Alcohol intake and risk of non-Hodgkin lymphoma in men and women

Objective: The effect of alcohol intake on risk of NHL is unclear. We therefore conducted a population-based case-control study to examine the association between alcohol and NHL risk. Methods: 613 NHL cases and 480 population controls in Sweden reported their average consumption of beer, wine, and liquor 2years before the study. Unconditional logistic regression was used to estimate the odds ratios (OR) and corresponding 95% confidence intervals (CI) for associations between alcohol intake and NHL risk. Results: Intake of total alcohol, beer, wine, or liquor was not associated with risk of overall NHL. There was no difference in risk of NHL among those who habitually consumed above 19.1g of ethanol per day, compared to those who consumed on average 0–2.2g of ethanol per day (OR = 1.2 (95% CI: 0.8, 1.7); p _trend = 0.29). However, the association was significantly positive among males (OR = 1.8 (95% CI: 1.1, 2.9); p _trend = 0.06). Total alcohol, beer, wine, or liquor intake was not associated with any major histopathologic subtype of NHL examined, apart from an association between high wine consumption and increased risk of chronic lymphocytic leukemia. Conclusions: Alcohol does not appear to be a major etiologic factor for overall NHL, nor its common subtypes.     

Anthropometrics,Physical Activity,Related Medical Conditions,and the Risk of Non-Hodgkin Lymphoma

Background: Recent reports suggest that obesity, or conditions associated with obesity, might be risk factors for non-Hodgkin lymphoma (NHL), a cancer with dramatically increasing incidence in western countries over the last several decades. Physical inactivity increases the risk of obesity and of type 2 diabetes, but there are few data on the association of physical activity with risk of NHL. Methods: We evaluated these factors in a population-based case–control study conducted in Detroit, Iowa, Los Angeles, and Seattle from 1998 to 2000. Incident HIV-negative NHL cases aged 20–74 years were rapidly reported in each area (n = 1321). Controls were identified through random digit dialing and Medicare files, and were frequency matched to cases on sex, age, race, and study site (n = 1057). Risk factor data were collected by in-person interviews and self-administered questionnaires. Unconditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI), adjusted for age, sex, race and study center. Results: High body mass index (OR = 1.73 for 35+ versus <25 kg/m²; 95% CI 1.15–2.59) and history of gallstones (OR = 1.95, 95% CI 1.11–3.40) were positively associated with diffuse NHL, but were not associated with follicular or all NHL combined. Height was positively associated with risk of all NHL combined (OR = 1.38 for >70 versus <65 inches; 95% CI 0.98–1.94), and positive associations were apparent for both diffuse and follicular NHL. Non-occupational physical activity was inversely associated with risk of all NHL combined (ORs with increasing level: 1, 0.75, 0.71, 0.55, 0.68; p-trend = 0.04) and for diffuse and follicular NHL. We observed no association of total energy intake, type 2 diabetes, or hypertension with risk of NHL. In a multivariable model to predict risk of diffuse NHL, BMI (OR = 2.15 for 35+ versus <25 kg/m²; 95% CI 1.09–4.25) and height (OR = 1.63 for 71+ versus <65 inches; 95% CI 0.75–3.57) were positively associated with risk while physical activity was weakly and inversely associated risk (ORs with increasing level: 1, 0.76, 0.72, 0.78, 0.82; p-trend = 0.9). Conclusion: BMI and history of gallstones were positively associated with risk of diffuse NHL, supporting a role for obesity in this NHL subtype. Height was positively associated with NHL risk across subtypes, and suggests a role for early life nutrition in NHL risk. Non-occupational physical activity was only weakly and inversely associated with NHL risk after adjustment for obesity, height and alcohol use.     

