Abstract
PurposeThe t(14;18) translocation might represent an intermediate step in the pathogenesis of follicular lymphoma (FL), one of the most common subtypes of non-Hodgkin lymphoma. Circulating t(14;18)-positive cells can also be detected in 30–60 % of healthy individuals at low frequencies. Some studies found a negative association between reproductive factors or use of menopausal hormone therapy (MHT) with FL. The objective of this study was to evaluate whether there is an association between number of frequencies, oral contraceptive (OC) use, menopausal status and MHT, and t(14;18) prevalence and frequency in a representative population analysis based on an epidemiologic study in the northeastern part of Germany.MethodsThe analysis is based on results of buffy coat samples from 1,981 women of the Study of Health in Pomerania (SHIP-0) and data obtained in standardized face-to-face interviews. For prevalence, odds ratios (OR) and 95 % confidence intervals (CI) were calculated using unconditional logistic regression. Frequency data were analyzed using negative binomial regression. The multivariable models included age, number of pregnancies, menopausal status (premenopausal, natural, medical/surgical menopause), OC use and MHT as a measure for exogenous hormone exposure use.ResultsWe found no association between reproductive history and combined exogenous hormone use on the prevalence of circulating t(14;18)-positive cells. Modeling MHT and OC use separately in a sensitivity analysis, the MHT parameter yielded statistical significance [OR 1.37 (95 % CI 1.04;1.81)]. t(14;18) frequency was associated with use of OC [incidence rate ratio (IRR) for ever use 3.18 (95 % CI 1.54;6.54)], current use [IRR 3.86 (1.56;9.54)], >10 years use [IRR 3.93 (1.67;9.23)] and MHT [restricted to postmenopausal women; IRR 2.63 (95 % CI 1.01;6.85)] in bivariate age-adjusted analyses. In the multivariable model, medical/surgical menopause [IRR 2.46 (1.11;5.44)] and the category ever use of OC and MHT were statistically significant [IRR 2.41 (1.09;5.33)].ConclusionsExogenous hormone use might be a risk factor for t(14;18) frequency rather than for t(14;18) prevalence. Further research on healthy individuals carrying a t(14;18) translocation and possible risk factors for malignant lymphoma is necessary to determine the additional molecular or immunological events that have to occur to develop FL.Electronic supplementary materialThe online version of this article (doi:10.1007/s10552-015-0525-4) contains supplementary material, which is available to authorized users.
Highlights
Non-Hodgkin lymphomas (NHL) comprise a heterogeneous group of lymphoid malignancies of different morphology and Cancer Causes Control (2015) 26:455–465 genetic characteristics [1]
We found no association between reproductive history and combined exogenous hormone use on the prevalence of circulating t(14;18)-positive cells
Modeling menopausal hormone therapy (MHT) and oral contraceptive (OC) use separately in a sensitivity analysis, the MHT parameter yielded statistical significance [odds ratios (OR) 1.37]. t(14;18) frequency was associated with use of OC [incidence rate ratio (IRR) for ever use 3.18], current use [IRR 3.86 (1.56;9.54)],[10 years use [IRR 3.93 (1.67;9.23)] and MHT [restricted to postmenopausal women; IRR 2.63] in bivariate age-adjusted analyses
Summary
Non-Hodgkin lymphomas (NHL) comprise a heterogeneous group of lymphoid malignancies of different morphology and Cancer Causes Control (2015) 26:455–465 genetic characteristics [1]. Causes for common NHL subtypes remain largely unclear [2]. Risk factors for NHL were often associated with the immune system [3], including HIV infection and immunosuppressive therapy following organ transplantation [2]. Progesterone, and prolactin modulate the immune system and influence the immune response. Estrogen decreases plasma levels of interleukin 6, which is a growth factor for intermediate- and high-grade NHL [4, 5]. Estrogen and progesterone levels rise [6, 7]. Reproductive factors could explain the lower prevalence of NHL in females compared to males [8, 9]
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