Journal Article

Immune-Related Conditions and Immune-Modulating Medications as Risk Factors for Non-Hodgkin's Lymphoma: A Case-Control Study

Eric A. Engels, James R. Cerhan, Martha S. Linet, Wendy Cozen, Joanne S. Colt, Scott Davis, Gloria Gridley, Richard K. Severson and Patricia Hartge

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 162, issue 12, pages 1153-1161
Published in print December 2005 | ISSN: 0002-9262
Published online October 2005 | e-ISSN: 1476-6256 | DOI:
Immune-Related Conditions and Immune-Modulating Medications as Risk Factors for Non-Hodgkin's Lymphoma: A Case-Control Study

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In immunosuppressed or autoimmune disease states, disordered immune responses may lead to non-Hodgkin's lymphoma (NHL). In a US population-based case-control study of NHL (1998–2000), the authors collected personal histories of immune-related conditions and use of immune-modulating therapies as well as family histories of autoimmune conditions. The study included 1,321 NHL cases and 1,057 controls; only half received some questionnaire components. NHL was associated with Sjögren's syndrome (odds ratio (OR) = 13, 95% confidence interval (CI): 1.7, 100) and lupus (OR = 4.2, 95% CI: 1.2, 15). Two specific NHL subtypes were strongly associated with Sjögren's syndrome: salivary gland (OR = 290, 95% CI: 33, 2600) and marginal zone (OR = 75, 95% CI: 9.1, 610). NHL was less convincingly associated with receipt of an organ transplant (OR = 2.0, 95% CI: 0.4, 11). Other autoimmune conditions were too rare to evaluate or not associated with NHL. Corticosteroid use was unrelated to NHL (OR = 1.0, 95% CI: 0.8, 1.2), but methotrexate use was marginally associated (OR = 2.3, 95% CI: 0.7, 7.5). Family history of dermatomyositis was associated with NHL (7 cases vs. 0 controls, OR = infinite; two-sided p = 0.02), but dermatomyositis was absent in cases themselves. Family history of remaining conditions was unrelated to NHL. Results suggest that disordered immunity in some immune-related conditions can lead to NHL.

Keywords: autoimmune diseases; case-control studies; immunosuppression; lymphoma, non-Hodgkin; methotrexate; organ transplantation; risk factors; Sjogren's syndrome; CI, confidence interval; NHL, non-Hodgkin's lymphoma; OR, odds ratio; SEER, Surveillance, Epidemiology, and End Results; SLE, systemic lupus erythematosus

Journal Article.  5647 words. 

Subjects: Public Health and Epidemiology

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