NHL患者HBV感染分析

目的回顾性分析乙型肝炎病毒感染与非霍奇金淋巴瘤发病的关系。方法对1999—2005年我科收治的104例非霍奇金淋巴瘤患者乙肝五项检测结果统计,并随机抽取同期住院的104例其他恶性肿瘤患者(原发肝细胞肝癌除外),104例健康体检者作为对照进行比较。结果三组患者乙肝阳性率分别为37.5%、16.8%和9%;差异有统计学意义。结论非霍奇金淋巴瘤患者的HBV感染率显著高于普通人群和一般肿瘤患者(原发肝细胞肝癌除外)。     

Tobacco and the risk of acute leukaemia in adults

Self-reported smoking histories were collected during face-to-face interviews with 807 patients with acute leukaemia and 1593 age- and sex-matched controls. Individuals who had smoked regularly at some time during their lives were more likely to develop acute leukaemia than those who had never smoked (odds ratio (OR) = 1.2, 95% confidence interval (CI) 1.0-1.4). The association was strongest for current smokers, defined here as smoking 2 years before diagnosis (OR = 1.4, 95% CI 1.1-1.7). With respect to the numbers of years smoked, risk estimates were raised in all groups except those who had smoked for fewer than 10 years. Similarly, the odds ratio decreased as the number of years 'stopped smoking' increased, falling to one amongst those who had given up smoking for more than 10 years. No significant linear trends were found, however, with either the numbers of years smoked or the numbers of years stopped smoking, and no significant differences were found between AML and ALL.     

恶性淋巴瘤危险因素病例对照研究

[目的]探讨恶性淋巴瘤发病的危险因素。[方法]采用1：2配比病例对照研究的方法，对南通市及其周围地区48例经细胞学或病理学确诊的恶性淋巴瘤患者及96例对照进行问卷调查，相关资料采用条件Logistic回归分析。[结果]三废污染（OR=3.07,90%CI1.23-7.67)、有机溶剂（OR=3.88,90%CI1.18-13.97)、避孕药（OR=2.26,90%CI1.15-6.60)、家族肿瘤史（OR=17.30,90%CI4.42-57.66)和饮酒（OR=0.66,90%CI 0.43-1.00)与恶性淋巴瘤的发病有关。[结论]三废污染、有机溶剂、避孕药和家族肿瘤史可能是恶性淋巴瘤的危险因素，而少量饮酒可以降低恶性淋巴瘤的发病危险性。     

Is Surgery Necessary in the Treatment of Primary Gastric Non-Hodgkin Lymphoma?

Fifty-two patients with primary gastric lymphoma were randomly assigned to two different surgical approaches. Twenty-eight cases were diagnosed by endoscopy and treated with chemotherapy CHOP-Bleo (cyclophosphamide, adriamycin, vincristine, prednisone and bleomycin) alternating with CMED (cyclophosphamide, metothexate, etoposide and dexamethasone). Twenty four cases underwent debulking surgery (partial or total gastrectomy) followed by the same chemotherapy. No differences were observed in relapse free disease or survival in resected or unresected patients. Complications were more frequent and severe in patients who underwent surgery. We believe that surgery is not necessary in the treatment of patients with primary gastric lymphoma.     

Alcohol consumption and non-Hodgkin lymphoma in a cohort of older women.

We investigated the relation of alcohol consumption to risk of non-Hodgkin's lymphoma (NHL) in a cohort of 35 156 Iowa women aged 55-69 years who participated in the Iowa Women's Health Study in 1986. Alcohol consumption at baseline was obtained using a mailed questionnaire. During the 9-year follow-up period, 143 incident cases of NHL were identified. Higher alcohol consumption was significantly associated with a decreased risk of NHL (P-trend = 0.03). Compared to non-drinkers, multivariate-adjusted relative risks (RRs) were decreased for women with intake of < or = 3.4 g day(-1) (RR = 0.78; 95% confidence interval (CI) 0.51-1.21) and > 3.4 g day(-1) (RR = 0.59; 0.36-0.97). The inverse association could not be attributed to one particular type of alcoholic beverage, although red wine (RR = 0.21 for > 2 glasses per month vs non-drinker; 0.05-0.86; P-trend = 0.02) has the most distinct effect. The apparent protective effect was universal regardless of specific NHL grade or Working Formulation subtype, but was most pronounced for nodal NHL (RR = 0.48; 0.26-0.90; P-trend = 0.01) and low-grade NHL (RR = 0.52; 0.21-1.26; P-trend = 0.05). These data suggest that moderate alcohol consumption is inversely associated with the risk of NHL in older women and the amount of alcohol consumed, rather than the type of alcoholic beverages, appears to be the main effect determinant.     

