|Co-factors||Blood transfusion||AIDS symptoms||NHL|
|Blood transfusions and risk of non-Hodgkin's lymphoma subtypes and chronic lymphocytic leukemia.|| ||Cerhan JR, Wallace RB, Dick F, Kemp J, Parker AS, Zheng W, Sellers TA, Folsom AR.
| ||"Allogeneic blood transfusion has been suggested as a risk factor for non-Hodgkin's lymphoma (NHL), possibly specific to certain NHL subtypes... Self-reported transfusion history and risk of NHL subtypes and CLL were examined in a cohort of 37,934 older Iowa women, using data from a questionnaire mailed in 1986. Through 1997, 229 cases of NHL and 57 cases of CLL in the cohort were identified through linkage to the Iowa Surveillance, Epidemiology and End Results Cancer. Women who reported ever receiving a blood transfusion were at increased risk for all NHLs [age adjusted relative risk (RR), 1.6; 95% confidence interval (CI), 1.2-2.1). On the basis of the Working Formulation classification, blood transfusion was positively associated with low-grade NHL (RR, 2.7; 95% CI, 1.7-4.5) but not with intermediate-grade NHL (RR, 1.1; 95% CI, 0.7-1.6); there were only 8 cases of high-grade NHL. Blood transfusion was positively associated with follicular (RR, 2.8; 95% CI, 1.6-5.1) and small lymphocytic (RR, 3.4; 95% CI, 1.5-7.9) NHL subtypes but not with diffuse NHL (RR, 1.0; 95% CI, 0.7-1.5)... Finally, transfusion was associated with nodal (RR, 1.8; 95% CI, 1.3-2.5) but not extranodal (RR, 1.2; 95% CI, 0.7-2.1) NHL. Further adjustment for marital status, farm residence, diabetes, alcohol use, smoking, and red meat and fruit consumption did not alter these associations. In conclusion, prior blood transfusion was associated with NHL..., and the strongest associations were seen for low-grade NHL, particularly follicular and small lymphocytic NHL."|
| ||Cancer Epidemiol Biomarkers Prev. 2001 Apr;10(4):361-8.||2001|
|Blood transfusion as a risk factor for non-Hodgkin lymphoma.|| ||Brandt L, Brandt J, Olsson H, Anderson H, Moller T.
| ||In a case-control study of 280 out of 426 consecutive patients with a recent diagnosis of non-Hodgkin 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 > or = 26 years before diagnosis. In the interval 6-15 years, the OR for transfusion was 2.83 (95% CI 1.60-4.99) whereas ORs for transfusions received in other intervals were lower and not significantly elevated. Histological diagnoses (Kiel classification) and results of staging procedures were known for 185 patients. For low-grade NHL of nodal B-cell chronic lymphocytic leukaemia (B-CLL) or immunocytoma type, the OR for transfusions was 4.15 (95% CI 1.92-9.01). For low-grade nodal lymphomas of follicle centre cell type and high-grade nodal lymphomas, no relation to transfusions could be demonstrated. For high-grade extranodal lymphoma as sole manifestation, OR for transfusions was 3.27 (95% CI 1.30-8.24). It is concluded that blood transfusion may be a risk factor for NHLs especially those of B-CLL or immunocytoma type and for high-grade extranodal lymphoma.|
| ||Br J Cancer. 1996 May;73(9):1148-51.||1996|
|Transfusion history and cancer risk in older women.|| ||Cerhan JR, Wallace RB, Folsom AR, Potter JD, Munger RG, Prineas RJ.
| ||To test the hypothesis that history of blood transfusion is associated with an increased incidence of cancer in older women. Prospective cohort study. General community in the state of Iowa. Random sample of 37,337 cancer-free Iowa women ages 55 to 69 years. Transfusion history was assessed with a mailed questionnaire completed in January 1986. Cancer incidence in 5 years was ascertained by a population-based cancer registry. Women who had ever received a blood transfusion were at an increased risk for non-Hodgkin lymphoma (relative risk (RR) = 2.20; 95% CI, 1.35 to 3.58) and kidney cancer (RR = 2.53; CI, 1.34 to 4.78). The relative risks for these cancers were greater with decreasing time from first transfusion... These findings suggest that previous blood transfusion may be a risk factor for non-Hodgkin lymphoma and kidney cancer but is not associated with the most common neoplasms.|
| ||Ann Intern Med. 1993 Jul 1;119(1):8-15.||1993|
|New epidemiologic leads in the etiology of non-Hodgkin lymphoma in the elderly: the role of blood transfusion and diet.|| ||Cerhan JR.
| ||"The incidence of non-Hodgkin lymphoma (NHL) in persons over the age of 65 years has increased dramatically since the 1950s in western countries. The strongest known risk factors for NHL are primary or acquired immunosuppression, but these severe deficiencies are relatively rare and cannot explain the rapid increase observed in the elderly... In four out of four studies, prior history of blood transfusion was associated with approximately a doubling in NHL risk, even for a transfusion first received a decade or more before diagnosis... Allogeneic blood transfusion is known to suppress the immune system..."|
| ||Biomed Pharmacother. 1997;51(5):200-7.||1997|
|Allogeneic blood transfusion as a risk factor for the subsequent development of non-Hodgkin's lymphoma.|| ||Vamvakas EC.
| ||In summary, it is impossible to reconcile the contradictory results of the studies of the association between previous blood transfusion and subsequent development of NHL (Figs 1 and 2)... One can, however, be reassured that the evidence so far points to--at worst--a doubling of risk, and--at best--no increase in risk after a previous transfusion. Along these lines, Figure 1 shows the results of the 3 cohort studies, which were remarkably consistent in reporting a 2-fold increase in the risk of developing NHL after a blood transfusion; and Figure 2 shows the results of the 6 case-control studies, which usually observed no increased risk. If allogeneic blood transfusion does have an immunosuppressive effect, this effect is probably transient and weak, compared with the severity of the immunosuppression encountered in the posttransplantation situation. Immune impairment may be the common determinant for the increased risk of NHL observed in transplanted and transfused patients, and--if this were the case--the difference in the duration and intensity of the immunosuppressive state would be logically congruent with the observed patterns of lymphoma development: that is, the risk of NHL is increased 20- to 120-fold in the transplanted patients, as compared with only 2-fold in the previously transfused patients.... In conclusion, allogeneic blood transfusion from healthy donors may be associated with a small increase in the risk of development of NHL after the transfusion.|
| ||Transfus Med Rev. 2000 Jul;14(3):258-68.||2000|