scholarly journals Late Health Outcomes After Contemporary Lymphome Malin de Burkitt Therapy for Mature B-Cell Non-Hodgkin Lymphoma: A Report From the Childhood Cancer Survivor Study

2019 ◽  
Vol 37 (28) ◽  
pp. 2556-2570 ◽  
Author(s):  
Matthew J. Ehrhardt ◽  
Yan Chen ◽  
John T. Sandlund ◽  
Elizabeth C. Bluhm ◽  
Robert J. Hayashi ◽  
...  
Keyword(s):  
Health Status ◽  
Health Outcomes ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Socioeconomic Outcomes ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk ◽  
Childhood Cancer Survivor Study

PURPOSE The widely used, risk-based Lymphome Malin de Burkitt (LMB) chemotherapy regimen has improved survival rates for children with mature B-cell non-Hodgkin lymphoma (NHL); however, associated late effects remain understudied. We assessed late health outcomes after LMB treatment in the Childhood Cancer Survivor Study. PATIENTS AND METHODS Multivariable regression models compared chronic health conditions, health status, and socioeconomic and neurocognitive outcomes between survivors of NHL treated with the LMB regimen (n = 126), survivors of NHL treated with non-LMB regimens (n = 444), and siblings (n = 1,029). RESULTS LMB survivors were a median age of 10.2 years (range, 2.5 to 20.5 years) at diagnosis and 24.0 years (range, 10.3 to 35.3 years) at evaluation. Compared with siblings, LMB survivors were at increased risk for adverse health outcomes. However, survivors of NHL treated with LMB and non-LMB regimens did not differ with regard to risk of having any chronic health conditions, impaired health status, neurocognitive deficits, or poorer socioeconomic outcomes. Increased risk for the following specific neurologic conditions was observed in LMB survivors compared with non-LMB survivors: epilepsy (relative risk [RR], 15.2; 95% CI, 3.1 to 73.4); balance problems (RR, 8.9; 95% CI, 2.3 to 34.8); tremors (RR, 7.5; 95% CI, 1.9 to 29.9); weakness in legs (RR, 8.1; 95% CI, 2.5 to 26.4); severe headaches (RR, 3.2; 95% CI, 1.6 to 6.3); and prolonged arm, leg, or back pain (RR, 4.0; 95% CI, 2.2 to 7.1). The survivors from the group C LMB risk group (n = 50) were at the highest risk for these conditions; however, except for worse functional status (odds ratio, 2.7; 95% CI, 1.2 to 5.8), they were not at increased risk for other adverse health status or socioeconomic outcomes compared with non-LMB survivors. CONCLUSION Survivors treated with LMB and non-LMB regimens are largely comparable in late health outcomes except for excess neurotoxicity among LMB survivors. These data inform treatment efforts seeking to optimize disease control while minimizing toxicity.

scholarly journals Estimated Late Health Outcomes in Children Newly Diagnosed with Mature B-Cell Non-Hodgkin Lymphoma Treated with Contemporary LMB Chemotherapy Based upon Similarly Treated Participants in the Childhood Cancer Survivor Study (CCSS)

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3609-3609
Author(s):  
Matthew J. Ehrhardt ◽  
Yan Chen ◽  
John Sandlund ◽  
Elizabeth C. Bluhm ◽  
Robert J. Hayashi ◽  
...  
Keyword(s):  
Health Status ◽  
Health Outcomes ◽  
Survival Rates ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk ◽  
Group A ◽  
Group B

