacchetta ◽  
M Chiavarini ◽  
G Naldini ◽  
R Fabiani
Keyword(s):  
Systematic Review ◽  
Malignant Melanoma ◽  
Publication Bias ◽  
Oral Contraceptives ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cutaneous Malignant Melanoma ◽  
Hormonal Factors ◽  
Increased Risk

Abstract Background The probability of developing invasive cutaneous malignant melanoma (CMM) is higher in women than in men up until the age of 49. Several studies investigated the association between hormonal factors and CMM. The aim of this systematic review and meta-analysis is to summarize the evidence on the association between Oral Contraceptives (OC) and the risk of CMM. Methods This review and meta-analysis follow the PRISMA guidelines. A systematic literature search was conducted on Medline and Web of Science until December 2019. Studies were eligible if reported a risk estimate for the association between OC and CMM. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using random effect model. Results The results of the pooled analysis of all 32 studies showed no significant association between OC and the risk of CMM (OR 1.02; 95% CI 0.94-1.11; I2=39.32%, p = 0.013). The stratified analyses by study design found no significant association between OC and the risk of CMM neither in the 18 case-control studies (OR 1.02; 95% CI 0.87-1.21; I2=56.91%, p = 0.002) nor in the 14 cohort studies (OR 1.04; 95% CI 0.98-1.11; I2=0.00%, p = 0.557). No significant publication bias could be detected by Egger's test or Begg's test. Conclusions This meta-analysis of available literature suggests no significant association between OC and the risk of developing CMM. Further investigations are needed to evaluate the possible relationship of OC use and other hormonal factors potentially contributing to the increased risk of CMM in women during their reproductive years. Key messages Oral contraceptives (OC) do not significantly contribute to the risk of Cutaneous Malignant Melanoma (CMM). Further studies are needed to investigate the potential role of other hormonal factors in the increased probability of developing CMM in women during their reproductive years.

scholarly journals Pregnancy-related complications and incidence of atrial fibrillation: a systematic review and meta-analysis

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Al Bahhawi ◽  
A Aqeeli ◽  
S L Harrison ◽  
D A Lane ◽  
I Buchan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Cohort Studies ◽  
Observational Studies ◽  
Large Scale ◽  
Data Extraction ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Random Effects Models ◽  
Increased Risk

Abstract Funding Acknowledgements Type of funding sources: None. Background Pregnancy-related complications have been previously associated with incident cardiovascular disease. However, data are scarce on the association between pregnancy-related complications and incident atrial fibrillation (AF). This systematic review examines associations between pregnancy-related complications and incident AF. Methods A systematic search of the literature utilising MEDLINE and EMBASE (Ovid) was conducted from 1990 to 6 April 2020. Observational studies examining the association between pregnancy-related complications including hypertensive disorders of pregnancy (HDP), gestational diabetes, placental abruption, preterm birth, low birth weight, small-for-gestational-age and stillbirth, and incidence of AF were included. Screening and data extraction were conducted independently by two reviewers. Inverse-variance random-effects models were used to pool hazard ratios. Results: Six observational studies met the inclusion criteria one case-control study and five retrospective cohort studies, with four studies eligible for meta-analysis.  Sample sizes ranged from 1,839-1,303,365. Mean/median follow-up for the cohort studies ranged from 7-36 years. Most studies reported an increased risk of incident AF associated with pregnancy-related complications. The pooled summary statistic from four studies reflected a greater risk of incident AF for HDP (hazard ratio (HR) 1.47, 95% confidence intervals (CI) 1.18-1.84; I2 = 84%) and from three studies for pre-eclampsia (HR 1.71, 95% CI 1.41-2.06; I2 = 64%; Figure). Conclusions The results of this review suggest that pregnancy-related complications particularly pre-eclampsia appear to be associated with higher risk of incident AF. The small number of included studies and the significant heterogeneity in the pooled results suggest further large-scale prospective studies are required to confirm the association between pregnancy-related complications and AF. Abstract Figure.

Association between red blood cell transfusions and development of non-Hodgkin lymphoma: a meta-analysis of observational studies

Blood ◽  
2010 ◽  
Vol 116 (16) ◽  
pp. 2897-2907 ◽  
Author(s):  
Jorge J. Castillo ◽  
Samir Dalia ◽  
Sheila K. Pascual
Keyword(s):  
Cohort Studies ◽  
Hodgkin Lymphoma ◽  
Observational Studies ◽  
Meta Analysis ◽  
Case Control ◽  
Lymphocytic Leukemia ◽  
Blood Transfusions ◽  
Non Hodgkin Lymphoma ◽  
Newcastle Ottawa Scale ◽  
Trim And Fill