沙利度胺联合化疗治疗非霍奇金淋巴瘤临床观察

目的 观察沙利度胺联合化疗治疗非霍奇金淋巴瘤(NHL)的临床疗效及毒副反应.方法 65例NHL分为两组,治疗组36例给予沙利度胺联合化疗,对照组29例仅给予化疗.采用酶联免疫吸附试验检测两组患者治疗前后血清血管内皮细胞生长因子(sVEGF)水平,并观察临床疗效和毒副反应.结果 治疗组总有效率为94.4％,对照组为93....     

Response to Brentuximab Vedotin by CD30 Expression in Non-Hodgkin Lymphoma

BackgroundThe safety and efficacy of brentuximab vedotin (BV), an antibody-drug conjugate directed to the CD30 antigen, has been assessed in several trials in patients with peripheral T-cell lymphoma (PTCL), cutaneous T-cell lymphoma (CTCL), or B-cell non-Hodgkin lymphoma (NHL). The objective of this research was to examine the relationship between CD30 expression level and clinical response to BV.Patients and MethodsWe analyzed response in patients treated with BV monotherapy in 5 prospective clinical studies in relapsed or refractory PTCL, CTCL, or B-cell NHL. CD30 expression was assessed by immunohistochemistry (IHC) using the Ber H2 antibody for 275 patients.ResultsAcross all 5 studies, 140 (50.9%) patients had tumors with CD30 expression <10%, including 60 (21.8%) with undetectable CD30 by IHC. No significant differences were observed for any study in overall response rates between patients with CD30 expression ≥10% or <10%. Median duration of response was also similar in the CD30 ≥10% and <10% groups for all studies.ConclusionsIn this analysis of studies across a range of CD30-expressing lymphomas, CD30 expression alone, as measured by standard IHC, does not predict clinical benefit from BV, making the determination of a threshold level of expression uncertain.     

海南省恶性淋巴瘤危险因素病例对照研究

[目的]探讨海南省恶性淋巴瘤发病的危险因素。[方法]调查156例经病理确诊的恶性淋巴瘤患者和106例同性别、年龄相差上下不超过5岁的健康人。数据采用条件Logistic回归单因素和多因素逐步同归分析。[结果]与恶性淋巴瘤发病相关的因素有：乙型肝炎病毒感染（OR=1．851，95％可信区间1．075～3．189），慢性炎症持续时间（OR=1．794，95％可信区间1．416～2．273），经济状况（OR=0．401，95％可信区间0．243～0．660）。[结论]乙型肝炎病毒感染及慢性炎症持续时间长可增加患恶性淋巴瘤的危险性；而经济状况好则为保护因素。     

COED-B方案和CHOP方案治疗非霍奇金淋巴瘤的临床比较观察

目的 比较分析COED-B方案和传统CHOP方案治疗非霍奇金淋巴瘤的疗效.方法 84例非霍奇金淋巴瘤患者随机分为COED-B组和CHOP组,COED-B组患者采取COED-B方案化疗,CHOP组患者采取传统CHOP方案化疗,比较分析治疗效果、不良反应以及生存期.结果 COED-B组治疗总有效率(88.1%)显著高于CHOP组(59.5%),差异有统计学意义(P<0.05).2组患者常见不良反应包括贫血、胃肠道反应、靶细胞降低、脱发等,发生率比较差异均无统计学意义(P均>0.05).COED-B组1 a生存率显著高于CHOP组,差异有统计学意义(P<0.05);2组患者3、5 a生存率比较差异均无统计学意义(P均>0.05).COED-B组患者中位无疾病进展时间(6.8个月)显著短于CHOP组(10.4个月),差异有统计学意义(P<0.05).结论 COED-B方案能够提高非霍奇金淋巴瘤的疗效,具有高效、低毒、经济的特性,对基层医院治疗非霍奇金淋巴瘤有重要意义.     