Abstract Introduction: Since the mid-1990's, overall survival rates for children diagnosed with mature B-cell non-Hodgkin lymphoma (B-NHL) have exceeded 90%, due in large part to the widespread utilization of the LMB chemotherapy regimen. As a result, a population of survivors living beyond 5 years from diagnosis and treatment with this regimen is emerging, providing the first opportunity to study late-occurring and chronic health outcomes following contemporary B-NHL therapy. Methods: Late health outcomes and health status were self-reported among CCSS participants who were 5-year survivors of childhood B-NHL and whose treatment exposures were consistent with LMB-defined risk-groups (A - low; B - intermediate; and C - high risk). Combinations of individual chemotherapy agents (cyclophosphamide [CPM], vincristine, prednisone, doxorubicin [doxo], high-dose methotrexate [HD-MTX], cytarabine, and etoposide) and respective cumulative doses (for CPM, doxo, HD-MTX, and etoposide) were abstracted from medical records. Chronic health conditions occurring ≥5 years from cancer diagnosis were graded per the Common Terminology Criteria for Adverse Events (version 4.03). Decreased fertility was defined as failure to achieve or sire a pregnancy after ≥1 year of trying among survivors of childbearing age (15-44 years). Health status outcomes were obtained from validated questionnaires. Standardized mortality ratios (SMRs) were estimated. Cox and logistic regression models (adjusted for age, sex, and race) provided hazard (HR) and odds ratios (OR) and 95% confidence intervals (CI) of health conditions and status compared to a sibling comparison group (n=4,023). Results: We identified 94 B-NHL survivors (median age 10 [range 2-20] years at diagnosis, 24 [10-39] years at evaluation, 14 [7-26] years post diagnosis), for which pertinent LMB treatment exposures are included in Table 1. Compared to siblings, survivors were more likely to be male (79% vs. 48%, p<0.001), younger at evaluation (24.3 ± 6.1 vs. 26.7 ± 9.2 years, p<0.001), and non-white race (22% vs 13%, p=0.006). Thirty-five (37%) survivors had ≥1 chronic condition (grades 1-5); a 4-fold increased risk (HR 4.1, 95% CI: 2.9-5.8) compared to siblings (Group A HR 2.6, 95% CI 1.2-5.6, Group B HR 5.2, 95% CI 3.1-8.6, and Group C HR 4.2, 95% CI 2.4-7.6). The most frequently occurring conditions were obesity (24%) and decreased fertility (10%). Excluding these, Group B (HR 5.3, 95% CI 1.6-17.3) and Group C (HR 5.7, 95% CI 1.7-19.0) survivors remained at increased risk of having ≥1 chronic condition. Group A survivors showed a similar HR without statistical significance (HR 4.0, 95% CI 0.5-31.3). Three survivors died during study follow-up (SMR 6.5, 95% CI 1.3-19.0), only one died due to a non-cancer related cause of death. All Groups (A-C) were more likely than siblings to report impaired functional status (OR 11.2, 95% CI 3.5-35.6; 4.5, 95% CI 1.5-13.1; and 15.1, 95% CI 6.0-37.8, respectively). Groups B and C survivors were more likely to report poor mental health (OR 2.9, 95% CI 1.0-8.6 and 3.7, 95% CI 1.0-12.9, respectively), while Group B survivors were more likely to report poor general health (OR 5.1, 95% CI 2.2-11.9). No associations with activity limitations (p's>0.1) or sociodemographic differences (educational level less than a college degree, p's>0.1; household income less than $60,000/year, p's>0.1) were identified in any Groups. Cancer-related pain and anxiety did not differ in Groups B or C compared to survivors in Group A (p=0.9 and 0.2, respectively). Conclusions: Despite excellent survival rates, children diagnosed with B-NHL and treated with contemporary LMB chemotherapy regimens are at risk for chronic health conditions and health status limitations by 14 years from diagnosis. Studies exploring the trajectory of these findings and the impact of early interventions are needed to inform future frontline treatment protocols. Disclosures No relevant conflicts of interest to declare.

scholarly journals Cytokine polymorphisms in Th1/Th2 pathway genes, body mass index, and risk of non-Hodgkin lymphoma

Blood ◽  
2011 ◽  
Vol 117 (2) ◽  
pp. 585-590 ◽  
Author(s):  
Yingtai Chen ◽  
Tongzhang Zheng ◽  
Qing Lan ◽  
Francine Foss ◽  
Christopher Kim ◽  
...  
Keyword(s):  
Body Mass Index ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Body Mass ◽  
Significant Interaction ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Lymphocytic Leukemia ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk

Abstract We conducted a population-based, case-control study in Connecticut women to test the hypothesis that genetic variations in Th1 and Th2 cytokine genes modify the relationship between body mass index (BMI) and risk of non-Hodgkin lymphoma (NHL). Compared with those with BMI less than 25 kg/m2, women with BMI more than or equal to 25 kg/m2 had 50% to 90% increased risk of NHL among women who carried IFNGR2 (rs9808753) AA, IL5 (rs2069812) CT/TT, IL7R (rs1494555) AA, and TNF (rs1799724) CC genotypes, but no increased risk among women with IFNGR2 AG/GG, IL5 CC, IL7R AG/GG, and TNF CT/TT genotypes. A significant interaction with BMI was only observed for IFNGR2 (rs9808753 Pforinteraction = .034) and IL7R (rs1494555 Pforinteraction = .016) for NHL overall; IL7R (rs1494555 Pforinteraction = .016) and TNF (1799724 Pforinteraction = .031) for B-cell lymphoma; and IL5 (rs2069812 Pforinteraction = .034) for T-cell lymphoma. After stratification by common B-cell lymphoma subtypes, a significant interaction was observed for IFNGR2 (rs9808753 Pforinteraction = .006), IL13 (rs20541 Pforinteraction = .019), and IL7R (rs1494555 Pforinteraction = .012) for marginal zone B-cell lymphoma; IL7R (rs1494555 Pforinteraction = .017) for small lymphocytic lymphoma/chronic lymphocytic leukemia; and IL12A (rs568408 Pforinteraction = .013) and TNF (1799724 Pforinteraction = .04) for follicular lymphoma. The results suggest that common genetic variation in Th1/Th2 pathway genes may modify the association between BMI and NHL risk.

