Article

Pediatric, elderly, and emerging adult-onset peaks in Burkitt's lymphoma incidence diagnosed in four continents, excluding Africa.

Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health/DHHS, Rockville, MD 20892, USA.
American Journal of Hematology (Impact Factor: 4). 03/2012; 87(6):573-8. DOI: 10.1002/ajh.23187
Source: PubMed

ABSTRACT Burkitt's lymphoma (BL) in the general population and immunosuppressed persons with AIDS in the United States was characterized by three age-specific incidence peaks near 10, 40, and 70 years. We hypothesized that BL from different geographical areas may exhibit pediatric, adult, and elderly age incidence peaks. We investigated this hypothesis using data on 3,403 cases obtained from the International Agency for Research on Cancer (1963-2002). Data from Africa were sparse or incomplete, and thus were excluded. Age-standardized rates (ASRs) and age-specific incidence rates were calculated, supplemented with the calculations performed using age-period-cohort (APC) models. The ASR rose 5.3% (95% confidence interval [CI], 5.0-5.6) per year in males and 4.6% (95% CI, 4.5-4.8) in females. The ASR increased gradually in children, steeply in adults and most rapidly in the elderly both in males and in females. Overall, BL male/female ASR ratio was 2.5, but it declined from 3.1 (95% CI, 3.0-3.3) for pediatric BL to 2.3 (95% CI, 2.2-2.4) for adult BL and 1.5 (95% CI, 1.4-1.6) for elderly BL. Age-specific incidence peaks occurred near 10 and 70 years in all regions and periods. A peak near 40 years of age emerged in the mid-1990s, particularly in men. Findings using APC models confirmed those based on the standard analyses. Our findings, based on the international BL cases, support our hypothesis that BL is multimodal and that BL peaks at different ages may be clues to differences in the etiology and/or biology of BL at those ages.

0 Bookmarks
 · 
138 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Non-Hodgkin lymphoma (NHL) is amongst the most frequent cancer subtypes in children and in adults. However, there are major differences in the distribution of NHL subtypes between the pediatric and adult patient populations. At least for diffuse large B-cell lymphoma (DLBCL) recent data indicate that patient age at diagnosis correlates with molecular features of the lymphoma. Concerning treatment, in common pediatric protocols the same therapy is used for DLBCL and Burkitt lymphoma/leukemia (BL/B-AL). In adult patients, there is an established gold standard treatment for DLBCL, while the optimal treatment of BL/B-AL is under evaluation. Importantly, the correct diagnosis of the NHL subtype plays a crucial role in the treatment decision in adults with aggressive B-cell lymphoma. Adolescent and young adult patients are caught between the two age groups of children on the one hand and adults on the other. Whether the lymphoma biology and subtypes found in this age group resemble rather their pediatric or their adult counterparts is not yet answered. Also, systematic data on the optimal treatment for adolescents with lymphoma are lacking. Therefore, this article reviews current data on patient characteristics, biology, treatment and outcome, mainly in pediatric patients. These data are compared to those published for adult patients with B-cell NHL aiming to look for hints on optimal classification and treatment in adolescents and young adults with B-NHL.
    Current Hematologic Malignancy Reports 06/2013;
  • American Journal of Hematology 05/2013; · 4.00 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: There are limited data characterizing the subtype-specific incidence of lymphoid neoplasms in the WHO Classification era. Data were obtained on all incident lymphoid neoplasms registered in Australia during 1982-2006. Subtypes were grouped using the InterLymph nested hierarchical classification, based on the 2008 WHO Classification. Temporal trends were examined using joinpoint regression; average annual percent change in incidence was computed. Multiple Poisson regression was used to compare incidence by sex and age. The incidence of all non-Hodgkin lymphoma (NHL) increased by 2.5%/year during 1982-1996 and was stable thereafter. During 1997-2006 several mature B- and NK-/T-cell NHL subtypes increased in incidence, including diffuse large B-cell (1.3%/year), follicular (2.5%/year), Burkitt (6.8%/year), marginal zone (13.2%/year), mantle cell (4.2%/year), peripheral T-cell lymphoma (4.7%/year), and plasmacytoma (7.1%/year). Whilst chronic lymphocytic leukemia incidence was stable, small lymphocytic lymphoma incidence declined (8.1%/year). Hodgkin lymphoma (HL) incidence increased during 1997-2006 (2.2%/year), both classical (4.3%/year) and nodular lymphocyte predominant (12.1%/year) HL. Diagnostic artifact, evidenced by a sustained decline in the incidence of NHL not otherwise specified (NOS; 5.8%/year) and lymphoid neoplasms NOS (5.6%/year), limits the interpretation of temporal trends for some subtypes. A marked male predominance was observed for almost all subtypes. Incidence of mature B- and NK-/T-cell NHL subtypes increased sharply with age, except for Burkitt lymphoma/leukemia. For HL subtypes, a bimodal age distribution was only evident for nodular sclerosis HL. Variation in incidence patterns over time and by sex and age supports etiological differences between lymphoid neoplasm subtypes. © 2014 Wiley Periodicals, Inc.
    International Journal of Cancer 03/2014; · 6.20 Impact Factor

Full-text (2 Sources)

Download
57 Downloads
Available from
May 27, 2014