title: Medical history, lifestyle, family history, and occupational risk factors for mantle cell lymphoma: the InterLymph Non-Hodgkin Lymphoma Subtypes Project.
abstract: BACKGROUND
  The etiology of mantle cell lymphoma (MCL), a distinctive subtype accounting for 2%-10% of all non-Hodgkin lymphoma, is not known.
  
  
  METHODS
  We investigated associations with self-reported medical history, lifestyle, family history, and occupational risk factors in a pooled analysis of 557 patients with MCL and 13766 controls from 13 case-control studies in Europe, North America, and Australia. Odds ratios (ORs) and 95% confidence intervals (CIs) associated with each exposure were examined using multivariate logistic regression models.
  
  
  RESULTS
  The median age of the MCL patients was 62 years and 76% were men. Risk of MCL was inversely associated with history of hay fever (OR = 0.63, 95% CI = 0.48 to 0.82), and the association was independent of other atopic diseases and allergies. A hematological malignancy among first-degree relatives was associated with a twofold increased risk of MCL (OR = 1.99, 95% CI = 1.39 to 2.84), which was stronger in men (OR = 2.21, 95% CI = 1.44 to 3.38) than women (OR = 1.61, 95% CI = 0.82 to 3.19). A modestly increased risk of MCL was also observed in association with ever having lived on a farm (OR = 1.40, 95% CI = 1.03 to 1.90). Unlike some other non-Hodgkin lymphoma subtypes, MCL risk was not statistically significantly associated with autoimmune disorders, tobacco smoking, alcohol intake, body mass index, or ultraviolet radiation.
  
  
  CONCLUSIONS
  The novel observations of a possible role for atopy and allergy and farm life in risk of MCL, together with confirmatory evidence of a familial link, suggest a multifactorial etiology of immune-related environmental exposures and genetic susceptibility. These findings provide guidance for future research in MCL etiology.
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW). karin.ekstrom.smedby@ki.se.
authors.forename: Karin E
authors.initials: KE
authors.lastname: Smedby
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Joshua N
authors.initials: JN
authors.lastname: Sampson
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Turner
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Susan L
authors.initials: SL
authors.lastname: Slager
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Marc
authors.initials: M
authors.lastname: Maynadié
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Eve
authors.initials: E
authors.lastname: Roman
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Habermann
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Flowers
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Sonja I
authors.initials: SI
authors.lastname: Berndt
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Paige M
authors.initials: PM
authors.lastname: Bracci
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Henrik
authors.initials: H
authors.lastname: Hjalgrim
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Dennis D
authors.initials: DD
authors.lastname: Weisenburger
authors.affiliation: Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Morton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology / Q000208:ethnology; D016022:Case-Control Studies; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D049690:History, Ancient; D006801:Humans; D008019:Life Style; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D009367:Neoplasm Staging; D009656:North America / Q000453:epidemiology / Q000208:ethnology; D016273:Occupational Exposure; D012307:Risk Factors; D055815:Young Adult