A Relapsed Non-Hodgkin Lymphoma Presenting as Panhypopituitarism Successfully Treated by Chemotherapy

We report a case of relapsed large B-cell non-Hodgkin lymphoma (NHL) affecting the anterior pituitary. The NHL relapsed after three years in complete remission. The patient was a 72-year-old woman who presented fever, weakness, hyponatremia, and hypotension. The levels of thyroid-stimulating hormone and gonadotropins were very low and magnetic resonance imaging showed infiltration of the pituitary gland and stalk. After controlling the hormonal deficiencies with substitution using hydroxycortisone and levothyroxin, the patient was treated with combination chemotherapy using cyclophosphamide, vincristine, mitoxantrone, etoposide, and bleomycin (VNCOP-B regimen), achieving a complete regression of the pituitary mass and partial recovery of the endocrine function. Lymphoproliferative disorders affecting the anterior pituitary are exceedingly rare, with only six cases in immunocompetent adults reported in the literature. To our knowledge this is the first report of a relapsed NHL presenting by hypopituitarism.     

剂量调整 B-NHL-BFM95方案治疗儿童非霍奇金淋巴瘤临床研究

目的：探讨改良 B-NHL-BFM95方案治疗儿童非霍奇金淋巴瘤的临床疗效和毒副反应。方法入组20例经病理确诊的14岁以下非霍奇金淋巴瘤患者,均接受改良 B-NHL-BFM95方案治疗,未行放疗。结果近期疗效：18例（900%）CR,2例（100%）PD。治疗期间大部分患者出现Ⅲ、Ⅳ度骨髓抑制,经对症处理恢复正常,不影响下一步治疗。中位随访55个月,全组3 a 无事件生存率800%,Ⅰ~Ⅱ期1000%,Ⅲ~Ⅳ期600%;低危组1000%,中危组857%,高危组500%。结论改良 B-NHL-BFM-95方案治疗儿童非霍奇金淋巴瘤,特别是低、中危儿童非霍奇金淋巴瘤疗效显著,毒副反应可耐受。     

GemOX方案治疗老年复发难治性非霍奇金淋巴瘤疗效观察

目的 探讨吉西他滨联合奥沙利铂(GemOX方案)治疗老年复发难治性非霍奇金淋巴瘤(NHL)的疗效和毒副反应.方法全组30例患者均接受GemOX方案化疗:吉西他滨1000 mg/m2,d1.8,静脉滴注;奥沙利铂130 mg/m2,d1,静脉滴注.每21 ～28 d为1个周期,完成2个周期化疗后评价疗效,完成1个周期化疗...     

Treatment of Relapsed or Refractory Aggressive Non-Hodgkin Lymphoma with Two Ifosfamide-Based Regimens,IMVP and ICE

Abstract

We report the outcomes of 45 patients with relapsed or refractory aggressive non-Hodgkin's lymphoma (NHL) treated with a combination of ifosfamide, carboplatinum and etoposide (ICE) and 28 patients treated with a combination of ifosfamide, methotrexate and etoposide (IMVP) during two 5-year periods. The response rate (RR) to ICE was 47%, 2-year overall survival (OS) 31% and 2-year event-free survival (EFS) 22%. These results were similar to those obtained with IMVP (RR 39%, 2-year OS 23%, 2-year EFS 13%; p=0.355 for RR, 0.275 for OS, 0.668 for EFS). Higher IPI scores and refractoriness to treatment were negative prognostic factors, immunophenotype (B vs. T) had no influence on prognosis. Changing from IMVP to ICE does not substantially improve the outcome of patients with relapsed or refractory aggressive NHL. Patients with relapsed/refractory aggressive B-NHL do not have a superior out-come in comparison to those with T-NHL if treated with chemotherapy alone.     

