Anthropometric characteristics,physical activity and risk of hematological malignancies: A systematic review and meta-analysis of cohort studies

Overweight/obesity, adult attained height and physical activity are possible risk factors for hematological malignancies. This meta-analysis aims to evaluate the associations between these factors and hematological cancer risk in adults. Eligible cohort studies were sought in PubMed up to May 31, 2016; overall, 44 studies were included in the present analyses. Pooled relative risk estimates were calculated using random-effects models; separate analyses were conducted for non-Hodgkin lymphoma (NHL) and subtypes (diffuse large B-cell lymphoma, DLBCL; follicular cell lymphoma; small lymphocytic lymphoma/chronic lymphocytic leukemia, SLL/CLL), Hodgkin lymphoma (HL), multiple myeloma (MM), leukemia and subtypes (acute lymphoblastic leukemia, acute myeloid leukemia, AML). Obesity was associated with increased risk of NHL, HL, MM, leukemia overall and AML in both sexes, as well as with higher DLBCL risk in women; the dose–response meta-regression analysis confirmed these associations. Less pronounced effects were observed regarding overweight, as it was associated with increased MM risk in both sexes, NHL risk in males, DLBCL and overall leukemia risk in females. Taller men presented with significantly higher risk of NHL and taller women were affected by higher risk of NHL, DLBCL, FL, CLL/SLL, MM, leukemia and AML. On the other hand, physical activity and abdominal fatness were not associated with the risk of hematological malignancies. In conclusion, this meta-analysis highlights the pivotal role of anthropometric measures in shaping the risk of hematological malignancies in adults. Additional, well-designed studies stemming from all the continents are needed for the further substantiation and generalization of the results.     

Clinical effects of TA-077 in non-Hodgkin's lymphomas

Ten patients with non-Hodgkin's lymphomas (NHL), six untreated and four with previous chemotherapy, were treated with TA-077, a new derivative of nitrosourea. Partial remission was observed in three untreated cases (30%) of NHL [Case 1: 71-year-old female with B cell lymphoma/diffuse small cell type, Case 2: 79-year-old male with T cell lymphoma/diffuse large cell type, and Case 3: 64-year-old female with adult T cell leukemia lymphoma (ATLL)]. Remission durations were as follows: Case 1; 33 days, Case 2; 38 days and Case 3; 14 days. Side effects were transient anorexia (40%), nausea & vomiting (30%), liver dysfunction (10%) and delayed hematological toxicities (80%). Hematological toxicities consisted of leukocytopenia (80%), thrombocytopenia (60%) and anemia (20%). Our study suggests that TA-077 is a useful agent as one of the drugs used in combination chemotherapy against NHL, since it was effective for refractory T cell malignancies such as ATLL.     

Outcomes for lymphoid malignancies in the Nurses' Health Study (NHS) as compared to the Surveillance,Epidemiology and End Results (SEER) Program

Vital statistics for the lymphoid malignancies obtained from the Surveillance, Epidemiology and End Results (SEER) Program have seldom been directly compared to data from alternative national databases. While SEER is recognized as the standard, some lymphoid malignancies—especially the chronic ones—may be underreported. We compared the incidence, all‐cause and cause‐specific mortality for Hodgkin's lymphoma (HL), non‐Hodgkin's lymphoma (NHL), multiple myeloma (MM) and chronic lymphocytic leukaemia (CLL) in SEER to that in the Nurses' Health Study (NHS), a national cohort study of 121 700 female registered nurses, matching for age and race. In over 2.5 million person‐years, the incidence of HL was the same as in SEER (SIR = 1.01 [0.75, 1.26]), while the incidence of NHL, CLL and MM were slightly higher. All‐cause mortality was lower for the lymphoid malignancies except for MM, which was the same; there were no differences in cause‐specific mortality, except for MM (HR = 1.26 [1.07, 1.48]). Our analysis suggests that, at least among white women, SEER is a reliable data source with respect to lymphoid malignancies. Copyright © 2009 John Wiley & Sons, Ltd.     

Chromosomal abnormalities of 200 Chinese patients with non-Hodgkin's lymphoma in Taiwan: with special reference to T-cell lymphoma.

