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。通过在普通人群中加深对非霍奇金淋巴瘤病因的了解，我们将确定发生非霍奇金淋巴瘤风险最高的个体，并阐明淋巴肿大的机制。此外，非霍奇金淋巴瘤是发生在免疫抑制个体中最常见的恶性肿瘤之一，包括艾滋病毒/艾滋病患者和接受医源性免疫抑制以防止移植后排斥反应的患者。由于艾滋病毒携带者的寿命更长，免疫功能得到改善，这项研究将根据其他病因确定感染艾滋病毒的人患非霍奇金淋巴瘤的风险最高。1.我们完成了主要病例对照研究的分析，并在同行评议期刊上发表了约80篇报告。2.为了更好地进行全球淋巴瘤研究和基因多态性研究，我们正在国际淋巴瘤流行病学联合会(InterLymph)内汇集数据。3.我们还继续与InterLymph合作进行其他分析，包括广泛的环境、病史和生活方式因素。4.通过这项合作研究，我们证明了不同的淋巴瘤亚型的风险模式不同。特别是，我们发现各种与免疫相关的疾病(例如，自身免疫性疾病、丙型肝炎病毒感染)与某些NHL亚型关系最密切。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结合起来，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.