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Blood, 15 April 2008, Vol. 111, No. 8, pp. 4029-4038. Prepublished online as a Blood First Edition Paper on February 8, 2008; DOI 10.1182/blood-2007-10-119974.
CLINICAL TRIALS AND OBSERVATIONS Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the InterLymph Consortium1 Department of Medicine, Clinical Epidemiology Unit, Karolinska University Hospital, Stockholm, Sweden; 2 National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia; 3 Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD; 4 Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine, University of California–Los Angeles, Los Angeles, CA; 5 Department of Anatomical Pathology, St Vincent's Hospital, Sydney, Australia; 6 Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; 7 Environmental Epidemiology, Imperial College London, London, United Kingdom; 8 Epidemiology Unit, Center for Study and Prevention of Cancer, Istituto Scientifico Regione Toscana, Florence, Italy; 9 Department of Epidemiology and Biostatistics, University of California–San Francisco, San Francisco, CA; 10 Epidemiology & Genetics Unit, University of York, York, United Kingdom; 11 Cancer Control Research Program, BC Cancer Agency, Vancouver, BC; 12 Istituto di Ricerche Farmacologiche "Mario Negri" and Istituto di Statistica Medica e Biometria, Università degli Studi di Milano, Milan, Italy; 13 Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT; 14 Division of Clinical Epidemiology, German Cancer Research Centre, Heidelberg, Germany; 15 Epidemiologia i Registre del Càncer, Institut Català d'Oncologia, Barcelona, Spain; 16 Department of Preventive Medicine, Northwestern University Medical School, Chicago, IL; 17 Epidemiology and Biostatistics Unit, Aviano Cancer Centre, Aviano, Italy; 18 Department of Public Health, Occupational Health Section, University of Cagliari, Cagliari, Italy; 19 Registry of Hematological Malignancies of Cote d'Or, Dijon, France; 20 Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic; 21 School of Nursing, Dublin City University, Dublin, Ireland; 22 International Agency for Research on Cancer, Lyon, France; 23 Fred Hutchinson Cancer Research Center & School of Public Health and Community Medicine, University of Washington, Seattle, WA; 24 Department of Family Medicine and Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI; 25 Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN; 26 Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California–Los Angeles, Los Angeles, CA; 27 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and 28 Keck School of Medicine, Department of Preventive Medicine, University of Southern California, Los Angeles, CA Some autoimmune disorders are increasingly recognized as risk factors for non-Hodgkin lymphoma (NHL) overall, but large-scale systematic assessments of risk of NHL subtypes are lacking. We performed a pooled analysis of self-reported autoimmune conditions and risk of NHL and subtypes, including 29 423 participants in 12 case-control studies. We computed pooled odds ratios (OR) and 95% confidence intervals (CI) in a joint fixed-effects model. Sjögren syndrome was associated with a 6.5-fold increased risk of NHL, a 1000-fold increased risk of parotid gland marginal zone lymphoma (OR = 996; 95% CI, 216-4596), and with diffuse large B-cell and follicular lymphomas. Systemic lupus erythematosus was associated with a 2.7-fold increased risk of NHL and with diffuse large B-cell and marginal zone lymphomas. Hemolytic anemia was associated with diffuse large B-cell NHL. T-cell NHL risk was increased for patients with celiac disease and psoriasis. Results for rheumatoid arthritis were heterogeneous between studies. Inflammatory bowel disorders, type 1 diabetes, sarcoidosis, pernicious anemia, and multiple sclerosis were not associated with risk of NHL or subtypes. Thus, specific autoimmune disorders are associated with NHL risk beyond the development of rare NHL subtypes in affected organs. The pattern of associations with NHL subtypes may harbor clues to lymphomagenesis.
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