BACKGROUND: The distribution of the histopathological subtypes of non-Hodgkin's lymphoma (NHL) is different among various geographical areas. However, there are few reports concerning cytogenetic findings of NHL, especially T-cell lymphoma, in Asian people. PATIENTS AND METHODS: We analyzed the chromosomal abnormalities of 200 adult patients with NHL in Taiwan and correlated the non-random aberrations with the histological subtypes. RESULTS: One hundred and thirty-eight patients (69%) had B-cell lymphoma. The incidence of the t(14;18) in total lymphoma was lower in Taiwan (12%) than in the West (20-30%), but its incidence in follicular lymphoma was comparable between the two areas (17 of 28 patients, 61% versus approximately 50-60%). Sixty-two patients (31%) had T-cell lymphoma, including 11 angiocentric T/natural killer (NK)-cell lymphoma and only two angioimmunoblastic T-cell lymphoma (AILD). The recurrent chromosomal abnormalities in T-cell lymphoma comprised 6q deletion (30%), 11q deletion (20%), 17p deletion (16%), -17 (16%), -Y (14%) and + 8 (11%). Angiocentric T/NK-cell lymphoma had a significantly higher frequency of 1q duplication (P=0.001), 6p duplication (P <0.001) and 11q deletion (P=0.011) than other T-cell lymphoma. The incidences of +3 and +5, two common abnormalities in AILD, were quite low in T-cell lymphoma in Taiwan (4% and 2%, respectively), compared with those in the West (16-32% and approximately 15%, respectively). The 11q deletion, not a common aberration in T-cell lymphoma in western countries, occurred quite frequently in Taiwan. CONCLUSIONS: The chromosomal aberrations of NHL are quite different among various geographical areas, which may reflect the differences in the distribution of the histological subtypes of lymphoma among various areas.     

Non-hodgkin lymphoma in gabon and its relation to HTLV-I

A case-control study was performed in Libreville, Gabon, to determine whether a relationship can be established between the relatively high proportion of non-Hodgkin lymphoma (NHL) among all cancer cases and the high seroprevalence rate of HTLV-I observed, and to discover whether cases of adult T-leukemia/lymphoma (ATLL) related to HTLV-I exist in Gabon. From November 1987 to April 1989, a total of 32 patients with NHL were recruited; 6 were infants with Burkitt's lymphoma and 26 were adults with NHL. Each patient was matched with 2 asymptomatic controls for age, sex and ethnic group. HTLV-I serology was done by ELISA and Western blot. Comparison of the groups was done by chi-square analysis. None of the 6 infants with Burkitt's lymphoma and none of their controls had antibodies to HTLV-I. Of the 26 patients with NHL, 7 (26.9%) had HTLV-I antibodies. Among the 52 controls, the HTLV-I rate was 13.4% (n = 7). There was no difference between cases and controls (Fisher's exact test, p = 0.16). Among the 26 NHL, 4 cases fitted the criteria of ATLL and were HTLV-I-positive; 3 others who were positive for HTLV-I were a woman with lymphoblastic gastric NHL and 2 old men with an unclassified lymphoma. From the results of this limited series it is not possible to state that there is an association between NHL and HTLV-I infection. Nevertheless, cases of ATLL related to HTLV-I are reported from this area. Based on the HTLV-I seroprevalence rates reported in Gabon, the estimated incidence rate of ATL among seropositive people in Gabon appears much lower than in Japan. Different explanations can be proposed, but under-diagnosis of ATLL is probably one of the main factors.     

Response to COVID-19 Vaccination Post-CAR T Therapy in Patients With Non-Hodgkin Lymphoma and Multiple Myeloma

COVID-19 adversely affects individuals with cancer. Several studies have found that seroconversion rates among patients with hematologic malignancies are suboptimal when compared to patients without cancer. Patients with non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) are immunocompromised due to impaired humoral and cellular immunity in addition to prescribed immunosuppressive therapy. Chimeric antigen receptor T-cell (CAR T) therapy is now widely used for NHL and MM, but little is known about seroconversion rates after COVID-19 vaccination among these populations. We evaluated SARS-CoV-2 spike-binding IgG antibody levels following COVID-19 vaccination among NHL and MM CAR T therapy recipients. Out of 104 CAR T infusions, 19 patients developed known COVID-19 infection post-CAR T. We tested 17 patients that received CAR T for antibody spike titers post COVID-19 vaccination, only 29 % (n = 5) were able to mount a clinically relevant antibody response (>250 IU/mL).     

