Etiologic heterogeneity among non-Hodgkin lymphoma subtypes.
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.
Morton
Lindsay M
LM
Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Rockville, MD, USA. mortonli@mail.nih.gov
Wang
Sophia S
SS
Cozen
Wendy
W
Linet
Martha S
MS
Chatterjee
Nilanjan
N
Davis
Scott
S
Severson
Richard K
RK
Colt
Joanne S
JS
Vasef
Mohammad A
MA
Rothman
Nathaniel
N
Blair
Aaron
A
Bernstein
Leslie
L
Cross
Amanda J
AJ
De Roos
Anneclaire J
AJ
Engels
Eric A
EA
Hein
David W
DW
Hill
Deirdre A
DA
Kelemen
Linda E
LE
Lim
Unhee
U
Lynch
Charles F
CF
Schenk
Maryjean
M
Wacholder
Sholom
S
Ward
Mary H
MH
Hoar Zahm
Shelia
S
Chanock
Stephen J
SJ
Cerhan
James R
JR
Hartge
Patricia
P
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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