title: Medical history, lifestyle, and occupational risk factors for hairy cell leukemia: the InterLymph Non-Hodgkin Lymphoma Subtypes Project.
abstract: BACKGROUND
  Little is known about the etiology of hairy cell leukemia (HCL), a rare B-cell lymphoproliferative disorder with marked male predominance. Our aim was to identify key risk factors for HCL.
  
  
  METHODS
  A pooled analysis of individual-level data for 154 histologically confirmed HCL cases and 8834 controls from five case-control studies, conducted in Europe and Australia, was undertaken. Age-, race and/or ethnicity-, sex-, and study-adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression.
  
  
  RESULTS
  The usual patterns for age and sex in HCL were observed, with a median age of 55 years and sex ratio of 3.7 males to females. Cigarette smoking was inversely associated with HCL (OR = 0.51, 95% CI = 0.37 to 0.71) with dose-response relationships observed for duration, frequency, and lifetime cigarette smoking (P(trend) < .001). In contrast, occupation as a farmer was positively associated with HCL (OR = 2.34, 95% CI = 1.36 to 4.01), with a dose-response relationship observed for duration (OR = 1.82, 95% CI = 0.85 to 3.88 for ≤ 10 years vs never; and OR = 2.98, 95% CI = 1.50 to 5.93 for >10 years vs never; P(trend) = .025). Adult height was also positively associated with HCL (OR = 2.69, 95% CI = 1.39 to 5.29 for upper vs lower quartile of height). The observed associations remained consistent in multivariate analysis.
  
  
  CONCLUSIONS
  Our observations of an increased risk of HCL from farming exposures and decreased risk from smoking exposures, independent of one another, support a multifactorial origin and an etiological specificity of HCL compared with other non-Hodgkin lymphoma subtypes. The positive association with height is a novel finding that needs replication.
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt). A.Monnereau@bordeaux.unicancer.fr.
authors.forename: Alain
authors.initials: A
authors.lastname: Monnereau
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Susan L
authors.initials: SL
authors.lastname: Slager
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Ann Maree
authors.initials: AM
authors.lastname: Hughes
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Alex
authors.initials: A
authors.lastname: Smith
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Bengt
authors.initials: B
authors.lastname: Glimelius
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Habermann
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Sonja I
authors.initials: SI
authors.lastname: Berndt
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Anthony
authors.initials: A
authors.lastname: Staines
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Aaron D
authors.initials: AD
authors.lastname: Norman
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: James R
authors.initials: JR
authors.lastname: Cerhan
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Joshua N
authors.initials: JN
authors.lastname: Sampson
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Morton
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), Environmental Epidemiology of Cancer Group and Univ Paris Sud, Villejuif, France (AM, JC); Registry of Hematological Malignancies in Gironde, Bergonié Institute, Bordeaux, France (AM); Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN (SLS, TMH, ADN, JRC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK (ASm); Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden (BG); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (SIB, JNS, LMM); School of Nursing and Human Sciences, Dublin City University, Dublin, Leinster, Ireland (ASt).
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Clavel
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; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000453:epidemiology* / Q000209:etiology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology / Q000208:ethnology; D016273:Occupational Exposure; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult