Abstract
Objective: No studies of either the cross-sectional or prospective association of behavioral lifestyle characteristics and the onset of Chronic Lymphocytic Leukemia (CLL) exist. Methods: Multiple interview or questionnaire measures of emotional distress and social support, as well as personality characteristics, exercise, sleep quality, aspirin or lipid-lowering medication use, smoking status and history, educational history and farming/pesticide exposure were tested as correlates of age at initial diagnosis of CLL (AAID-CLL) in 183 patients recruited from the electronic records of Henry Ford Hospital or internet support sites. Results: Aspirin use, having always been “Fit” and living alone were positively associated with AAID. Negative associations were observed for farming/pesticide exposure, years of education, being married, self description as a “Lone Wolf” or “Worrier”, taking “nerve” or “sleeping” pills, awakenings per night, Packyears of Smoking and the Interpersonal Sensitivity, Depression, Anxiety, Hostility and Paranoia scales of the Symptom Checklist 90 - Revised, as well as the AIAI (anger), Depression and Anxiety scales of the Spouse/Friend Ketterer Stress Symptom Frequency Checklist. Conclusions: Aspirin use and exercise may exert a modifiable delaying influence in the onset of CLL. Conversely, emotional distress and smoking may hasten its onset. Prospective, and interventional, tests of these findings are needed.
Highlights
Recognized risk factors for the initiation of Chronic Lymphocytic Leukemia (CLL) include: certain chemical exposures (Agent Orange, pesticides/ farming), family history of CLL, male sex and Euroamerican derivation [1]
Because quality of life is strongly confounded with emotional distress, these studies may provide some insight regarding the impact of distress on CLL onset
CLL patients report poorer emotional/social qualityof-life than age/gender matched controls, and female CLL patients report poorer social/emotional quality-oflife than males [2,3,4,5]. While these findings might be interpreted as the result of having CLL, several findings contradict this hypothesis: 1) Self-reported quality-of-life measures were not dramatically different between patients at the “watch and wait” stage for CLL versus those undergoing active treatment; and 2) Newly diagnosed patients were not more distressed than those diagnosed an average of six years previously [6]
Summary
Recognized risk factors for the initiation of CLL include: certain chemical exposures (Agent Orange, pesticides/ farming), family history of CLL, male sex and Euroamerican derivation [1]. CLL patients report poorer emotional/social qualityof-life than age/gender matched controls, and female CLL patients report poorer social/emotional quality-oflife than males [2,3,4,5]. While these findings might be interpreted as the result of having CLL, several findings contradict this hypothesis: 1) Self-reported quality-of-life measures (including emotional distress) were not dramatically different between patients at the “watch and wait” stage for CLL versus those undergoing active treatment; and 2) Newly diagnosed patients were not more distressed than those diagnosed an average of six years previously [6]
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