Red Meat Intake and Risk of Non-Hodgkin Lymphoma: A Meta-Analysis

Background: While the incidence of non-Hodgkins lymphoma (NHL) has been rising worldwide, the reasonsremain undefined. Recent research has focused on effect of red andf processed meat intake as a risk factor, butwith inconclusive results. We therefore conducted a meta-analysis of data published to date, to ascertain theoverall association between intake and NHL. Materials and Methods: A published literature search was performedthrough Pubmed, Cochrane Library, Medline, and Science Citation Index Expanded databases for articlespublished in English. Pooled odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated usingrandom or fixed effects models. Heterogeneity was assessed using Chi-square and I2 statistics. Disseminationbias was evaluated by funnel plot analysis.We performed a formal meta-analysis using summary measures fromthese studies. Results: In total, 11 published studies were included in the final analysis. The combined analysisrevealed that there was significant association between the red meat and NHL risk (OR=1.10, 95%CI: 1.02 to1.19, p=0.01). Additionally, there was showed significance association between processed red meat and NHL risk(OR=1.17, 95%CI: 1.06 to 1.29, p=0.001). In subgroup analysis, a statistical significant association was notedbetween diffuse large B-cell lymphoma (DLBCL) (OR=1.20, 95%CI: 1.04 to 2.37, P=0.01) and red meat intake.Conclusions: In this meta-Analysis, there was evidence for association between consumption of red meat, orprocessed meat and risk of NHL, particularly with the DLBCL subtype in the red meat case.     

醇醛脱氢酶基因多态及饮酒习惯与胃癌易感性

[目的]探讨乙醇脱氢酶2（ADH2）和乙醛脱氢酶2（ALDH2）基因多态及饮酒习惯与胃癌易感性的关系。[方法]选取江苏省泰兴市和常熟市382例男性胃癌新发病例作为病例组,同时按同居住地、同性别及年龄±2岁1：1个体匹配抽取对照。收集所有研究对象的饮酒习惯等因素。采用聚合酶链反应（PCR）和变性高效液相色谱法（DHPLC）检测研究对象ADH2和ALDH2基因型。[结果]①病例组与对照组相比,ADH2和ALDH2各基因型分布频度差异均未达统计学意义。（9携带ALDH2G／A或A／A且酒精消耗总量≥2．5kg·年者,患胃癌的OR值分别是携带ALDH2G／G且酒精消耗总量〈2．5kg·年及≥2．5kg·年者的2．53（95％CI：0．86—7．49）和2．46（95％CI：0．90～6．72）倍,亦是携带ALDH2G／A或A／A且酒精消耗总量〈2．5kg·年者的2．72（95％CI：0．89～8-31）倍,但差异均未达到统计学意义（P〉0．05）。②与同时携带ADH2A／A和AI。DH2G／G者相比．同时携带ADH2G／A或G／G和ALDH2G／A或A,A者无论是否饮酒,患胃癌风险均无明显增加,即使当饮酒者的酒精消耗总量≥2．5kg·年亦如此（OR=3．13,95％CI：0．78,12．64）。[结论]本研究未发现ADH2和ALDH2基因多态及饮酒与胃癌易感性有关。     

Breastfeeding and the Risk of Childhood Hodgkin Lymphoma: A Systematic Review and Meta-analysis

