Anthropometric Characteristics, Physical Activity, and Risk of Non-Hodgkin’s Lymphoma Subtypes and B-Cell Chronic Lymphocytic Leukemia: A Prospective Study

Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
American Journal of Epidemiology (Impact Factor: 5.23). 10/2002; 156(6):527-35. DOI: 10.1093/aje/kwf082
Source: PubMed


Anthropometric characteristics, physical activity, and risk of non-Hodgkin's lymphoma, its subtypes, and B-cell chronic lymphocytic leukemia (B-CLL) were evaluated in a prospective cohort study of 37,931 Iowa women who were aged 55-69 years at baseline in 1986. Through 1998, 261 cases of non-Hodgkin's lymphoma (137 diffuse, 58 follicular, and 32 small lymphocytic lymphomas) and 63 cases of B-CLL were identified by linkage to the Iowa Cancer Registry. Height, weight, body mass index, waist/hip ratio, and physical activity were not associated with risk of non-Hodgkin's lymphoma overall or with diffuse or follicular lymphoma in particular. After adjustment for other non-Hodgkin's lymphoma risk factors, there was an inverse association of baseline body mass index (relative risks (RRs) across quartiles: 1, 0.4, 0.4, 0.3; p trend = 0.03) with risk of small lymphocytic lymphoma. In contrast, for B-CLL there were suggestive positive associations with body mass index at age 50 years (RRs across quartiles: 1, 1.9, 1.5, 2.7; p trend = 0.03) and (more weakly) baseline body mass index (RRs across quartiles: 1, 1.1, 1.6, 1.3; p trend = 0.3). In summary, we found no evidence that height, weight, body mass, or physical activity plays an important role in non-Hodgkin's lymphoma overall or in diffuse or follicular lymphoma in particular. The opposite associations of body mass index with small lymphocytic lymphoma versus B-CLL may be a chance finding but, if confirmed, would suggest different etiologies for these malignancies.

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Available from: Thomas Sellers, Jun 22, 2014
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    • "Using ICD-10, our results for NHL, myeloma and leukaemia are consistent with a report from this cohort after 9 years of follow-up, although the association was then marginally nonsignificant for multiple myeloma (Green et al, 2011). Perhaps reflecting lower statistical power, previous studies using comparable classifications reported no association for NHL (Cerhan et al, 2002), and only marginally significant association for leukaemia (Ross et al, 2004). "
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    ABSTRACT: Background: Greater adiposity and height have been associated with increased risk of haematological malignancies. Associations for disease subtypes are uncertain. Methods: A cohort of 1.3 million middle-aged UK women was recruited in 1996–2001 and followed for 10 years on average. Potential risk factors were assessed by questionnaire. Death, emigration, and incident cancer were ascertained by linkage to national registers. Adjusted relative risks were estimated by Cox regression. Results: During follow-up, 9162 participants were diagnosed with lymphatic or haematopoietic cancers. Each 10 kg m−2 increase in body mass index was associated with relative risk of 1.20 (95% confidence interval: 1.13–1.28) for lymphoid and 1.37 (1.22–1.53) for myeloid malignancy (P=0.06 for heterogeneity); similarly, Hodgkin lymphoma 1.64 (1.21–2.21), diffuse large B-cell lymphoma 1.36 (1.17–1.58), plasma cell neoplasms 1.21 (1.06–1.39), acute myeloid leukaemia 1.47 (1.19–1.81), and myeloproliferative/myelodysplastic syndromes 1.32 (1.15–1.52). Each 10 cm increase in height was associated with relative risk of 1.21 (1.16–1.27) for lymphoid and 1.11 (1.02–1.21) for myeloid malignancy (P=0.07 for heterogeneity); similarly, mature T-cell malignancies 1.36 (1.03–1.79), diffuse large B-cell lymphoma 1.28 (1.14–1.43), follicular lymphoma 1.28 (1.13–1.44), plasma cell neoplasms 1.12 (1.01–1.24), chronic lymphocytic leukaemia/small lymphocytic lymphoma 1.23 (1.08–1.40), and acute myeloid leukaemia 1.22 (1.04–1.42). There was no significant heterogeneity between subtypes. Conclusion: In middle-aged women, greater body mass index and height were associated with modestly increased risks of many subtypes of haematological malignancy.
    British Journal of Cancer 05/2013; 108(11). DOI:10.1038/bjc.2013.159 · 4.84 Impact Factor
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    • "Few studies have investigated body mass index and CLL risk separately from other leukaemias or lymphomas, and there is little evidence of a relationship (Ross et al, 2004; Chang et al, 2005). There is also very little information on the possible role of physical activity or diet and risk of CLL (Cerhan et al, 2002). "
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    ABSTRACT: This overview of the epidemiology of chronic lymphocytic leukaemia (CLL) summarizes the evolution of classification and coding systems and describes the intersection of pathogenesis and aetiology. The role of the putative precursor to CLL, monoclonal B-cell lymphocytosis (MBL), is considered, and ideas for future investigations of the MBL-CLL relationship are outlined. We discuss the epidemiology of CLL, focusing on descriptive patterns and methodological considerations. Postulated risk factors are reviewed including the role of ionizing and non-ionizing radiation, occupational and environmental chemical exposures, medical conditions and treatments, and lifestyle and genetic factors. We conclude by raising key questions that need to be addressed to advance our understanding of CLL aetiology. Recommendations for future epidemiological studies are given, including the standardization of reporting of CLL across cancer registries, the clarification of the natural history of MBL, and the circumvention of the methodological shortcomings of prior epidemiological investigations in relation to radiation, chemical exposures and infectious agents.
    British Journal of Haematology 01/2008; 139(5):672-86. DOI:10.1111/j.1365-2141.2007.06847.x · 4.71 Impact Factor
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    • "We also observed a strong positive association between BMI and NHL among women, but not men. Previous prospective studies of overweight and NHL have been inconsistent (Moller et al, 1994; Wolk et al, 2001; Cerhan et al, 2002; Calle et al, 2003; Samanic et al, 2004), though several case – control studies have reported an association between overweight and NHL in both sexes (Holly et al, 1999; Pan et al, 2004; Skibola et al, 2004). The incidence of NHL has increased in many parts of the world (Muller et al, 2005) and obesity might be a contributing factor. "
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    ABSTRACT: We investigated the relation of overweight and obesity with cancer in a population-based cohort of more than 145 000 Austrian adults over an average of 9.9 years. Incident cancers (n=6241) were identified through the state cancer registry. Using Cox proportional-hazards models adjusted for smoking and occupation, increases in relative body weight in men were associated with colon cancer (hazard rate (HR) ratio 2.48; 95% confidence interval (CI): 1.15, 5.39 for body mass index (BMI) > or =35 kg m(-2)) and pancreatic cancer (HR 2.34, 95% CI: 1.17, 4.66 for BMI>30 kg m(-2)) compared to participants with normal weight (BMI 18.5-24.9 kg m(-2)). In women, there was a weak positive association between increasing BMI and all cancers combined, and strong associations with non-Hodgkin's lymphomas (HR 2.86, 95% CI: 1.49, 5.49 for BMI> or =30 kg m(-2)) and cancers of the uterine corpus (HR 3.93, 95% CI: 2.35, 6.56 for BMI> or =35 kg m(-2)). Incidence of breast cancer was positively associated with high BMI only after age 65 years. These findings provide further evidence that overweight is associated with the incidence of several types of cancer.
    British Journal of Cancer 10/2005; 93(9):1062-7. DOI:10.1038/sj.bjc.6602819 · 4.84 Impact Factor
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