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Medical history, lifestyle, family history, and occupational risk factors for chronic lymphocytic leukemia/small lymphocytic lymphoma: the InterLymph Non-Hodgkin Lymphoma Subtypes Project

Susan L Slager, Yolanda Benavente, Aaron Blair, Roel Vermeulen, James R Cerhan, Adele Seniori Costantini, Alain Monnereau, Alexandra Nieters, Jacqueline Clavel, Timothy G Call, Marc Maynadié, Qing Lan, Christina A Clarke, Tracy Lightfoot, Aaron D Norman, Joshua N Sampson, Delphine Casabonne, Pierluigi Cocco, Silvia de Sanjosé

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are two subtypes of non-Hodgkin lymphoma. A number of studies have evaluated associations between risk factors and CLL/SLL risk. However, these associations remain inconsistent or lacked confirmation. This may be due, in part, to the inadequate sample size of CLL/SLL cases.

METHODS: We performed a pooled analysis of 2440 CLL/SLL cases and 15186 controls from 13 case-control studies from Europe, North America, and Australia. We evaluated associations of medical history, family history, lifestyle, and occupational risk factors with CLL/SLL risk. Multivariate logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: We confirmed prior inverse associations with any atopic condition and recreational sun exposure. We also confirmed prior elevated associations with usual adult height, hepatitis C virus seropositivity, living or working on a farm, and family history of any hematological malignancy. Novel associations were identified with hairdresser occupation (OR = 1.77, 95% CI = 1.05 to 2.98) and blood transfusion history (OR = 0.79, 95% CI = 0.66 to 0.94). We also found smoking to have modest protective effect (OR = 0.9, 95% CI = 0.81 to 0.99). All exposures showed evidence of independent effects.

CONCLUSIONS: We have identified or confirmed several independent risk factors for CLL/SLL supporting a role for genetics (through family history), immune function (through allergy and sun), infection (through hepatitis C virus), and height, and other pathways of immune response. Given that CLL/SLL has more than 30 susceptibility loci identified to date, studies evaluating the interaction among genetic and nongenetic factors are warranted.

Original languageEnglish
Pages (from-to)41-51
Number of pages11
JournalJournal of the National Cancer Institute. Monographs
Volume2014
Issue number48
DOIs
Publication statusPublished - Aug 2014

Bibliographical note

Published by Oxford University Press 2014.

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