Risk Of Hematopoietic Cancers Research Articles

Abstract 16828: Risk of Hematopoietic Cancer in Congenital Heart Diseased Children With or Without Genetic Syndromes

Background: Individuals with genetic syndromes can manifest both congenital heart disease (CHD) and cancer due to possible common underlying pathways. However, reliable risk estimates of hematopoietic cancer (HC) among children with CHD based on large population-based data are scant. Method: We conducted a population-based analysis to estimate the cumulative incidence of HC in a cohort of children (0-18) born between 1999 and 2017 with at least one hospitalization records of CHD diagnosis or CHD-related procedural code. The data source was the Canadian Institute for Health Informatics-Discharge Abstract Database which regularly collects hospitalization and day surgery records in all Canadian provinces except Quebec, comprising over 30 million people. Hematopoietic cancer and syndromes were both identified by hospitalization diagnoses. We used modified Kaplan-Meier curve analysis to estimate the cumulative incidences [with 95% confidence intervals (CI)] up to 18 years of age, with death as a competing risk and stratified by the binary indicator of genetic syndrome status. Result: We followed 92815 CHD children from birth for 921,866 person-years. In this study population,10.5% had genetic syndromes and 461 cases of HC were observed, yielding incidence rates of HC 22.5 (95% CI: 19.4-25.4) and 3.0 (2.6-3.3) per 10,000 person-years for children with and without genetic syndrome, respectively. Cumulative incidence of HC up to age 18 was 2.6% (95% CI: 2.2-2.9%) among children with a genetic syndrome, and 0.40% (0.34-0.46%) without the syndrome. It was higher in the first 6 years of life (2.1%) than the subsequent 6-years intervals up to adulthood (0.4% in 6-12 years and 0.2% in 12-18 years of age). Conclusion: This is the first population-based analysis documenting that genetic syndromes in CHD children are a powerful predictor of hematopoietic cancers. The finding is important in informing risk-stratified policy recommendations to protect CHD children from cancer.

Abstract 3392: Personal use of permanent hair dyes and cancer risk and mortality in US women: Prospective cohort study

Abstract Background Personal use of permanent hair dyes has been discussed and examined as a potential risk factor for a variety of cancers. Epidemiological evidence regarding the relationship between personal use of permanent hair dyes and cancer risk and mortality remains inconclusive. Methods The Nurses' Health Study is an ongoing prospective cohort study of US female nurses. A total of 117200 women free of cancer at baseline and who reported information on personal use of permanent hair dyes (1976-1982), were included in this analysis and followed for 36 years (1976-2012). Age- and multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95%CIs) for associations of personal use of permanent hair dyes with risk of overall and specific cancers and cancer-specific death were estimated by using Cox proportional hazard models. The exposures included status, duration, frequency, and integral use (cumulative dose, calculated based on both duration and frequency) of permanent hair dyes, age at first use and time since first use of permanent hair dyes. Results There were 20805 overall solid cancer cases (not including major non-melanoma skin cancers), 1807 overall hematopoietic cancer cases, 22560 basal cell carcinoma cases, 2792 cutaneous squamous cell carcinoma cases and 4860 cancer-specific deaths documented during follow-up. Compared with women who never used permanent hair dyes, there was no significant association between ever-users and overall solid cancer risk (not including major non-melanoma skin cancers) (HR =0.98, 95%CI, 0.96-1.01), overall hematopoietic cancer risk (HR =1.00, 95%CI, 0.91-1.10), risk of most specific cancers, and cancer-specific death (HR=0.96, 95%CI, 0.91-1.02). A slightly increased risk of basal cell carcinoma was observed among ever-users. Larger cumulative dose was associated with higher risk of basal cell carcinoma, breast cancer and ovarian cancer. Mixed findings were observed for never/ever use and cumulative dose of permanent hair dyes in analyses stratified by natural hair color for some endpoints. Increased risk of Hodgkin lymphoma (based on very limited cases) was observed only among women with naturally dark hair who dyed their hair presumably using dark-colored permanent hair dyes. Higher risks of basal cell carcinoma and breast cancer were observed specifically among women with naturally light hair. Conclusion There was no positive association between personal use of permanent hair dyes and risk of most cancers and cancer-specific mortality, except for basal cell carcinoma, breast cancer and ovarian cancer. There were mixed findings for some endpoints (Hodgkin lymphoma, basal cell carcinoma and breast cancer) in analyses stratified by hair color. Further research is needed to confirm current findings. Citation Format: Yin Zhang, Brenda Birmann, Jiali Han, Edward Giovannucci, Frank Speizer, Meir Stampfer, Bernard Rosner, Eva Schernhammer. Personal use of permanent hair dyes and cancer risk and mortality in US women: Prospective cohort study [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3392.

Rotating Nightshift Work and Hematopoietic Cancer Risk in US Female Nurses.

