Medical history, lifestyle, family history, and occupational risk factors for chronic lymphocytic leukemia/small lymphocytic lymphoma: The InterLymph non-Hodgkin lymphoma subtypes project

Susan L. Slager, Yolanda Benavente, Aaron Blair, Roel Vermeulen, James R. Cerhan, Adele Seniori Costantini, Alain Monnereau, Alexandra Nieters, Jacqueline Clavel, Timothy G. Call, Marc Maynadié, Qing Lan, Christina A. Clarke, Tracy Lightfoot, Aaron D. Norman, Joshua N. Sampson, Delphine Casabonne, Pierluigi Cocco, Silvia de Sanjosé

Research output: Contribution to journalArticlepeer-review

66 Scopus citations

Abstract

Background: Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are two subtypes of non-Hodgkin lymphoma. A number of studies have evaluated associations between risk factors and CLL/SLL risk. However, these associations remain inconsistent or lacked confirmation. This may be due, in part, to the inadequate sample size of CLL/SLL cases. Methods: We performed a pooled analysis of 2440 CLL/SLL cases and 15 186 controls from 13 case-control studies from Europe, North America, and Australia. We evaluated associations of medical history, family history, lifestyle, and occupational risk factors with CLL/SLL risk. Multivariate logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: We confirmed prior inverse associations with any atopic condition and recreational sun exposure. We also confirmed prior elevated associations with usual adult height, hepatitis C virus seropositivity, living or working on a farm, and family history of any hematological malignancy. Novel associations were identified with hairdresser occupation (OR = 1.77, 95% CI = 1.05 to 2.98) and blood transfusion history (OR = 0.79, 95% CI = 0.66 to 0.94). We also found smoking to have modest protective effect (OR = 0.9, 95% CI = 0.81 to 0.99). All exposures showed evidence of independent effects. Conclusions: We have identified or confirmed several independent risk factors for CLL/SLL supporting a role for genetics (through family history), immune function (through allergy and sun), infection (through hepatitis C virus), and height, and other pathways of immune response. Given that CLL/SLL has more than 30 susceptibility loci identified to date, studies evaluating the interaction among genetic and nongenetic factors are warranted.

Original languageEnglish (US)
Pages (from-to)41-51
Number of pages11
JournalJournal of the National Cancer Institute - Monographs
Issue number48
DOIs
StatePublished - Aug 2014

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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