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J Natl Cancer Inst Monogr. 2014 Aug;2014(48):1-14. doi: 10.1093/jncimonographs/lgu005.

Rationale and Design of the International Lymphoma Epidemiology Consortium (InterLymph) Non-Hodgkin Lymphoma Subtypes Project.

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Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (LMM, JNS, SMM, JSC, SIB, MSL); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (JRC, DR, ADN, SLS); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia, The Australian School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Prince of Wales Clinical School, University of New South Wales, Sydney, Australia (CMV); Department of Cancer Etiology, City of Hope Beckman Research Institute, Duarte, CA (SSW); Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (KES); Unit of Infections and Cancer, Cancer Epidemiology Research Programme, Institut Catala d'Oncologia, IDIBELL, Barcelona, Spain, CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain (SdS, YB); Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Health Studies, University of Chicago, Chicago, IL (BCHC); Department of Epidemiology, Comprehensive Cancer Center, University of Alabama, Birmingham, AL (CFS); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Information Management Systems, Inc, Silver Spring, MD (MS); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, UK (EVK, ER); Cancer Control Research, BC Cancer Agency, Vancouver, BC, Canada (JJS); School of Medicine and Dentistry, University of Rochester, Rochester, NY (JLK); Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri and Department of Clinical Sciences and Community Hea



Non-Hodgkin lymphoma (NHL), the most common hematologic malignancy, consists of numerous subtypes. The etiology of NHL is incompletely understood, and increasing evidence suggests that risk factors may vary by NHL subtype. However, small numbers of cases have made investigation of subtype-specific risks challenging. The International Lymphoma Epidemiology Consortium therefore undertook the NHL Subtypes Project, an international collaborative effort to investigate the etiologies of NHL subtypes. This article describes in detail the project rationale and design.


We pooled individual-level data from 20 case-control studies (17471 NHL cases, 23096 controls) from North America, Europe, and Australia. Centralized data harmonization and analysis ensured standardized definitions and approaches, with rigorous quality control.


The pooled study population included 11 specified NHL subtypes with more than 100 cases: diffuse large B-cell lymphoma (N = 4667), follicular lymphoma (N = 3530), chronic lymphocytic leukemia/small lymphocytic lymphoma (N = 2440), marginal zone lymphoma (N = 1052), peripheral T-cell lymphoma (N = 584), mantle cell lymphoma (N = 557), lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (N = 374), mycosis fungoides/Sézary syndrome (N = 324), Burkitt/Burkitt-like lymphoma/leukemia (N = 295), hairy cell leukemia (N = 154), and acute lymphoblastic leukemia/lymphoma (N = 152). Associations with medical history, family history, lifestyle factors, and occupation for each of these 11 subtypes are presented in separate articles in this issue, with a final article quantitatively comparing risk factor patterns among subtypes.


The International Lymphoma Epidemiology Consortium NHL Subtypes Project provides the largest and most comprehensive investigation of potential risk factors for a broad range of common and rare NHL subtypes to date. The analyses contribute to our understanding of the multifactorial nature of NHL subtype etiologies, motivate hypothesis-driven prospective investigations, provide clues for prevention, and exemplify the benefits of international consortial collaboration in cancer epidemiology.

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