scholarly journals Prevalence and Predictors of Neurocognitive Impairment in Long-Term Survivors of Childhood Hodgkin Lymphoma: A Report from the Childhood Cancer Survivor Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 14-15
Author(s):  
Annalynn M Williams ◽  
Mengqi Xing ◽  
Sedigheh Mirzaei Salehabadi ◽  
Yutaka Yasui ◽  
Matt J. Ehrhardt ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Emotional Regulation ◽  
Neurocognitive Impairment ◽  
Elevated Risk ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Childhood Cancer Survivor Study ◽  
Task Efficiency ◽  
Long Term Survivors

Background: Long-term survivors of childhood Hodgkin lymphoma (HL) are at significant risk for cardiovascular, pulmonary, and endocrine morbidity in addition to subsequent cancers. Emerging evidence suggests that HL survivors may also experience persistent neurocognitive impairment, however the prevalence of neurocognitive impairment has not been well characterized. Further, little work has been done to examine how specific treatments or comorbidities are associated with these impairments. Methods: The current study included 1,760 survivors (52.0% female, mean[sd] 37.5 [6.0] years old, 23.6 [4.7] years from diagnosis) of childhood Hodgkin lymphoma and 3,180 sibling controls (54.5% female, 33.2 [8.5] years old) from the Childhood Cancer Survivor Study. Participants completed questionnaires assessing four domains of neurocognitive impairment (task efficiency, emotional regulation, organization, and memory). Impairment for each domain was defined as a score worse than the 90th percentile of community controls. Treatment exposures were abstracted from the medical record. Second malignancies (SMN) were self-reported and subsequently confirmed by pathology findings or medical record review. Chronic health conditions were self-reported and systematically graded according to the NCI CTCAE v4.3 (Grade 1 mild, Grade 2 moderate, Grade 3 severe/disabling, Grade 4 life-threatening). Generalized estimating equations were used to calculate risk of impairment in survivors compared with siblings adjusted for age, sex, and race. Among HL survivors, multivariable log-binomial regression was used to calculate risk of impairment associated with demographic, clinical, and treatment factors. Separate models examined risk associated with Grade 2+ chronic health conditions adjusted for age, sex, and race. Results: 10.8% of HL survivors reported impaired task efficiency (vs. 7.7% in siblings), 16.6% emotional regulation (vs. 11.5% in siblings), 12.1% organization (vs. 10.3% in siblings), and 8.1% memory (vs. 5.7% in siblings). Compared with siblings, survivors reported significantly higher risk of impairment in each of the four neurocognitive domains after adjusting for age, sex, and race (Table). Female survivors had elevated risk of impairment on emotional regulation (RR [95%CI] 1.4 [1.1,1.9)) and memory (2.0 [1.3,3.0]). Compared with white survivors (91.8% of the population), non-white survivors had higher risk of impairment in task efficiency (2.1 [1.2, 3.5]) and emotional regulation (1.7 [1.0,2.7]). Current smokers (12.3%) had higher risk of impairment in task efficiency (1.9 [1.2, 3.1]), emotional regulation (2.5 [1.7,3.7]), and memory (1.7 [1.0,3.0]). Having a late-relapse (&gt;5 years from diagnosis) or a second malignancy (20.0%) was associated with elevated risk of impairment in task efficiency (1.6 [1.06,2.3]). While not statistically significant, anthracycline exposure (39.8%) was associated with higher risk of impairment in task efficiency (1.3 [0.7,2.2]) and memory (1.6 [0.9,3.0]). No statistically significant associations were noted for bleomycin, corticosteroids, or chest radiation. HL survivors with pulmonary morbidity (8.5%) had a higher risk of impairment on task efficiency (1.9 [1.2,3.0]) compared to those without. Cardiovascular conditions (32.9%) were associated with elevated risk of impairment in all domains (RR range from 1.5 to 2.1, all p&lt;0.05, Table). Endocrine (54.3%) and neurologic conditions (6.6%) were associated with an increased risk of task efficiency, emotional regulation, and memory impairments (RR range from 1.4 to 5.5, all p&lt;0.05, Table). Conclusions: Survivors experienced significantly more neurocognitive impairment compared to sibling controls. Among survivors, potentially modifiable risk factors such as smoking and chronic health conditions were associated with neurocognitive impairment while treatment exposures showed little association. Mitigation or prevention of smoking and chronic health conditions may improve neurocognitive functioning in HL survivors Table Disclosures No relevant conflicts of interest to declare.

