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Hodgkin lymphoma risk following infectious and chronic inflammatory diseases: a large population-based case–control study from Sweden

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Abstract

Patients with Hodgkin lymphoma (HL) have a well-characterized immune deficiency of T cell function, originally identified by increased susceptibility to certain infections. Epidemiological evidence has long pointed to infectious etiologies in younger HL patients. With the aim of expanding our knowledge on the potential role of pre-existing immune deficiency in HL and an infectious/inflammatory etiology, we conducted a comprehensive population-based case–control study in HL patients diagnosed in Sweden in the period 1965–2004, and their matched controls. In a large population-based study including 7,414 HL patients and 29,240 matched controls, we evaluated the subsequent risk of HL in relation to a broad range of infectious and inflammatory conditions, using unconditional logistic regression. A previous history of any reported infection was associated with an 11 % increased risk of HL (P < 0.05). More specifically, we found sinusitis (odds ratio = 1.81; 95 % confidence interval = 1.06–3.07), tuberculosis (1.76; 1.01–3.07), encephalitis (7.88; 1.97–31.5), and herpes zoster (2.20; 1.11–4.35) to be associated with excess HL risk. A personal prior history of chronic inflammatory condition was not associated with an increased risk of HL (0.94; 0.71–1.14). Our results suggest that underlying immune deficiency is a primary phenomenon in HL. Alternatively, certain infectious agents may be potential HL triggers.

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Acknowledgments

This research was supported by grants from the Intramural Research Program of the NIH, NCI, Swedish Cancer Society, Stockholm County Council, and the Karolinska Institutet Foundations. The authors thank Ms. Shiva Ayobi, The National Board of Health and Welfare, Stockholm, Sweden; Ms. Susanne Dahllöf, Statistics Sweden, Örebro, Sweden; and Ms. Emily Steplowski, Information Management Services, Silver Spring, MD, for important efforts in the development of this database.

Conflict of interest

The authors have no conflict of interest to declare.

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    Authors and Affiliations

    1. Division of Hematology, Department of Medicine, Karolinska University Hospital Solna and Institutet, 171 76, Stockholm, Sweden

      Sigurdur Y. Kristinsson, Magnus Björkholm, Jan Sjöberg & Ola Landgren

    2. Faculty of Medicine, University of Iceland, Reykjavik, Iceland

      Sigurdur Y. Kristinsson & Sigrun Helga Lund

    3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

      Ying Gao, Neil Caporaso & Lynn R. Goldin

    4. Myeloma Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

      Ola Landgren

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    1. Sigurdur Y. Kristinsson
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    2. Ying Gao
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    3. Magnus Björkholm
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    5. Jan Sjöberg
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    6. Neil Caporaso
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    7. Lynn R. Goldin
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    Corresponding author

    Correspondence to Sigurdur Y. Kristinsson.

    Additional information

    S. Y. Kristinsson and Y. Gao contributed equally.

    Appendix

    Appendix

    See Table 4.

    Table 4 Conditions analyzed in the study
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    Kristinsson, S.Y., Gao, Y., Björkholm, M. et al. Hodgkin lymphoma risk following infectious and chronic inflammatory diseases: a large population-based case–control study from Sweden. Int J Hematol 101, 563–568 (2015). https://doi.org/10.1007/s12185-015-1772-6

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    • DOI: https://doi.org/10.1007/s12185-015-1772-6

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