AbstractThe incidence of non-Hodgkin lymphoma (NHL) has increased steadily for the past few decades. Previous studies have suggested an association between blood transfusions and NHL. The main objective of this study was to evaluate this relationship with a meta-analysis of observational studies. A literature search was undertaken, looking for case-control and cohort studies evaluating the risk of developing NHL in persons who received allogeneic blood transfusions; 14 studies were included. Outcome was calculated and reported as relative risk (RR). Heterogeneity was assessed with Cochrane Q and I2 statistics. Dissemination bias was evaluated by funnel plot visualization and trim-and-fill analysis. Quality assessment was performed with the Newcastle-Ottawa scale. Our analysis showed a RR of developing NHL of 1.05 (95% CI, 0.89-1.25; P = .42) and 1.34 (95% CI, 1.15-1.55; P < .01) in case-control and cohort studies, respectively. When pooling all studies, RR was 1.2 (95% CI, 1.07-1.35; P < .01). In subset analysis, RR of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was 1.66 (95% CI, 1.08-2.56; P = .02). The RR of NHL was elevated in both men and women and in persons receiving transfusions either before or after 1992. Blood transfusions appear to increase the risk of developing NHL; however, the risk of CLL/SLL appears higher than for other NHL subtypes.

scholarly journals Prenatal vitamin D status and offspring’s growth, adiposity and metabolic health: a systematic review and meta-analysis

2018 ◽  
Vol 119 (3) ◽  
pp. 310-319 ◽  
Author(s):  
Christina Santamaria ◽  
Wei Guang Bi ◽  
Line Leduc ◽  
Negar Tabatabaei ◽  
Prévost Jantchou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Observational Studies ◽  
Growth Parameters ◽  
Meta Analysis ◽  
Metabolic Health ◽  
Vitamin D Status ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
Offspring Growth

AbstractIn this systematic review and meta-analysis of observational studies, we aimed to estimate the associations between prenatal vitamin D status and offspring growth, adiposity and metabolic health. We searched the literature in human studies on prenatal vitamin D status and offspring growth in PubMed, up to July 2017. Studies were selected according to their methodological quality and outcomes of interest (anthropometry, fat mass and diabetes in offspring). The inverse variance method was used to calculate the pooled mean difference (MD) with 95 % CI for continuous outcomes, and the Mantel–Haenszel method was used to calculate the pooled OR with 95 % CI for dichotomous outcomes. In all, thirty observational studies involving 35 032 mother–offspring pairs were included. Vitamin D status was evaluated by circulating 25-hydroxyvitamin D (25(OH)D) level. Low vitamin D status was based on each study’s cut-off for low 25(OH)D levels. Low prenatal vitamin D levels were associated with lower birth weight (g) (MD −100·69; 95 % CI −162·25, −39·13), increased risk of small-for-gestational-age (OR 1·55; 95 % CI 1·16, 2·07) and an elevated weight (g) in infant at the age of 9 months (g) (MD 119·75; 95 % CI 32·97, 206·52). No associations were observed between prenatal vitamin D status and other growth parameters at birth, age 1 year, 4–6 years or 9 years, nor with diabetes type 1. Prenatal vitamin D may play a role in infant adiposity and accelerated postnatal growth. The effects of prenatal vitamin D on long-term metabolic health outcomes in children warrant future studies.

scholarly journals A posteriori dietary patterns and metabolic syndrome in adults: a systematic review and meta-analysis of observational studies

2018 ◽  
Vol 21 (9) ◽  
pp. 1681-1692 ◽  
Author(s):  
Sakineh Shab-Bidar ◽  
Mahdieh Golzarand ◽  
Mina Hajimohammadi ◽  
Sara Mansouri
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Observational Studies ◽  
Meta Analysis ◽  
A Posteriori ◽  
Significant Positive Association ◽  
Western Dietary Pattern ◽  
Increased Risk

AbstractObjectiveObservational studies reported potential associations between different dietary patterns and the risk of metabolic syndrome (MetS); however, a consistent perspective has not been established to date. The current systematic review and meta-analysis aimed to evaluate the relationship between a posteriori dietary patterns and MetS by pooling available data.DesignMEDLINE and EMBASE databases were searched for relevant articles published up to July 2015 with no time restriction and with English language restriction. Two independent reviewers completed study selection and data extraction. Random-effects models (DerSimonian–Laird method) were used to pool effect sizes of eligible studies. The potential sources of heterogeneity were assessed using the I2 statistic.ResultsNineteen papers that identified dietary patterns using an a posteriori method were selected and included in the meta-analysis. The ‘Healthy/Prudent’ dietary pattern was inversely associated with risk of MetS (OR=0·89; 95 % CI 0·84, 0·94, P=0·002). In contrast, the ‘Unhealthy/Western’ dietary pattern had a significant positive association with risk of MetS (OR=1·16; 95 % CI 1·11, 1·22, P<0·001).ConclusionsOur findings provide evidence that greater adherence to a healthy/prudent dietary pattern is associated with a lower risk of MetS, while an unhealthy/Western dietary pattern is associated with increased risk of MetS. These data suggest that a diet based on healthy food choices is also beneficial for prevention of MetS.

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