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 Blood, 1 March 2007, Vol. 109, No. 5, pp. 2198-2201.
Prepublished online as a Blood First Edition Paper on November 2, 2006; DOI 10.1182/blood-2006-08-044008.

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NEOPLASIA

Brief Report

Respiratory tract infections and subsequent risk of chronic lymphocytic leukemia

Ola Landgren1, Joshua S. Rapkin1, Neil E. Caporaso1, Lene Mellemkjaer2, Gloria Gridley1, Lynn R. Goldin1, and Eric A. Engels1

1 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD; 2 Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark

Recent evidence suggests that chronic lymphocytic leukemia (CLL) might occur following a response to an infectious agent. We conducted a population-based study including 4249 CLL patients diagnosed in Denmark from 1977 to 1997 and 15 690 frequency-matched controls to quantify risk of CLL following various airway infections. Through data linkage we gathered information on hospital inpatient/outpatient discharges that listed infections present at least 1 year prior to CLL. Using logistic regression, we calculated odds ratios (ORs) and 95% confidence intervals (CIs). Personal history of pneumonia was associated with significantly increased CLL risk (OR = 1.4; 1.2-1.8); risk was restricted to 1 to 4.99 years prior to CLL diagnosis (OR = 1.6; 1.2-2.0). Individuals with 3 or more prior pneumonia events had a significant 2.5-fold (1.1-5.6) elevated CLL risk, and risk increased with the number of pneumonia episodes (Ptrend < .001). None of 9 other respiratory-tract infections was significantly associated with CLL risk. Pneumonia might be a potential CLL trigger or it could represent premalignant immune disruption preceding CLL.


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