53 Health Outcomes of Siblings of Children with Chronic Health Conditions: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e38-e39
Author(s):  
Benjamin Martinez ◽  
Petros Pechlivanoglou ◽  
Dorisa Meng ◽  
Benjamin Traubici ◽  
Quenby Mahood ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Rating Scale ◽  
Well Being ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Increased Risk ◽  
Scale Scores

Abstract Primary Subject area Mental Health Background Chronic childhood health conditions are known to have an impact on the well-being of family members. Parental caregivers face well-defined adverse health outcomes, though less is known about the health impacts on siblings. Objectives To assess clinical health outcomes in siblings of children with chronic health condition(s) compared to siblings of healthy children or normative data. Design/Methods We searched Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, PsycInfo, and CINAHL through June 4, 2020. We included English-language studies that: (1) reported clinically diagnosable mental or physical health outcomes of siblings of children (0-18 years old) diagnosed with any childhood chronic health condition; (2) included a comparison group; and (3) used an experimental or observational study design. Risk of bias was assessed using the Newcastle-Ottawa Scale. Results We included 28 studies of the 9053 screened, comprising 10 cohort studies and 18 cross-sectional studies. Studies from 11 different countries reported most commonly on siblings of children with disabilities (12 studies), cancer (8 studies), or psychiatric disorders (4 studies). Siblings of children with chronic conditions had greater depression rating scale scores than their comparison groups (standardized mean difference 0.49; 95% CI 0.33-0.65; P &lt; .001 [5 studies]) (Fig. 1), whereas anxiety scores did not differ significantly (standardized mean difference 0.24; 95% CI -0.03-0.52; P = .08 [6 studies]) (Fig. 2). Studies that reported on prevalence of psychiatric diagnoses, rather than rating scale scores, had mixed results, either indicating increased risk (3 studies) or no increased risk (4 studies) among exposed siblings. We did not meta-analyze effects for mortality (3 studies) or physical health outcomes (dental caries [1 study], traumatic brain injury [1 study], sexually transmitted infection [1 study], overweightness/obesity [1 study]) given the limited number of studies and between-study heterogeneity. Included studies were rated as high quality (12 studies) or of moderate quality (16 studies). Conclusion Siblings of children with chronic health conditions may be at an increased risk of depression. Our findings suggest the need for targeted interventions to support the psychological well-being of siblings of children with chronic health conditions.

scholarly journals B-cell non-Hodgkin lymphoma linked to Coxiella burnetii

Blood ◽  
2016 ◽  
Vol 127 (1) ◽  
pp. 113-121 ◽  
Author(s):  
Cléa Melenotte ◽  
Matthieu Million ◽  
Gilles Audoly ◽  
Audrey Gorse ◽  
Hervé Dutronc ◽  
...  
Keyword(s):  
Tumor Microenvironment ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk ◽  
Key Points

Key PointsCoxiella burnetii is associated with an increased risk of lymphoma; its presence in the tumor microenvironment may favor lymphomagenesis. Lymphoma has to be considered in patients with Q fever and lymphoid disorders, especially those with persistent focalized infections.

scholarly journals Genetic Variation in B-Cell–Activating Factor Is Associated with an Increased Risk of Developing B-Cell Non–Hodgkin Lymphoma

2009 ◽  
Vol 69 (10) ◽  
pp. 4217-4224 ◽  
Author(s):  
Anne J. Novak ◽  
Susan L. Slager ◽  
Zachary S. Fredericksen ◽  
Alice H. Wang ◽  
Michelle M. Manske ◽  
...  
Keyword(s):  
Genetic Variation ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Non Hodgkin Lymphoma ◽  
B Cell Activating Factor ◽  
Increased Risk

scholarly journals Health outcomes in a national sample of American Indian and Alaska Native adults: Differences between multiple-race and single-race subgroups

