RESEARCH - Altered immunity as a risk factor for non-Hodgkin lymphoma

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Cancer Epidemiology Biomarkers & Prevention 16, 405-408, March 1,

2007. Published Online First March 2, 2007;

doi: 10.1158/1055-9965.EPI-06-1070

Altered Immunity as a Risk Factor for Non-Hodgkin Lymphoma

E. Grulich1, M. Vajdic1 and Cozen2

1 National Centre in HIV Epidemiology and Clinical Research,

University of New South Wales, Sydney, Australia and 2 Departments of

Preventive Medicine and Pathology, Keck School of Medicine, University

of Southern California, Los Angeles, California

This review examines the association between disorders of immunity,

including immune deficiency, atopy, and autoimmune disease, and

non-Hodgkin lymphoma (NHL). Immune deficiency is one of the strongest

known risk factors for NHL. Risk is increased whether the immune

deficiency is congenital, iatrogenic, or acquired. Risk of NHL

increases with degree of immune deficiency, and there is no evidence

of a threshold. In the profoundly immune deficient, NHL is frequently

caused by infection with the ubiquitous EBV. Whether mild, subclinical

immune deficiency is related to increased NHL risk is unknown. There

is inconsistent evidence that atopic conditions, such as asthma,

hayfever, and eczema, characterized by an immune response that is

skewed toward Th2, are associated with a decreased risk of NHL. These

data come mainly from case-control studies. Concern has been expressed

that the association may be due to reverse causality if early symptoms

of NHL include a lessening of atopic manifestations. Case-control and

cohort studies of people with autoimmune conditions have generally

shown that rheumatoid arthritis, systemic lupus erythematosis, and

Sjogren's disease are associated with increased NHL risk. It seems to

be the intensity of the inflammatory disease rather than its treatment

which is related to increased risk of NHL. The study of altered

immunity as a cause of NHL in case-control studies is limited by the

fact that development of NHL in itself leads to altered immunity.

Cohort studies of the role of altered immunity should be a top

priority in epidemiologic studies of NHL etiology. (Cancer Epidemiol

Biomarkers Prev 2007;16(3):405–8)

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Read the full article here:

http://cebp.aacrjournals.org/cgi/content/full/16/3/405

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