Antibodies to HTLV-I p24 in sera of blood donors, elderly people and patients with hemopoietic diseases in France and in French West Indies

Human T-cell lymphoma/leukemia virus type I (HTLV-I) is a type-C retrovirus originally isolated from patients with leukemia or lymphoma involving mature T lymphocytes. Epidemiological studies have shown that HTLV-I infection occurs not only in leukemic but also in normal people in at least two areas of the world: the Caribbean basin and the South-West of Japan. We report here the results of a large seroepidemiological study of HTLV-I infection in normal French blood donors, elderly subjects living in institutions and patients with various malignant hemopathies, obtained by the classical HTLV-I p24 radioimmunoassay. We were unable to demonstrate antibodies to HTLV-I in 510 sera from French volunteer blood donors born and living in continental France or in sera from 262 blood donors born in other countries (mainly in Europe and North Africa) and living in continental France at the time of collection. In contrast, among 131 sera from blood donors born in French overseas territories (French Guiana, French West Indies, and Reunion) but living at the time of collection in continental France, 2 (1.5%) were found to possess anti-HTLV-I antibodies. In a sample of 2,597 blood donors from Martinique, 39 (1.5%) were positive. A positive correlation with age was observed whereas no statistical relationship was found between HTLV-I antibodies and sex, red cell blood groups or the place of residence in Martinique. On the other hand, a very high level of positive values was observed in Martinique among old people living in institutions, 14% of those aged over 60 years being positive. HTLV-I-associated hematological malignancies have not been observed in patients born and living in continental France whereas a large number exist in the French West Indies. In the same area, the presence of anti-HTLV-I antibodies in 12% of patients with myeloma, a typical B-cell disease, merits attention.     

Impact of Frailty on Hospital Outcomes Among Patients with Lymphoid Malignancies Receiving Autologous Hematopoietic Stem Cell Transplantation in the United States

BackgroundFrailty could affect outcomes of autologous hematopoietic stem cell transplantation (aHSCT). This study sought to examine the effects of frailty on hospital outcomes among patients with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), and multiple myeloma (MM) who received aHSCT.Materials and MethodsThis study was a retrospective analysis of Nationwide Inpatient Sample database, 2005 to 2014. Outcome variables were in-hospital mortality, prolonged length of stay and hospitalization cost. Frail patients were defined using the Johns Hopkins Adjusted Clinical Groups frailty-defining diagnosis indicator.ResultsThere were 20,573 NHL, 8,974 HL, and 40,750 MM patients. Among them, 5.5% NHL, 3.8% HL, and 4.8% MM patients were frail. Among patients with NHL, there were significant associations between frailty and in-hospital mortality (Odds Ratio [OR], 4.04, 95% CI: 2.11-7.76), and prolonged length of stay (OR, 2.32, 95% CI: 1.56-3.46). Similarly, among HL, there were significant associations between frailty and in-hospital mortality (OR, 1.82, 95% CI: 1.43-2.76), and prolonged length of stay (OR, 1.55, 95% CI: 1.34-2.84). Likewise, for MM, there were significant associations between frailty and in-hospital mortality (OR, 4.28, 95% CI: 2.16-8.48), and prolonged length of stay (OR, 3.00, 95% CI: 2.00-4.51). These associations remained significant after stratifying by age and comorbidities. Significant differences were observed in hospitalization cost between frail and non-frail patients.ConclusionAmong patients with lymphoid malignancies undergoing HSCT, frailty was associated with greater in-hospital mortality, longer length of stay, and higher hospitalization costs. Comprehensive health status assessments for identifying and managing frail patients in this population could improve patient outcomes.     

Detection of simian virus 40 DNA sequences in Egyptian patients with different hematological malignancies

SV40 DNA sequences have been detected in non-Hodgkin's lymphoma patients. A link between SV40 and NHL is biologically plausible since SV40 causes hematological malignancies in laboratory rodents. We investigated 266 Egyptian cases of hematological malignancies (158 NHL, 54 HD, 26 ALL, 13 AML, 8 CLL, 7 CML) and 34 subjects as a control for detection of SV40 DNA using nested PCR. SV40 DNA sequences were found in (53.8%) of NHL, (29.6%) of HD and in (40.7%) of different types of leukemia cases. Frequency of SV40 DNA sequences was higher in NHL patients compared with those with the other tumors and control group (p < 0.05). The highest frequency was in Burkitt's lymphoma followed by diffuse large B-cell lymphoma. The present study suggests that SV40 is significantly associated with non-Hodgkin's lymphoma and most probably acts as a cofactor in the pathogenesis of these tumors. This could lead to new diagnostic, therapeutic, and preventive approaches.     