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242934
Author(s):  
Ursula Running Bear ◽  
Nancy L. Asdigian ◽  
Janette Beals ◽  
Spero M. Manson ◽  
Carol E. Kaufman
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
American Indian ◽  
Access To Health Care ◽  
Multinomial Logistic Regression ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Access To Health ◽  
Increased Risk

Objectives To determine differences among multi-race (MR) American Indian and Alaska Natives (AIAN), single race (SR) AIANs, and SR-Whites on multiple health outcomes. We tested the following hypotheses: MR-AIANs will have worse health outcomes than SR-AIANs; SR-AIANs will have worse health outcomes than SR-Whites; MR-AIANs will have worse health outcomes than SR-Whites. Methods Behavioral Risk Factor Surveillance System data were used to examine general health, risk behaviors, access to health care, and diagnosed chronic health conditions. Those identifying as SR-White, SR-AIAN, and MR-AIAN were included in multinomial logistic regression models. Results Compared to SR-AIANs, MR-AIANs had more activity limitations, a greater likelihood of experiencing cost as a barrier to health care and were more likely to be at increased risk and diagnosed with more chronic health conditions. Both SR and MR-AIANs have worse health than SR-Whites; MR-AIANs appear to be at increased risk for poor health. Conclusions The current study examined access to health care and nine chronic health conditions, neither of which have been considered in prior work. MR AIANs are at increased risk compared to SR groups. These observations beg for further inquire into the mechanisms underlying these differences including stress related to identify, access to care, and discrimination. Findings support the continued need to address health disparities among AIANs regardless of SR or MR identification.

Hepatitis B Infection Is Associated with an Increased Risk of Non-Hodgkin Lymphoma: A Meta-Analysis.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2658-2658
Author(s):  
Samir Dalia ◽  
Julio Chavez ◽  
Jorge J Castillo ◽  
Lubomir Sokol
Keyword(s):  
Hepatitis B ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Cell Lymphoma ◽  
Meta Analysis ◽  
B Cell Lymphoma ◽  
Lymphocytic Leukemia ◽  
Hbv Infection ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk

Abstract Abstract 2658 Introduction: Hepatitis B virus (HBV) infection is a major global public health problem with the World Health Organization reporting about 350 million people with chronic HBV infection with the highest rates seen in Asia and Africa. Multiple studies have attempted to show an association between HBV infection and non-Hodgkin lymphoma (NHL) but have had conflicting results. Objectives: The primary aim of our study was to evaluate the association between HBV infection and the incidence of NHL using a meta-analysis of epidemiological studies. Secondary aims were to evaluate such association in NHL subtypes and by geographical region. Methods: A MEDLINE and Google Scholar search through July 2012 were undertaken using (Hepatitis B or hepatitis) AND (lymphoma OR “risk of lymphoma” OR “hematologic malignancies” OR “lymphoproliferative disorders” OR “non Hodgkin lymphoma”). Only epidemiological studies reporting on HBV infection and NHL were included. Hepatitis B status confirmation method was recorded. Meta-analyses were performed for NHL in general, by NHL subtypes, and according to geographical region. The outcome was calculated as odds ratio (OR). The random effects model (REM) was used to calculate the outcome. Heterogeneity was assessed by the I2 statistic. Publication bias was assessed by the trim-and-fill analysis. Literature search and data gathering were performed independently by at least 2 of the investigators. All graphs and calculations were obtained using Comprehensive Meta-Analysis version 2 (Biostat, Englewood, NJ). Results: Our search yielded 21 studies; 17 case-control studies accounted for 38,630 cases and 1,659,449 controls, and 4 prospective cohort studies accounted for 1,258 cases indentified in a cohort of over 2.4 million individuals. HBV infection was confirmed by seropositivity in 81% of studies (n=17). HBV infection patients had an OR 2.30 (95% CI 1.87–2.84; p=<0.001) of developing NHL. OR was significant in patients from Asian countries (OR 2.31, 95% CI 1.87–2.86, p<0.001) and in patients from American/European/Australian countries (OR 2.58, 95% CI 1.43–4.62, p=0.002). In subgroup analysis, HBV infection patients had an OR 2.10 (95% CI 1.27–3.49, p=0.004) of developing diffuse large B-cell lymphoma (DLBCL). In patients from Asian countries, HBV infection was associated with an increased risk of DLBCL (OR 3.05, 95% CI 1.86–5.00, p<0.001); an association was not found in patients from Europe or Australian studies. Patients with HBV infection had increased risk to develop follicular lymphoma (OR 1.966, 95% CI 1.211–3.193, p<0.001) and B-cell lymphomas (OR 2.67, 95% CI 2.08–3.43, p<0.001). Patients with HBV infection did not have increased risk to develop chronic lymphocytic leukemia/small cell lymphoma (OR 1.58, 95% CI 0.70–3.62, p=0.27) or T-cell lymphomas (OR 1.37, 95% CI 0.95–1.98, p=0.091). Conclusions: The results of this meta-analysis suggest a positive association between HBV infection and NHL, DLBCL, follicular lymphoma, and B-cell lymphoma. There was no association between HBV infection and chronic lymphocytic leukemia/small cell lymphoma or T-cell lymphomas. Future research is needed to better understand molecular mechanisms responsible for lymphomagenesis in patients with chronic HBV infection. Disclosures: No relevant conflicts of interest to declare.

