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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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Submitted August 25, 2006
Accepted October 23, 2006

Respiratory tract infections and subsequent risk of chronic lymphocytic leukemia

Ola Landgren*, Joshua S Rapkin, Neil E Caporaso, Lene Mellemkjaer, Gloria Gridley, Lynn R Goldin, and Eric A Engels

National Cancer Institute
Danish Cancer Society, Denmark

* Corresponding author; email: landgreo{at}mail.nih.gov.

Recent evidence suggests that chronic lymphocytic leukemia (CLL) might occur following a response to an infectious agent. We conducted a population-based study including 4,249 CLL patients diagnosed in Denmark 1977-1997 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 listing infections present ≥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 1-4.99 years prior to CLL diagnosis (OR=1.6;1.2-2.0). Individuals with 3+ 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<0.0001). None of nine other respiratory tract infections was significantly associated with CLL risk. Pneumonia might be a potential CLL trigger, or it could represent pre-malignant immune disruption preceding CLL.


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