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Vaccination history and risk of non-hodgkin lymphoma: a population-based, case–control study

Cancer Causes & Control volume 20, pages 517–523 (2009)Cite this article

Abstract

Objective

As factors that alter the immune system have been implicated in non-Hodgkin lymphoma (NHL) etiology, it is of interest to explore the association between vaccination and risk of NHL. Results of few epidemiologic studies conducted thus far are inconsistent, and only one has examined the association by histologic subtype.

Subjects

A population-based, case–control study of 387 patients with NHL and 535 controls conducted in Nebraska between 1999 and 2002.

Methods

Information on vaccination for tetanus, polio, influenza, smallpox, and tuberculosis, as well as important environmental factors, was collected by telephone interview. Risk was estimated by odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for confounders.

Results

We found that NHL risk was inversely associated with ever receiving a polio (OR = 0.59, CI = 0.40–0.87) or smallpox (OR = 0.71, CI = 0.51–0.98) vaccination, and positively associated with influenza vaccination (OR = 1.53, CI = 1.14–2.06). No significant association was found for tetanus or tuberculosis vaccination. The patterns of association were similar between men and women. Analysis by histologic subtypes showed that polio vaccination was associated with a lower risk of follicular (OR = 0.54, CI = 0.31–0.92) and chronic lymphocytic leukemia/small lymphocytic lymphomas (OR = 0.29, CI = 0.12–0.69) and smallpox vaccination was associated with a lower risk of marginal zone lymphoma (OR = 0.41, CI = 0.19–0.88). In contrast, ever receiving an influenza vaccination was associated with a higher risk of follicular (OR = 1.98, CI = 1.23–3.18) and diffuse large B cell lymphomas (OR = 1.88, CI = 1.13–3.12).

Conclusion

Risk of NHL is inversely associated with polio and smallpox vaccination and positively associated with influenza vaccination. These associations appear to differ by histologic subtype.

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Acknowledgments

This research was supported by research grant 99B083 from the American Institute for Cancer Research (BCC) and National Cancer Institute grant R25 CA100600 (HAL). Dr. Evens was supported in part by an NCI award (K23 CA109613). The authors would like to thank Mr. Martin Bast of the Nebraska Lymphoma Registry and Tissue Bank for coordinating the patient identification and physician consent.

Author information

Affiliations

  1. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 North Lake Shore Drive, Suite 1102, Chicago, IL, 60611-4402, USA

    Heather A. Lankes, Angela J. Fought & Brian C.-H. Chiu

  2. Division of Hematology/Oncology Lymphoma Program, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Andrew M. Evens

  3. The Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA

    Andrew M. Evens & Brian C.-H. Chiu

  4. Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA

    Dennis D. Weisenburger

Authors
  1. Heather A. Lankes
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  2. Angela J. Fought
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  3. Andrew M. Evens
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  4. Dennis D. Weisenburger
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  5. Brian C.-H. Chiu
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Corresponding author

Correspondence to Brian C.-H. Chiu.

Additional information

Specific contributions of all authors to published work: HAL provided input into the statistical analyses and drafted and revised this report. BCC designed and oversaw conduct of the epidemiologic case–control study and provided input into the statistical analyses. DDW was responsible for reviewing cases. HAL, AJF, AME, BCC, and DDW provided input into the data analyses and interpretation. All authors contributed to the final version of this report.

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Lankes, H.A., Fought, A.J., Evens, A.M. et al. Vaccination history and risk of non-hodgkin lymphoma: a population-based, case–control study. Cancer Causes Control 20, 517–523 (2009). https://doi.org/10.1007/s10552-008-9259-x

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Keywords

  • Non-Hodgkin lymphoma
  • Vaccination
  • Risk factors
  • Epidemiology