Multidisciplinary Studies of Hematopoietic Malignancies

非霍奇金淋巴瘤（NHL）是美国第六大常见恶性肿瘤。通过提高对普通人群NHL发病原因的了解，我们将确定NHL发病风险最高的个体，并阐明淋巴瘤发生的机制。此外，NHL是免疫抑制个体中最常见的恶性肿瘤之一，包括HIV/AIDS患者和接受医源性免疫抑制以预防移植后的移植排斥反应的患者。由于艾滋病毒感染者的寿命更长，免疫功能也有所改善，因此本研究将根据其他病因确定艾滋病毒阳性个体患NHL的风险最高。我们完成了主要病例对照研究的分析，并在同行评议的期刊上发表了大约80篇报告。2. 为了进行GWAS并更有力地研究遗传多态性，我们汇集了国际淋巴瘤流行病学联盟（InterLymph）的数据。3. 我们继续与InterLymph在其他分析方面进行合作，包括广泛的环境、病史和生活方式因素。通过这项合作研究，我们证明了风险模式根据淋巴瘤的亚型而变化。特别是，我们发现各种免疫相关的医疗状况（例如，自身免疫性疾病，丙型肝炎病毒感染）与某些NHL亚型最密切相关。这些亚型与那些在艾滋病毒/艾滋病患者和实体器官移植后最强烈升高的亚型相同。5. 我们将其他来源的环境数据与研究数据相结合，继续调查环境风险。这项工作正在进行中。

Non-Hodgkin lymphoma (NHL) is the sixth most common malignancy in the US. By improving understanding of the causes of NHL in the general population, we will identify the individuals at highest risk of developing NHL as well as elucidate mechanisms of lymphomagenesis. Additionally, NHL is one of the most common malignancies occurring among immunosuppressed individuals, including those with HIV/AIDS and those receiving iatrogenic immunosuppression to prevent graft rejection following transplantation. Because individuals with HIV are living longer with improved immune function, this research will identify HIV-positive individuals who are at highest risk for developing NHL based on other etiologic factors.1. We completed analysis of the main case-control study and published approximately 80 reports in peer-reviewed journals. 2. To conduct a GWAS and to study genetic polymorphisms with more power, we are pooling data within the International Lymphoma Epidemiology Consortium (InterLymph). 3. We continued to collaborate with InterLymph on other analyses as well, including a broad range of environmental, medical history, and lifestyle factors.4. Through this collaborative research, we demonstrated that the patterns of risk vary according to the subtype of lymphoma. In particular, we showed that various immune-related medical conditions (e.g., autoimmune diseases, hepatitis C viral infection) are most closely associated with certain NHL subtypes. These subtypes are the same as those that are most strongly elevated among individuals with HIV/AIDS and following solid organ transplantation. 5. We combined environmental data from other sources with study data to continue to investigate environmental risks. This work is ongoing.