Purpose: Numerous observational epidemiological studies have evaluated associations between breastfeedingand the risk of childhood Hodgkin lymphoma; however, the existing results are inconsistent. We thereforeconducted a systematic review and meta-analysis. Methods: Medical literature was searched in the Pubmed andEmbase databases to identify all English-language relevant studies up to April 10, 2013. Reference lists werethereafter hand-searched for additional articles. Studies that reported relative risk ratios (RRs) or odds ratios(ORs) with 95% confidence intervals (CIs) were included. This meta-analysis was conducted in accordancewith the guidelines for the meta-analysis of observational studies in epidemiology. Results: We finally included10 case-control studies in our meta-analysis, involving 1,618 childhood Hodgkin lymphoma cases and 8,181controls. Overall, we did found a borderline significant association between breastfeeding and reduced riskof childhood Hodgkin lymphoma comparing ever breastfed children to never breastfed children (pooled OR=0.79; 95%CI, 0.58-1.08; P=0.13), with limited evidence for between-study heterogeneity (P =0.12, I2 = 35.70%).Conclusion: There is limited evidence for an inverse association between breastfeeding and risk of childhoodHodgkin lymphoma.     

Socioeconomic Inequality in Concurrent Tobacco and Alcohol Consumption

Background: Whilst several studies have examined inequity of tobacco use and inequity of alcohol drinking individually, comparatively little is known about concurrent tobacco and alcohol consumption. The present study therefore investigated inequity of concurrent tobacco and alcohol consumption in Thailand. Methods: The 2015 Health and Welfare Survey was obtained from Thailand’s National Statistical Office and used as a source of national representative data. Concurrent tobacco and alcohol consumption was defined as current and concurrent use of both tobacco and alcohol. The wealth assets index was used as an indicator of socioeconomic inequity. Socioeconomic status included 5 groups ranging from poorest (Q1) to richest (Q5). A total of 55,920 households and 113,705 participants aged 15 years or over were included and analyzed. A weighted multiple logistic regression was performed. Results: The prevalence of concurrent tobacco and alcohol consumption, tobacco consumption only, and alcohol consumption only were 15.2% (95% CI: 14.9, 15.4), 4.7% (95% CI: 4.5, 4.8), and 18.9% (95% CI: 18.7, 19.1), respectively. Weighted multiple logistic regression showed that concurrent tobacco and alcohol consumption was high in the poorest socioeconomic group (P for trend: <0.001), and tobacco consumption only was also high in the poorest group (P for trend: <0.001). A high prevalence of alcohol consumption was observed in the richest group (P for trend: <0.001). Conclusions: These findings suggest that tobacco and alcohol consumption prevention programs would be more effective if they considered socioeconomic inequities in concurrent tobacco and alcohol consumption rather than focusing on single drug use.     

Association of Risk of Gastric Cancer and Consumption of Tobacco,Alcohol and Tea in the Chinese Population

This study aimed at summarizing epidemiological research findings on associations between tobacco, alcoholand tea consumption and risk of gastric cancer (GC) in the Chinese population. The review searched PubMed,Embase, China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM) databases andreference lists of review papers for all studies published in English or Chinese languages. Information extracted,via two independent researchers, from retrieved articles included first author, year of publication, study design,sample size, source of controls and adjusted odds ratio (OR) or relative risk (RR) with the corresponding 95%confidence intervals (CIs) for each category. Statistical analyses used software STATA version 12.0. The systematicsearch found 89 articles containing 25,821 GC cases and 135,298 non-cases. The overall random effects in termsof pooled OR and 95%CI for tobacco, alcohol and tea consumption were 1.62 (95%CI: 1.50-1.74), 1.57 (95%CI:1.41-1.76) and 0.67 (95%CI: 0.59-0.76) respectively; while the heterogeneity among included studies rangedfrom 80.1% to 87.5%. The majority of subgroup analyses revealed consistent results with the overall analyses.All three behavioral factors showed statistically significant dose-dependent effects on GC (P<0.05). The studyrevealed that tobacco smoking and alcohol drinking were associated with over 1/2 added risk of GC, while teadrinking conferred about 1/3 lower risk of GC in the Chinese population. However, these results should beinterpreted with caution given the fact that most of the included studies were based on a retrospective designand heterogeneity among studies was relatively high.