title: Etiologic heterogeneity among non-Hodgkin lymphoma subtypes.
abstract: Understanding patterns of etiologic commonality and heterogeneity for non-Hodgkin lymphomas may illuminate lymphomagenesis. We present the first systematic comparison of risks by lymphoma subtype for a broad range of putative risk factors in a population-based case-control study, including diffuse large B-cell (DLBCL; N = 416), follicular (N = 318), and marginal zone lymphomas (N = 106), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; N = 133). We required at least 2 of 3 analyses to support differences in risk: (1) polytomous logistic regression, (2) homogeneity tests, or (3) dichotomous logistic regression, analyzing all 7 possible pairwise comparisons among the subtypes, corresponding to various groupings by clinical behavior, genetic features, and differentiation. Late birth order and high body mass index (>/= 35) kg/m(2)) increased risk for DLBCL alone. Autoimmune conditions increased risk for marginal zone lymphoma alone. The tumor necrosis factor G-308A polymorphism (rs1800629) increased risks for both DLBCL and marginal zone lymphoma. Exposure to certain dietary heterocyclic amines from meat consumption increased risk for CLL/SLL alone. We observed no significant risk factors for follicular lymphoma alone. These data clearly support both etiologic commonality and heterogeneity for lymphoma subtypes, suggesting that immune dysfunction is of greater etiologic importance for DLBCL and marginal zone lymphoma than for CLL/SLL and follicular lymphoma.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Rockville, MD, USA. mortonli@mail.nih.gov
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Morton
authors.forename: Sophia S
authors.initials: SS
authors.lastname: Wang
authors.forename: Wendy
authors.initials: W
authors.lastname: Cozen
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.forename: Nilanjan
authors.initials: N
authors.lastname: Chatterjee
authors.forename: Scott
authors.initials: S
authors.lastname: Davis
authors.forename: Richard K
authors.initials: RK
authors.lastname: Severson
authors.forename: Joanne S
authors.initials: JS
authors.lastname: Colt
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Vasef
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Rothman
authors.forename: Aaron
authors.initials: A
authors.lastname: Blair
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Cross
authors.forename: Anneclaire J
authors.initials: AJ
authors.lastname: De Roos
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
authors.forename: David W
authors.initials: DW
authors.lastname: Hein
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Hill
authors.forename: Linda E
authors.initials: LE
authors.lastname: Kelemen
authors.forename: Unhee
authors.initials: U
authors.lastname: Lim
authors.forename: Charles F
authors.initials: CF
authors.lastname: Lynch
authors.forename: Maryjean
authors.initials: M
authors.lastname: Schenk
authors.forename: Sholom
authors.initials: S
authors.lastname: Wacholder
authors.forename: Mary H
authors.initials: MH
authors.lastname: Ward
authors.forename: Shelia
authors.initials: S
authors.lastname: Hoar Zahm
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Chanock
authors.forename: James R
authors.initials: JR
authors.lastname: Cerhan
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
mesh_terms: D000328:Adult; D000368:Aged; D015551:Autoimmunity; D001722:Birth Order; D015992:Body Mass Index; D016022:Case-Control Studies; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell; D016015:Logistic Models; D018442:Lymphoma, B-Cell, Marginal Zone; D008224:Lymphoma, Follicular; D016403:Lymphoma, Large B-Cell, Diffuse; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D008460:Meat / Q000009:adverse effects; D008875:Middle Aged; D011110:Polymorphism, Genetic; D012307:Risk Factors; D055815:Young Adult
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