Lympho-hemopoietic malignancies in India

Available information on lympho-hemopoietic malignancies in India is presented. The incidence of most cancers, including multiple myeloma, lymphomas, and leukemias, is lower compared to that in the West; chronic myelogenous leukemia, however, is higher and the incidence of non-Hodgkin’s lymphoma (NHL) is rising. Most cancers occur at a younger age. Higher frequencies of mixed-cellularity Hodgkin’s disease, diffuse large-cell NHL and T cell acute lymphoblastic leukemia are noted. Most patients present in advanced stages and have poorer prognostic factors. Treatment results are comparable if stagewise distribution and poor prognostic factors are taken into account.     

血液肿瘤CAR-T细胞治疗的现状与挑战

过继性细胞免疫疗法（adoptive cellular immunotherapy,ACI）是药物开发中一种全新模式,目前已具备在肿瘤疾病中带来临床益处的明确证据。其中嵌合抗原受体修饰的T细胞（chimeric antigen receptor-modified T cells,CAR-T）疗法利用基因工程技术重编程T细胞,使其具备非主要组织相容性抗原复合物（major histocompability complex,MHC）限制性的靶向结合并杀伤肿瘤细胞的能力,并在急性B淋巴细胞性白血病（B-cell acute lymphoblastic leukemia,B-ALL）、非霍奇金淋巴瘤（non-Hodgkin's lymphoma,NHL）、多发性骨髓瘤（multiple myeloma,MM）患者中展现出显著的缓解率,为难治复发性血液肿瘤疾病提供了治愈希望,因此多项商品化CAR-T产品也获批应用于临床,开拓了肿瘤免疫治疗的新时代。然而,细胞因子释放综合征（cytokine release syndrome,CRS）、免疫效应细胞相关神经毒性综合征（immune effector cell-associated neurotoxicity syndrome,ICANS）和其他并发症的发生是其应用的安全性挑战,并且部分患者发生CAR-T治疗无效或复发,需要提出优化CAR-T细胞疗法的新策略,在不同水平强化肿瘤清除作用,以确保安全性和有效性。本文对血液肿瘤领域的CAR-T细胞疗法临床研究进展进行综述,并归纳了下一代CAR-T细胞疗法面临的主要挑战,为拓展CAR-T细胞基础研究及临床转化研究方向提供思路。      

Lymphoma incidence in a Swedish county during 1969-1987.

The incidence of lymphoid malignancies (acute leukemias and myelomatosis excluded) during 1969-1987 in the County of Uppsala was calculated on the basis of the regional cancer register and local registers from the only oncological, hematological, dermatological and pathological departments in this well-defined geographical area. Of the 774 patients included, 639 had histopathological specimens available, all of which were re-examined. Seventy-nine patients were diagnosed on the basis of bone marrow investigations (greater than 70% re-examined, all had a low-grade non-Hodgkin's lymphoma = NHL) and 54 on fine-needle aspiration biopsies (not re-examined). Seventy-nine of the lymphoma diagnoses were based on autopsy specimens. The overall age standardized incidence was 16.2/100,000/year (NHL: 13.6, Hodgkin's disease = HD: 1.5) according to the Swedish 1970 census (according to world standard population: 10.2); male: 20.9 (12.9) and female: 12.4 (7.9). The annual change in trend was +3.0% +/- 2.6 (NHL: +3.6% +/- 2.4, HD: no change). The omission of the 54 'fine needle cases' led to an overall incidence of 15.0 (9.7) and an annual change in trend of +3.5% +/- 1.9. Among the histopathological specimens, an NHL was found in 524 patients and HD in 69. In 46 registered patients, the diagnosis malignant lymphoma was wrong. The diagnosis changed to NHL in 43 patients registered as HD.     