scholarly journals A prospective study of serum soluble CD30 concentration and risk of non-Hodgkin lymphoma

Blood ◽  
2009 ◽  
Vol 114 (13) ◽  
pp. 2730-2732 ◽  
Author(s):  
Mark P. Purdue ◽  
Qing Lan ◽  
Otoniel Martinez-Maza ◽  
Martin M. Oken ◽  
William Hocking ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Ovarian Cancer Screening ◽  
Hiv Patients ◽  
Cell Stimulation ◽  
Non Hodgkin Lymphoma ◽  
Soluble Cd30 ◽  
Increased Risk ◽  
A Prospective Study ◽  
Nested Case Control

Abstract Prediagnostic serum concentration of soluble CD30 (sCD30), a marker for chronic B-cell stimulation, has been associated with increased risk of developing AIDS-related non-Hodgkin lymphoma (NHL) in a recent study of HIV+ patients. To investigate among healthy persons whether serum sCD30 is associated with NHL risk, we carried out a nested case-control study within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. There was a strong dose-response relationship between prediagnostic sCD30 concentration and NHL risk among 234 cases and 234 individually matched controls (odds ratio [95% confidence interval] for second, third, and fourth quartiles vs first quartile: 1.4 [0.8-2.6], 2.2 [1.2-4.1], 4.1 [2.2-7.8]; Ptrend < .001), which persisted among cases diagnosed 6 to 10 years after providing a blood sample. Given that a similar relationship has been observed among HIV+ patients, our findings suggest that chronic B-cell stimulation may be an important mechanism involved in B-cell lymphomagenesis among severely immunocompromised and healthy populations alike.

scholarly journals Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium

Blood ◽  
2008 ◽  
Vol 111 (8) ◽  
pp. 4029-4038 ◽  
Author(s):  
Karin Ekström Smedby ◽  
Claire M. Vajdic ◽  
Michael Falster ◽  
Eric A. Engels ◽  
Otoniel Martínez-Maza ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Fixed Effects ◽  
Large Scale ◽  
Marginal Zone ◽  
Pooled Analysis ◽  
Autoimmune Disorders ◽  
Non Hodgkin Lymphoma ◽  
Increased Risk ◽  
Large B Cell

Abstract Some autoimmune disorders are increasingly recognized as risk factors for non-Hodgkin lymphoma (NHL) overall, but large-scale systematic assessments of risk of NHL subtypes are lacking. We performed a pooled analysis of self-reported autoimmune conditions and risk of NHL and subtypes, including 29 423 participants in 12 case-control studies. We computed pooled odds ratios (OR) and 95% confidence intervals (CI) in a joint fixed-effects model. Sjögren syndrome was associated with a 6.5-fold increased risk of NHL, a 1000-fold increased risk of parotid gland marginal zone lymphoma (OR = 996; 95% CI, 216-4596), and with diffuse large B-cell and follicular lymphomas. Systemic lupus erythematosus was associated with a 2.7-fold increased risk of NHL and with diffuse large B-cell and marginal zone lymphomas. Hemolytic anemia was associated with diffuse large B-cell NHL. T-cell NHL risk was increased for patients with celiac disease and psoriasis. Results for rheumatoid arthritis were heterogeneous between studies. Inflammatory bowel disorders, type 1 diabetes, sarcoidosis, pernicious anemia, and multiple sclerosis were not associated with risk of NHL or subtypes. Thus, specific autoimmune disorders are associated with NHL risk beyond the development of rare NHL subtypes in affected organs. The pattern of associations with NHL subtypes may harbor clues to lymphomagenesis.

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