Immune-related conditions and immune-modulating medications as risk factors for non-Hodgkin's lymphoma: a case-control study.
In immunosuppressed or autoimmune disease states, disordered immune responses may lead to non-Hodgkin's lymphoma (NHL). In a US population-based case-control study of NHL (1998-2000), the authors collected personal histories of immune-related conditions and use of immune-modulating therapies as well as family histories of autoimmune conditions. The study included 1,321 NHL cases and 1,057 controls; only half received some questionnaire components. NHL was associated with Sjögren's syndrome (odds ratio (OR) = 13, 95% confidence interval (CI): 1.7, 100) and lupus (OR = 4.2, 95% CI: 1.2, 15). Two specific NHL subtypes were strongly associated with Sjögren's syndrome: salivary gland (OR = 290, 95% CI: 33, 2600) and marginal zone (OR = 75, 95% CI: 9.1, 610). NHL was less convincingly associated with receipt of an organ transplant (OR = 2.0, 95% CI: 0.4, 11). Other autoimmune conditions were too rare to evaluate or not associated with NHL. Corticosteroid use was unrelated to NHL (OR = 1.0, 95% CI: 0.8, 1.2), but methotrexate use was marginally associated (OR = 2.3, 95% CI: 0.7, 7.5). Family history of dermatomyositis was associated with NHL (7 cases vs. 0 controls, OR = infinite; two-sided p = 0.02), but dermatomyositis was absent in cases themselves. Family history of remaining conditions was unrelated to NHL. Results suggest that disordered immunity in some immune-related conditions can lead to NHL.
Engels
Eric A
EA
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, Rockville, MD 20852, USA. engelse@exchange.nih.gov
Cerhan
James R
JR
Linet
Martha S
MS
Cozen
Wendy
W
Colt
Joanne S
JS
Davis
Scott
S
Gridley
Gloria
G
Severson
Richard K
RK
Hartge
Patricia
P
D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications* / Q000453:epidemiology; D016022:Case-Control Studies; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology*; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects; D012307:Risk Factors; D018426:SEER Program; D012859:Sjogren's Syndrome / Q000150:complications / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D007166:Immunosuppressive Agents