Combined immunoradiotherapy induces long-term remission of CNS relapse of peripheral, diffuse, large-cell lymphoma after allogeneic stem cell transplantation: case study

Relapse of peripheral non-Hodgkin's lymphoma (NHL) in the central nervous system commonly has a poor prognosis. Graft-versus-leukemia effects (GvL) contribute substantially to eradication of hematological malignancies after allogeneic stem cell transplantation. Few data are available describing GvL activity within the brain. We report the case of a man allografted for peripheral NHL. On day +83 after transplantation a CNS relapse of the lymphoma occurred. The brain was irradiated with 44 Gy, anti-CD20 antibodies were given, and the immunosuppression was withdrawn. Subsequently, limited-stage, chronic graft-versus-host disease occurred. The lymphoma regressed completely, and the patient has been in continuous complete remission for 30 months. The favorable course suggests substantial contribution of immunomodulation to excellent outcome.     

Secondary hematological malignancies after breast cancer chemotherapy

According to several reports, the 10 year incidence of secondary acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS) after systemic chemotherapy is approximately 1.5%. The cumulative risk increases by 0.25 - 1% for the first 8 years after treatment. We have reported only 6 cases of hematological malignancies (0.3%) after breast cancer chemotherapy in our institute. We detected 2 cases of secondary AML and 1 case of MDS, 19, 52 and 12 months, respectively, after systemic chemotherapy for breast cancer. Published data on the occurrence of secondary hematological malignancies other than AML or MDS in this setting are scarce. We encountered diffuse large B-cell lymphoma, angioimmunoblastic lymphoma and mantle cell lymphoma as secondary hematological malignancies after systemic chemotherapy for breast cancer.     

Clinical analysis of 1629 newly diagnosed malignant lymphomas in current residents of Sichuan province,China

Previous studies in other provinces of China (Beijing, Xinjiang, Shanxi, Jiangxi, Shanghai, Guangdong, and Taiwan) suggest that the distributions of lymphoma subtypes differ compared with Western populations. In order to evaluate the characteristics of malignant lymphoma in Sichuan, China, we analyzed case series data from incident lymphoma patients diagnosed in 2008 from three hospitals, including a total of 1629 cases and including only current residents of Sichuan. The median age of diagnosis for cases was 54 years, with a higher proportion of male cases compared with female cases. The most commonly diagnosed subtypes included diffuse large B‐cell lymphoma (40.4%), NK/T‐cell lymphoma (NKTCL; 11.8%), mixed cellularity Hodgkin lymphoma (7.0%), mantle cell lymphoma (4.8%), and marginal zone B‐cell lymphoma (3.9%). Differences in demographic characteristics between Hodgkin lymphoma (HL) and non‐Hodgkin lymphoma (NHL) cases were apparent for median age at diagnosis (HL: 34 years; NHL: 57 years), and NHLs accounted for nearly all (99.3%) of the 931 cases of extranodal lymphoma. These findings indicate a higher proportion of NKTCL cases and a lower proportion of follicular lymphoma cases (2.3%) in these hospitals in Sichuan, relative to reports from some other provinces within China (e.g., Shanghai and Shanxi) and the USA. Copyright © 2015 John Wiley & Sons, Ltd.     

珠海地区淋巴瘤特点初探

 淋巴瘤在中国、欧美或中国不同的地区其发病是不尽相同的。本文采用1994年国际淋巴瘤研究小组(InternationalLymphomaStudyGroupILSG)拟定的新分类法,对珠海地区1980～1996年17年间报告的47例淋巴瘤(包括13例何杰金氏病和34例非何杰金氏淋巴瘤)重新分类,得出结论显示:1低发的淋巴瘤(0.21%);2低发的何杰金氏病(0.06%);3低发的非何杰金氏淋巴瘤(0.15%);4低比例的T淋巴瘤(88%);5高比例的B细胞性淋巴瘤(91.2%);6低比例的低度恶性淋巴瘤(58%)。珠海地区据此与国内外淋巴瘤不同的区别特点有待进一步地研究。     

Changes in acquired immunodeficiency syndrome-related non-Hodgkin lymphoma in the era of highly active antiretroviral therapy: incidence, presentation, treatment, and survival

