Glen J Titmarsh1, Mary Frances McMullin2, Charlene M McShane1, Mike Clarke1, Eric A Engels3, Lesley A Anderson4. 1. Centre for Public Health, Institute of Clinical Sciences, Block B, Queens University Belfast, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, United Kingdom. 2. Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Northern Ireland, United Kingdom. 3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Shady Grove, Room 6E226, Bethesda, MD, USA. 4. Centre for Public Health, Institute of Clinical Sciences, Block B, Queens University Belfast, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, United Kingdom. Electronic address: l.anderson@qub.ac.uk.
Abstract
INTRODUCTION: Antigenic stimulation is a proposed aetiologic mechanism for many haematological malignancies. Limited evidence suggests that community-acquired infections may increase the risk of acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS). However, associations with other myeloid malignancies including chronic myeloid leukaemia (CML) and myeloproliferative neoplasms (MPNs) are unknown. MATERIALS AND METHODS: Using the Surveillance, Epidemiology and End Result (SEER)-Medicare database, fourteen community-acquired infections were compared between myeloid malignancy patients [AML (n=8489), CML (n=3626) diagnosed 1992-2005; MDS (n=3072) and MPNs (n=2001) diagnosed 2001-2005; and controls (200,000 for AML/CML and 97,681 for MDS/MPN]. Odds ratios (ORs) and 95% confidence intervals were adjusted for gender, age and year of selection excluding infections diagnosed in the 13-month period prior to selection to reduce reverse causality. RESULTS: Risk of AML and MDS respectively, were significantly associated with respiratory tract infections, bronchitis (ORs 1.20 [95% CI: 1.14-1.26], 1.25 [95% CI: 1.16-1.36]), influenza (ORs 1.16 [95% CI: 1.07-1.25], 1.29 [95% CI: 1.16-1.44]), pharyngitis (ORs 1.13 [95% CI: 1.06-1.21], 1.22 [95% CI: 1.11-1.35]), pneumonia (ORs 1.28 [95% CI: 1.21-1.36], 1.52 [95% CI: 1.40-1.66]), sinusitis (ORs 1.23 [95% CI: 1.16-1.30], 1.25 [95% CI: 1.15-1.36]) as was cystitis (ORs 1.13 [95% CI: 1.07-1.18], 1.26 [95% CI: 1.17-1.36]). Cellulitis (OR 1.51 [95% CI: 1.39-1.64]), herpes zoster (OR 1.31 [95% CI: 1.14-1.50]) and gastroenteritis (OR 1.38 [95% CI: 1.17-1.64]) were more common in MDS patients than controls. For CML, associations were limited to bronchitis (OR 1.21 [95% CI: 1.12-1.31]), pneumonia (OR 1.49 [95% CI: 1.37-1.62]), sinusitis (OR 1.19 [95% CI: 1.09-1.29]) and cellulitis (OR 1.43 [95% CI: 1.32-1.55]) following Bonferroni correction. Only cellulitis (OR 1.34 [95% CI: 1.21-1.49]) remained significant in MPN patients. Many infections remained elevated when more than 6 years of preceding claims data were excluded. DISCUSSION: Common community-acquired infections may be important in the malignant transformation of the myeloid lineage. Differences in the aetiology of classic MPNs and other myeloid malignancies require further exploration.
