Number of siblings and the risk of lymphoma, leukemia, and myeloma by histopathology
Number of siblings and the risk of lymphoma, leukemia, and myeloma by histopathology
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DOI：
10.1158/1055-9965.epi-06-0087
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发表时间：
2006-07-01
影响因子：
3.8
通讯作者：
Hemminki, Kari
中科院分区：
文献类型：
--
作者：
Altieri, Andrea;Castro, Felipe;Hemminki, Kari
流行病学证据表明，暴露于儿童感染的几个标志物与儿童白血病和淋巴瘤的风险呈负相关。我们使用瑞典家族癌症数据库，通过组织病理学评估兄弟姐妹数量对非霍奇金淋巴瘤（n = 7，007）和霍奇金淋巴瘤（n = 3，115），白血病（n = 7，650）和多发性骨髓瘤（n = 1，492）风险的影响。Poisson回归模型包括年龄、性别、家族史、时期和社会经济指数。有四个或更多兄弟姐妹与没有兄弟姐妹相比，与儿童急性淋巴细胞白血病[ALL;率比（RR），2.11; P趋势= 0.001]、急性单核细胞白血病（RR，2.51; P趋势= 0.002）和多发性骨髓瘤（RR，1.34; P趋势= 0.006）的过度风险相关。有三个或三个以上的哥哥姐姐与没有哥哥姐姐相比，急性单核细胞白血病（MR，0.35; P趋势= 0.001）和儿童ALL（RR，0.69; P趋势= 0.01）的风险降低。有5个或5个以上兄弟姐妹的霍奇金淋巴瘤的风险为0.41（P趋势= 0.003）。急性髓性白血病、慢性淋巴细胞白血病和其他淋巴组织增生性恶性肿瘤与兄弟姐妹的数量无关。总之，我们发现在大家庭中儿童ALL和急性单核细胞白血病的风险过高。然而，对于ALL、急性单核细胞白血病和霍奇金淋巴瘤，与年长的兄弟姐妹相比，年幼的兄弟姐妹受到了强烈的保护。兄弟姐妹数量对急性单核细胞白血病的显著保护作用是一个潜在的新发现。可能的解释，我们的研究结果的背景下，一个假定的感染性病因进行了讨论。
Epidemiologic evidence indicates that several markers of exposure to childhood infections are inversely associated with the risk of childhood leukemia and lymphomas. We used the Swedish Family-Cancer Database to assess the effects of number of siblings on the risk of nonHodgkin's (n 7,007) and Hodgkin's lymphomas (n = 3,115), leukemias (n 7,650), and multiple myeloma (n = 1,492) by histopathology. Poisson regression models included terms for age, sex, family history, period, and socioeconomic index. Having four or more siblings compared with none was associated with an excess risk of childhood acute lymphoblastic leukemia [ALL; rate ratio (RR), 2.11; P-trend = 0.001], acute monocytic leukemia (RR, 2.51; P-trend = 0.002), and multiple myeloma (RR, 1.34; P-trend = 0.006). Having three or more older siblings compared with none decreased the risk of acute monocytic leukemia MR, 0.35; P-trend = 0.001) and childhood ALL (RR, 0.69; P-trend = 0.01). The risk of Hodgkin's lymphoma for five or more older siblings compared with none was 0.41 (P-trend = 0.003). Acute myeloid leukemia, chronic lymphocytic leukemia, and other lymphoproliferative malignancies were not associated with number of siblings. In conclusion, we found an excess risk of childhood ALL and acute monocytic leukemia in large families. However, for ALL, acute monocytic leukemia, and Hodgkin's lymphoma, younger siblings were strongly protected compared with older siblings. The remarkable protective effect of number of older siblings on acute monocytic leukemia is a novel finding of potential interest. Possible interpretations of our findings in the context of a putative infectious etiology are discussed.