BACKGROUND: The authors sought to determine whether the availability of highly active antiretroviral therapy (HAART) coincided with changes in the epidemiology of acquired immunodeficiency syndrome (AIDS)-related non-Hodgkin lymphoma (NHL). METHODS: Cancer registry data from 1988-2000 were linked with AIDS registry data from 1981 to July 2003 for San Diego County to identify 537 AIDS-NHL patients. By using the total number of patients with AIDS who were alive as of July 1 annually as the AIDS population denominator, the average annual incidence of NHL was estimated among patients with AIDS for the pre-HAART period (1988-1995) and post-HAART period (1996-2000). The chi-square test was used to compare proportions, and a Cox proportional hazards model was used to compare survival between the pre-HAART and post-HAART periods. RESULTS: The incidence of NHL decreased from 29.6 per 1000 person-years pre-HAART to 6.5 per 1000 person-years post-HAART. The proportion of patients who had NHL of central nervous system (CNS) origin decreased from 28% pre-HAART to 17% post-HAART. Among patients with systemic NHL, 54% received chemotherapy pre-HAART, and 72% received chemotherapy post-HAART. The percentage of intermediate-grade NHL increased from 33% pre-HAART to 49% post-HAART, and the percentage of high-grade NHL decreased from 38% to 19%, respectively. A diagnosis of human immunodeficiency virus infection preceding the NHL diagnosis and Stage IV NHL were associated with worse survival, whereas a diagnosis of NHL in the post-HAART period and chemotherapy were associated with better survival. The median survival was 4 months pre-HAART and 9 months post-HAART. CONCLUSIONS: Since the introduction of HAART, there has been a decrease in the incidence of systemic and CNS NHL among patients with AIDS. Among patients with systemic, AIDS-related NHL, there has been decreased high-grade histology, increased use of chemotherapy, and improved survival.     

Rituximab Therapy of B-Cell Neoplasms

The development of rituximab, an anti-CD20 monoclonal antibody, represents a revolutionary advance in the therapy of hematological malignancies. Rituximab was approved in 1997 by the Food and Drug Administration for the treatment of relapsed or refractory, CD20+, B-cell, low-grade or follicular non-Hodgkin's lymphoma (NHL). Recent studies have documented activity of rituximab in other CD20- expressing hematological malignancies including mantle cell lymphoma, small lymphocytic lymphoma, aggressive NHL, chronic lymphocytic leukemia, and Waldenstrom's macroglobulinemia. When used in combination with cytotoxic chemotherapy, rituximab achieves response rates of 90%–95% in low-grade follicular and aggressive NHL patients. Currently, rituximab is undergoing intensive investigation in several large phase II and III trials, both as a single agent and in combination with chemotherapy. Clinical research will help define the ultimate role of this agent and its potential impact on survival of patients with B-cell neoplasms. This article describes current clinical trials with rituximab and discusses their significance.     

Dietary factors of one-carbon metabolism in relation to non-Hodgkin lymphoma and multiple myeloma in a cohort of male smokers.

Reported associations between genetic polymorphisms in folate-metabolizing enzymes and lymphoid malignancies suggest etiologic involvement of one-carbon metabolism and its related dietary exposures. We examined dietary factors of one-carbon metabolism in relation to non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) among 27,111 healthy male smokers who completed baseline dietary questionnaires in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study cohort. During a follow-up of up to 16.4 years (1985-2001), 195 NHL and 32 MM cases were ascertained. Cox proportional hazard models were used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (95% CI). There was no significant association between dietary folate and NHL (HR comparing fourth to first quartile, 1.03; 95% CI, 0.68-1.55). Dietary vitamin B12 was inversely associated with NHL (HR, 0.61; 95% CI, 0.37-1.00; P(trend) = 0.06). The inverse association of vitamin B12 was evident for diffuse subtype but did not reach statistical significance. There were no significant associations of dietary vitamin B6 or B2, methionine, or alcohol with NHL. None of the dietary or supplemental one-carbon nutrients were associated with MM, although the power of these analyses was limited. Our results suggest that high intake of vitamin B12 among heavy smokers may be protective against NHL but warrant further studies, including among nonsmokers.     

Risk of non-Hodgkin's lymphoma and skin malignancies in patients diagnosed with cataract.

The rapid increase of non-Hodgkin's lymphoma (NHL) in industrialized countries is yet unexplained. Ultraviolet radiation (UVR) has been suggested as an aetiologic factor due to observed elevated risks of cutaneous malignancies after NHL and vice versa. Cataract, as related to UVR, was tested as a proxy variable to further elucidate this observation. Cataract in-patients (n = 49914) reported to the Swedish Patient Register and later developing NHL and cutaneous malignancies were identified by record linkage to the Swedish Cancer Registry. The observed number of malignancies among cataract patients did not differ significantly from that expected in the general population. In contrast, the risk of cutaneous malignant melanoma was lower than anticipated, based on Swedish background incidence figures. The results did not give support for a causal relationship between NHL and UVR.