Common community acquired infections and subsequent risk of chronic lymphocytic leukaemia.

Common community acquired infections and subsequent risk of chronic lymphocytic leukaemia.
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普通社区获得了感染,随后患慢性淋巴细胞性白血病的风险。

DOI:
10.1111/j.1365-2141.2009.07849.x
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发表时间:
2009-11
影响因子:
6.5
通讯作者:
Engels, Eric A.
Engels, Eric A.
中科院分区:
医学2区
文献类型:
--
作者:
Anderson, Lesley A.;Landgren, Ola;Engels, Eric A.

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新出现的证据支持免疫相关因素在慢性淋巴细胞白血病(CLL)病因中的作用。使用基于人群的美国SEER-Medicare数据库,我们确定了10,171名老年CLL患者和122,531名频率匹配的对照,以评估与随后CLL风险相关的几种社区获得性感染。根据性别、年龄、种族、日历年和医生索赔次数调整比值比(OR)。我们发现慢性淋巴细胞白血病的风险增加后,医疗保险索赔鼻窦炎(OR=1.11; 95%CI=1.05-1.17),咽炎(OR=1.15; 1.08-1.22),支气管炎(OR=1.14; 1.08-1.19)、肺炎(OR=1.17; 1.11-1.24)、流行性感冒(OR=1.10; 1.01-1.19)、蜂窝织炎(OR=1.08; 1.02-1.14)、带状疱疹(OR=1.26; 1.15-1.37)。当排除诊断/控制前5年的时间时,与肺炎和蜂窝织炎的相关性仍然显著。CLL风险随着肺炎(p=0.005)、蜂窝织炎(p<0.001)和带状疱疹(p<0.001)的严重程度/频率增加而增加。我们的研究结果表明,常见的感染可能在慢性淋巴细胞白血病的病因中发挥作用。或者,相关性可能反映了CLL诊断前几年存在的潜在免疫紊乱。
Emerging evidence supports a role for immune-related factors in the causation of chronic lymphocytic leukemia (CLL). Using the population-based U.S. SEER-Medicare database, we identified 10,171 elderly CLL patients and 122,531 frequency-matched controls to evaluate several community acquired infections associated with subsequent CLL risk. Odds ratios (ORs) were adjusted for gender, age, race, calendar year, and number of physician claims. We found increased CLL risk following Medicare claims for sinusitis (OR=1.11; 95%CI=1.05–1.17), pharyngitis (OR=1.15; 1.08–1.22), bronchitis (OR=1.14; 1.08–1.19), pneumonia (OR=1.17; 1.11–1.24), influenza (OR=1.10; 1.01–1.19), cellulitis (OR=1.08; 1.02–1.14), and herpes zoster (OR=1.26; 1.15–1.37). Associations with pneumonia and cellulitis remained significant when the 5-year period before diagnosis/control was excluded. CLL risk increased with increasing severity/frequency of pneumonia (p=0.005), cellulitis (p<0.001), and herpes zoster (p<0.001). Our findings suggest that common infections may play a role in CLL etiology. Alternatively, the associations might reflect an underlying immune disturbance present several years prior to CLL diagnosis.
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发表时间: 1999-12-01
影响因子: 6.4
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