INTRODUCTION: Antigenic stimulation is a proposed aetiologic mechanism for many haematological malignancies. Limited evidence suggests that community-acquired infections may increase the risk of acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS). However, associations with other myeloid malignancies including chronic myeloid leukaemia (CML) and myeloproliferative neoplasms (MPNs) are unknown. MATERIALS AND METHODS: Using the Surveillance, Epidemiology and End Result (SEER)-Medicare database, fourteen community-acquired infections were compared between myeloid malignancy patients [AML (n=8489), CML (n=3626) diagnosed 1992-2005; MDS (n=3072) and MPNs (n=2001) diagnosed 2001-2005; and controls (200,000 for AML/CML and 97,681 for MDS/MPN]. Odds ratios (ORs) and 95% confidence intervals were adjusted for gender, age and year of selection excluding infections diagnosed in the 13-month period prior to selection to reduce reverse causality. RESULTS: Risk of AML and MDS respectively, were significantly associated with respiratory tract infections, bronchitis (ORs 1.20 [95% CI: 1.14-1.26], 1.25 [95% CI: 1.16-1.36]), influenza (ORs 1.16 [95% CI: 1.07-1.25], 1.29 [95% CI: 1.16-1.44]), pharyngitis (ORs 1.13 [95% CI: 1.06-1.21], 1.22 [95% CI: 1.11-1.35]), pneumonia (ORs 1.28 [95% CI: 1.21-1.36], 1.52 [95% CI: 1.40-1.66]), sinusitis (ORs 1.23 [95% CI: 1.16-1.30], 1.25 [95% CI: 1.15-1.36]) as was cystitis (ORs 1.13 [95% CI: 1.07-1.18], 1.26 [95% CI: 1.17-1.36]). Cellulitis (OR 1.51 [95% CI: 1.39-1.64]), herpes zoster (OR 1.31 [95% CI: 1.14-1.50]) and gastroenteritis (OR 1.38 [95% CI: 1.17-1.64]) were more common in MDS patients than controls. For CML, associations were limited to bronchitis (OR 1.21 [95% CI: 1.12-1.31]), pneumonia (OR 1.49 [95% CI: 1.37-1.62]), sinusitis (OR 1.19 [95% CI: 1.09-1.29]) and cellulitis (OR 1.43 [95% CI: 1.32-1.55]) following Bonferroni correction. Only cellulitis (OR 1.34 [95% CI: 1.21-1.49]) remained significant in MPN patients. Many infections remained elevated when more than 6 years of preceding claims data were excluded. DISCUSSION: Common community-acquired infections may be important in the malignant transformation of the myeloid lineage. Differences in the aetiology of classic MPNs and other myeloid malignancies require further exploration.
Authors: Benjamin M Craig; Dana E Rollison; Alan F List; Christopher R Cogle Journal: Cancer Epidemiol Biomarkers Prev Date: 2012-01-11 Impact factor: 4.254
Authors: Sigurdur Y Kristinsson; Magnus Björkholm; Malin Hultcrantz; Åsa R Derolf; Ola Landgren; Lynn R Goldin Journal: J Clin Oncol Date: 2011-06-20 Impact factor: 44.544
Authors: Lukas F Mager; Carsten Riether; Christian M Schürch; Yara Banz; Marie-Hélène Wasmer; Regula Stuber; Alexandre P Theocharides; Xiaohong Li; Yu Xia; Hirohisa Saito; Susumu Nakae; Gabriela M Baerlocher; Markus G Manz; Kathy D McCoy; Andrew J Macpherson; Adrian F Ochsenbein; Bruce Beutler; Philippe Krebs Journal: J Clin Invest Date: 2015-05-26 Impact factor: 14.808
Authors: I Gañán-Gómez; Y Wei; D T Starczynowski; S Colla; H Yang; M Cabrero-Calvo; Z S Bohannan; A Verma; U Steidl; G Garcia-Manero Journal: Leukemia Date: 2015-03-12 Impact factor: 11.528
Authors: C J K Lam; R E Curtis; G M Dores; E A Engels; N E Caporaso; A Polliack; J L Warren; H A Young; P H Levine; A F Elmi; J F Fraumeni; M A Tucker; L M Morton Journal: Leukemia Date: 2015-09-15 Impact factor: 11.528
Authors: Morten Andersen; Zamra Sajid; Rasmus K Pedersen; Johanne Gudmand-Hoeyer; Christina Ellervik; Vibe Skov; Lasse Kjær; Niels Pallisgaard; Torben A Kruse; Mads Thomassen; Jesper Troelsen; Hans Carl Hasselbalch; Johnny T Ottesen Journal: PLoS One Date: 2017-08-31 Impact factor: 3.240