Alain Monnereau1, Susan L Slager2, Ann Maree Hughes2, Alex Smith2, Bengt Glimelius2, Thomas M Habermann2, Sonja I Berndt2, Anthony Staines2, Aaron D Norman2, James R Cerhan2, Joshua N Sampson2, Lindsay M Morton2, Jacqueline Clavel2. 1. 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. 2. 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).
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. Published by Oxford University Press 2014.
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. Published by Oxford University Press 2014.
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