Blood transfusion as a risk factor for non-Hodgkin lymphoma

Abstract

Summary In a case-control study of 280 out of 426 consecutive patients with a recent diagnosis of nonHodgkin lymphoma (NHL) and 1827 control subjects, 53 (19%) and 230 (13%) respectively had received blood transfusions 1 year or more before the interview. Using an age-and sex-stratified analysis the odds ratio (OR) for transfusion was 1.74 (95% CI 1.24-2.44). ORs were also determined for transfusions received in the intervals 1 -5, 6 -15, 16-25 and > , Carli et al., 1994, Cartwright et al., 1994, National Board of Health and Welfare, 1995. The causes of this increase are unknown, and in an attempt to identify risk factors for NHL a case-control study has been initiated in the Southern Health Care Region of Sweden.According to cohort studies of cancer morbidity in blood recipients, transfusions may be a risk factor for NHL. In a Swedish study (Blomberg et al., 1993) an excess of NHL was observed in previously transfused subjects, the standardised morbidity ratio being 4.09 (95% CI 1.65-8.43). Cerhan et al. (1993) obtained information about past transfusions from women aged 55-69 years who were resident in Iowa and followed up for 5 years. For women who had ever received a blood transfusion the relative risk of NHL was 2.20 (95% CI 1.35-3.58). Memon and Doll (1994) identified nearly 13 000 infants who received blood transfusions shortly after birth in England, Wales and Scotland and recorded the incidence of subsequent malignant tumours. The incidence of NHL at 15-49 years of age was about twice that expected, but the excess was not statistically significant.Our ongoing case-control study offered an opportunity to further evaluate the relation between previous blood transfusions and the development of NHL. We report here on the association between transfusions and NHL. The relation between the time lapse since transfusion and the risk of lymphoma has also been studied. Subjects and methods

Association between red blood cell transfusions and development of non-Hodgkin lymphoma: a meta-analysis of observational studies

“…After a detailed evaluation of the 19 articles, 5 were rejected because they were duplicated or did not pertain to NHL incidence or the use of RBC transfusions. Finally, 9 case-control [5][6][7][8][9][10][11][12][13] and 5 cohort studies [14][15][16][17][18] were included in our analysis.…”

“…Six studies originated from the United States 7-10,12,13 and 3 studies from Europe. 5,6,11 A total of 5904 cases and 10 107 controls were included in this meta-analysis. There was a male predominance of 64% and 63% in cases and controls, respectively.…”

“…Most of the studies did not show a statistically significant association between RBC transfusions and NHL, with exception of one study. 6 Exposure to transfusion was assessed by medical records in 3 studies, 5,9,11 by interviews in 4 studies, 8,10,12,13 and by mailed questionnaires in 2 studies. 6,7 Five studies assessed the diagnosis of NHL from medical records 6,7,9,11,13 and 4 studies from an independent pathology review.…”

The non-Hodgkin lymphomas: A review of the epidemiologic literature

“…[659][660][661][662][663][664] In a casecontrol study of women in Connecticut, no association was found between transfusions and risk of NHL (OR 5 1.0, 95% CI: 0.7-1.3) or any of the NHL types examined, 664 nor was NHL risk associated with number of transfusions, latency or age at first transfusion. Brandt et al 665 reported a significant positive association with transfusions (OR 5 1.74, 95% CI: 1.24-2.44), although no trend was apparent based on time of transfusion prior to NHL diagnosis. The strongest associations were observed with risk of low-grade B-CLL or immunocytoma (OR 5 4.15, 95% CI: 1.92-9.01) or high-grade extranodal lymphoma (OR 5 3.27, 95% CI: 1.30-8.24).…”

Histopathology of retrieved allografts of the femoral head

“…31 Although there are no definitive explanations for this phenomenon, recent reports have shown that blood transfusion may be a risk factor for developing NHL. 32,33 Allogenic bone grafting may have the same potential risk.…”