Ethnic variation in medical and lifestyle risk factors for B cell non-Hodgkin lymphoma: A case-control study among Israelis and Palestinians

Kleinstern, Geffen; Seir, Rania Abu; Perlman, Riki; Khatib, Areej; Abdeen, Ziad; Elyan, Husein; Nirel, Ronit; Amir, Gail; Ramlawi, Asad; Sabatin, Fouad; Boffetta, Paolo; Dann, Eldad J.; Kedmi, Meirav; Ellis, Martin; Nagler, Arnon; Yehuda, Dina Ben; Paltiel, Ora

doi:10.1371/journal.pone.0171709

Cited by 14 publications

(15 citation statements)

References 28 publications

(45 reference statements)

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“…The most common B‐NHL subtype was DLBCL (41.8%) followed by FL (26.7%) and MZL (14.9%). During the study period, 90% of eligible B‐NHL cases were recruited . Demographic characteristics are shown in Table .…”

Section: Resultssupporting

confidence: 85%

“…We performed a hospital-based case-control study among B-NHL adult (>18 y) patients diagnosed between 2009 and 2014 and healthy age-and-sex frequency-matched controls who accompanied patients to the hospital. 15 Participants answered interviewer-administered were most common in both DLBCL and MZL with 7.7%, followed by FL with 6.0% (Table 2); however, no significant association was found between AIDs mediated by T-cell activation and B-NHL or subtypes.…”

Section: Methodsmentioning

confidence: 98%

“…We performed a hospital‐based case‐control study among B‐NHL adult (>18 y) patients diagnosed between 2009 and 2014 and healthy age‐and‐sex frequency‐matched controls who accompanied patients to the hospital . Participants answered interviewer‐administered questionnaires (see detailed methods) including a history of AIDs and medications. Autoimmune disease status was confirmed using medication history (for both cases and controls) and review of medical records where possible including the presence of specific autoantibodies.…”

Section: Methodsmentioning

confidence: 99%

“…Demographic characteristics for controls and cases with overall B-NHL and subtypes (see detailed methods15 ) including a history of AIDs and medications. Autoimmune disease status was confirmed using medication history (for both cases and controls) and review of medical records where possible including the presence of specific autoantibodies.…”

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confidence: 99%

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Presence of autoimmune disease affects not only risk but also survival in patients with B‐cell non‐Hodgkin lymphoma

Kleinstern

Averbuch

Seir

et al. 2018

Hematological Oncology

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Although autoimmune diseases (AIDs) are known to predispose to non-Hodgkin lymphoma (NHL), their association with NHL prognosis has rarely been investigated. We examined associations between autoimmunity and B-cell NHL onset by comparing AID history (determined by self-report and medication review and supplemented by chart review where possible) among 435 adult B-NHL patients in Hadassah-Hebrew University Medical Center, diagnosed 2009-2014, and 414 age-and-sex frequency-matched controls. We examined AIDs as a whole, B- and T-cell-mediated AIDs, and autoimmune thyroid diseases. Among cases, we used Kaplan-Meier and Cox regression models to assess the association of AID with overall survival and relapse-free survival, adjusting for prognostically important patient and disease characteristics such as Ki67% staining, International Prognostic Index, rituximab treatment, and histological subgroup. Autoimmune diseases were associated with B-NHL (odds ratio [OR] = 1.95; 95% confidence interval (CI), 1.31-2.92), especially AIDs mediated by B-cell activation (OR = 5.20; CI, 1.90-14.3), which were particularly associated with marginal zone lymphoma (OR = 19.3; CI, 4.59-80.9). We found that time to relapse for all B-NHL patients with AIDs was significantly shorter (mean of 49.21 mo [±3.22]) than among patients without AID (mean of 59.74 mo [±1.62]), adjusted hazard ratio [HR ] = 1.69 (CI, 1.03-2.79). Specifically, in patients with diffuse large B-cell lymphoma, of whom 91.8% had received rituximab, a history of B-cell-mediated AIDs was associated with shorter relapse-free survival and overall survival, HR = 8.34 (CI, 3.01-23.1) and HR = 3.83 (CI, 1.20-12.3), respectively. Beyond confirming the well-known association between AIDs and B-NHL, we found that AID is an adverse prognostic factor in B-cell lymphoma, associated with a shortened time to relapse, suggesting that there are specific therapeutic challenges in the subgroup of patients suffering from both these diseases. Further work is required to address mechanisms of resistance to standard treatment in the setting of AID-associated B-NHL. In the era of immunotherapy, these findings have particular relevance.

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Section: Resultssupporting

confidence: 85%

Section: Methodsmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Presence of autoimmune disease affects not only risk but also survival in patients with B‐cell non‐Hodgkin lymphoma

Kleinstern

Averbuch

Seir

et al. 2018

Hematological Oncology

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“…However, reducing fat intake has probably more effect on other diseases than on the incidence of DLBCL. Kleinstern et al [ 17 ] performed an interesting study on lifestyle risk factors for B-NHL. In a case-control study, they investigated self-reported medical and lifestyle exposures, for overall B-NHL and subtypes among Palestinian Arabs (PA) and Israeli Jews (IJ).…”

Section: Epidemiology Of Lymphomamentioning

confidence: 99%

New developments in the pathology of malignant lymphoma: a review of the literature published from January to April 2017

Krieken

2017

J Hematopathol

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Physical activity and the risk of non‐Hodgkin lymphoma subtypes: A pooled analysis

Boyle

Kleinstern

Bracci

et al. 2022

Intl Journal of Cancer

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Non‐Hodgkin lymphoma (NHL) is composed of a heterogeneous collection of subtypes with considerable differences in genetics, biology and aetiology. Studies to date on physical activity and NHL risk have not had sufficient sample size to evaluate whether associations differ by subtype. We pooled data from nine case‐control studies to examine the association between moderate‐to‐vigorous intensity physical activity (MVPA) and risk of NHL overall and by subtype (diffuse large B‐cell lymphoma, follicular lymphoma, chronic lymphocytic leukaemia/small lymphocytic lymphoma, marginal zone lymphoma and mature T‐cell lymphoma). A total of 5653 cases and 9115 controls were included in the pooled analysis. Physical activity was harmonised across nine studies and modelled as study‐specific tertiles. Multinomial logistic regression was used to estimate the association between physical activity and NHL, adjusting for confounders. The overall odds of NHL was 13% lower among participants in the most active tertile of MVPA compared to the least active tertile (adjusted odds ratio = 0.87, 95% CI = 0.80, 0.95). Similar decreases were observed across NHL subtypes. In summary, in this pooled analysis of case‐control studies, physical activity was associated with a modest risk reduction for each NHL subtype examined and with overall NHL.

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Ethnic variation in medical and lifestyle risk factors for B cell non-Hodgkin lymphoma: A case-control study among Israelis and Palestinians

Cited by 14 publications

References 28 publications

Presence of autoimmune disease affects not only risk but also survival in patients with B‐cell non‐Hodgkin lymphoma

Presence of autoimmune disease affects not only risk but also survival in patients with B‐cell non‐Hodgkin lymphoma

New developments in the pathology of malignant lymphoma: a review of the literature published from January to April 2017

Physical activity and the risk of non‐Hodgkin lymphoma subtypes: A pooled analysis

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