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J Natl Cancer Inst Monogr. 2014 Aug;2014(48):41-51. doi: 10.1093/jncimonographs/lgu001.

Medical history, lifestyle, family history, and occupational risk factors for chronic lymphocytic leukemia/small lymphocytic lymphoma: the InterLymph Non-Hodgkin Lymphoma Subtypes Project.

Author information

1
Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, JRC, TGC, ADN); Unit of Infections and Cancer, Cancer Epidemiology Research Programme, Institut Català d' Oncologia, IDIBELL, L'Hospitalet de Llobregat, Spain, CIBER de Epidemiología y Salud Pública, Barcelona, Spain (YB, DC, SdS); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, QL, JNS); Institute for Risk Assessment Sciences, Utrecht University, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (RV); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO, Florence, Italy (ASC); Inserm, Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer Group, Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies, Gironde and Bergonié Institute, Bordeaux, France (AM); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, University of Burgundy, France (MM); Cancer Prevention Institute of California, Fremont, CA (CAC); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Cagliari, Italy (PC). slager@mayo.edu.
2
Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, JRC, TGC, ADN); Unit of Infections and Cancer, Cancer Epidemiology Research Programme, Institut Català d' Oncologia, IDIBELL, L'Hospitalet de Llobregat, Spain, CIBER de Epidemiología y Salud Pública, Barcelona, Spain (YB, DC, SdS); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (AB, QL, JNS); Institute for Risk Assessment Sciences, Utrecht University, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands (RV); Unit of Occupational and Environmental Epidemiology, Cancer Prevention and Research Institute ISPO, Florence, Italy (ASC); Inserm, Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer Group, Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies, Gironde and Bergonié Institute, Bordeaux, France (AM); Center for Chronic Immunodeficiency (CCI), University Medical Center Freiburg, Freiburg, Germany (AN); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, University of Burgundy, France (MM); Cancer Prevention Institute of California, Fremont, CA (CAC); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Cagliari, Italy (PC).

Abstract

BACKGROUND:

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are two subtypes of non-Hodgkin lymphoma. A number of studies have evaluated associations between risk factors and CLL/SLL risk. However, these associations remain inconsistent or lacked confirmation. This may be due, in part, to the inadequate sample size of CLL/SLL cases.

METHODS:

We performed a pooled analysis of 2440 CLL/SLL cases and 15186 controls from 13 case-control studies from Europe, North America, and Australia. We evaluated associations of medical history, family history, lifestyle, and occupational risk factors with CLL/SLL risk. Multivariate logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS:

We confirmed prior inverse associations with any atopic condition and recreational sun exposure. We also confirmed prior elevated associations with usual adult height, hepatitis C virus seropositivity, living or working on a farm, and family history of any hematological malignancy. Novel associations were identified with hairdresser occupation (OR = 1.77, 95% CI = 1.05 to 2.98) and blood transfusion history (OR = 0.79, 95% CI = 0.66 to 0.94). We also found smoking to have modest protective effect (OR = 0.9, 95% CI = 0.81 to 0.99). All exposures showed evidence of independent effects.

CONCLUSIONS:

We have identified or confirmed several independent risk factors for CLL/SLL supporting a role for genetics (through family history), immune function (through allergy and sun), infection (through hepatitis C virus), and height, and other pathways of immune response. Given that CLL/SLL has more than 30 susceptibility loci identified to date, studies evaluating the interaction among genetic and nongenetic factors are warranted.

PMID:
25174025
PMCID:
PMC4155456
DOI:
10.1093/jncimonographs/lgu001
[Indexed for MEDLINE]
Free PMC Article

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