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Title: Etiologic heterogeneity among non-Hodgkin lymphoma subtypes.
Authors: Morton LM,  Wang SS,  Cozen W,  Linet MS,  Chatterjee N,  Davis S,  Severson RK,  Colt JS,  Vasef MA,  Rothman N,  Blair A,  Bernstein L,  Cross AJ,  De Roos AJ,  Engels EA,  Hein DW,  Hill DA,  Kelemen LE,  Lim U,  Lynch CF,  Schenk M,  Wacholder S,  Ward MH,  Hoar Zahm S,  Chanock SJ,  Cerhan JR,  Hartge P
Journal: Blood
Date: 2008 Dec 15
PubMed ID: 18796628
PMC ID: PMC2597610
Abstract: Understanding patterns of etiologic commonality and heterogeneity for non-Hodgkin lymphomas may illuminate lymphomagenesis. We present the first systematic comparison of risks by lymphoma subtype for a broad range of putative risk factors in a population-based case-control study, including diffuse large B-cell (DLBCL; N = 416), follicular (N = 318), and marginal zone lymphomas (N = 106), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; N = 133). We required at least 2 of 3 analyses to support differences in risk: (1) polytomous logistic regression, (2) homogeneity tests, or (3) dichotomous logistic regression, analyzing all 7 possible pairwise comparisons among the subtypes, corresponding to various groupings by clinical behavior, genetic features, and differentiation. Late birth order and high body mass index (>/= 35) kg/m(2)) increased risk for DLBCL alone. Autoimmune conditions increased risk for marginal zone lymphoma alone. The tumor necrosis factor G-308A polymorphism (rs1800629) increased risks for both DLBCL and marginal zone lymphoma. Exposure to certain dietary heterocyclic amines from meat consumption increased risk for CLL/SLL alone. We observed no significant risk factors for follicular lymphoma alone. These data clearly support both etiologic commonality and heterogeneity for lymphoma subtypes, suggesting that immune dysfunction is of greater etiologic importance for DLBCL and marginal zone lymphoma than for CLL/SLL and follicular lymphoma.