BackgroundNightshift work is a plausible risk factor for hematologic cancer, but epidemiological evidence remains sparse, especially for individual subtypes. We prospectively examined the association of rotating nightshift work with hematopoietic cancer risk. MethodsThis cohort study included US women from the Nurses’ Health Study (NHS: n = 76 846, 1988–2012) and Nurses’ Health Study II (NHSII: n = 113 087, 1989–2013). Rotating nightshift work duration was assessed at baseline (both cohorts) and cumulatively updated (NHSII). Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for overall hematopoietic cancer and specific histologic subtypes. All statistical tests were two-sided. ResultsWe documented 1405 (NHS) and 505 (NHSII) incident hematopoietic cancer cases during follow-up. In NHS, compared with women who never worked rotating nightshifts, longer rotating nightshift work duration was associated with an increased risk of overall hematopoietic cancer (HR1–14y = 0.93, 95% CI = 0.83 to 1.04; HR≥15y = 1.28, 95% CI = 1.06 to 1.55; Ptrend = .009). In NHSII, results were similar though not statistically significant (HR1–14y = 0.99, 95% CI = 0.82 to 1.21; HR≥15y = 1.41, 95% CI = 0.88 to 2.26; Ptrend = .47). In the subtype analyses in the NHS, the association of history of rotating nightshift work with risk of diffuse large B-cell lymphoma varied by duration (HR1–14y = 0.71, 95% CI = 0.51 to 0.98; HR≥15y = 1.69, 95% CI = 1.07 to 2.67; Ptrend = .01) compared with those who never worked rotating nightshifts. Women reporting a longer history of rotating nightshifts also had suggestive (statistically nonsignificant) increased risks of overall non-Hodgkin lymphoma (HR≥15y = 1.19, 95% CI = 0.95 to 1.49), Hodgkin lymphoma (HR≥15y = 1.32, 95% CI = 0.43 to 4.06), and multiple myeloma (HR≥15y = 1.42, 95% CI = 0.85 to 2.39). ConclusionsLonger duration (≥15 years) of rotating nightshift work was associated with increased risks of overall and several subtypes of hematopoietic cancer.

Abstract A27: Risk of hematopoietic cancer associated mortality among workers in the poultry slaughtering and processing industries.

Abstract Objectives: Previous occupational cohort studies among poultry workers have revealed an excess risk of cancer-related mortality, including deaths due to hematopoietic malignancies. However, specific occupational and non-occupational exposures contributing to this excess risk have yet to be identified. Poultry workers are particularly at high risk since an average of 175,000 chickens are killed daily in poultry plants in the United States. This brings poultry workers into intimate contact with their blood, organs, and secretions, which may harbor transmissible oncogenic viruses. Moreover, they are exposed to potentially carcinogenic chemicals that are emitted during packaging and preparation. Hence, our study was conducted to provide preliminary evidence of which specific poultry related and non-poultry related occupational tasks increase the risk of mortality from hematopoietic cancer among poultry workers. Methods: A pilot case-cohort study was conducted using a combined cohort of 30,411 highly exposed poultry workers and 16,408 control subjects. Exposures pertaining to poultry and non-poultry related tasks were self-reported through telephone interviews from controls and next-of-kin for cases. Hematopoietic cancer mortality risk was assessed using logistic regression odds ratios (OR) and proportional hazard ratios (HR). Results: One hundred fifty-two cases of hematopoietic cancer occurred in this cohort between January 1, 1990 and December 31, 2003. Since this is a feasibility study, exhaustive attempts were not made to identify study subjects and their next of kin. Thus, we report here on the first 52 (69%) of the 75 cases whose next-of-kin were traced. Similarly, of the first 214 controls that were traced, 152 (71%) completed interviews. Preliminary analysis is currently underway to identify the specific task exposures contributing to this excess risk. Conclusion: We expect the results of our study will confirm known risk factors related to hematopoietic cancers, and uncover new risk exposures that have yet to be appreciated in the general population due to their low level exposures. Using high-risk unique populations offers an opportunity to better understand molecular mechanisms that investigators may explore to aid in future drug development. Citation Format: Saritha Bangara, Martha J. Felini, Subhash Aryal, David Sterling, Eric S. Johnson. Risk of hematopoietic cancer associated mortality among workers in the poultry slaughtering and processing industries. [abstract]. In: Proceedings of the AACR Special Conference on Hematologic Malignancies: Translating Discoveries to Novel Therapies; Sep 20-23, 2014; Philadelphia, PA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(17 Suppl):Abstract nr A27.

Cutaneous lymphoma in a patient with ulcerative colitis after immunosuppressive therapy

Introduction Biologics are generally safe and well tolerated. However, the risk of haematopoietic cancer in patients with inflammatory bowel disease receiving infliximab has been a growing concern. Case presentation We report the first case of cutaneous lymphoma after short use of infliximab in 75-year old Caucasian man with a 7-year history of ulcerative colitis. Conclusion Our current knowledge is not sufficient to rule out an increased risk of lymphoma associated with biologics, or allow definitive conclusions to be drawn about the association of infliximab and lymphoma. However, this case and others direct the attention to that both higher index of suspicion and closer follow up are required if patients are maintained on long-term infliximab together with other immunosuppressive therapy.

Occupational exposure to pesticides and risk of hematopoietic cancers: meta-analysis of case–control studies

In this study we conducted a meta-analysis of 13 case-control studies that examined the occurrence of hematopoietic cancers in pesticide related occupations in order to undertake a qualitative and quantitative evaluation of a possible relationship. Pubmed databases were searched for case-control studies published between 1990 and 2005 investigating the relation between hematopoietic cancers and occupational exposure to pesticides. Fixed and random effect meta-analysis models were used depending on the presence of heterogeneity between studies. The overall meta-odds ratio obtained after pooling 44 ORs from 13 studies was 1.3 (95% CI: 1.3-1.5). We realized stratified analysis on three different types of hematopoietic cancers (non-Hodgkin lymphoma (NHL), leukemia and multiple myeloma). A significant increased risk of NHL was found (OR = 1.35; 95% CI = 1.2-1.5). Moreover, increased risks of Leukemia (OR = 1.35; 95% CI = 0.9-2) and multiple myeloma (OR = 1.16; 95% CI = 0.99-1.36) were also detected but these results were not statistically significant. Significant heterogeneity existed among the different studies and a publication bias was detected. Therefore, a meta-regression was carried out. Our results showed that a long period of exposure (more than 10 years) provided an increase in the risk of all hematopoietic cancers and for NHL by fractions of 2.18 (95% CI = 1.43-3.35) and 1.65 (95% CI = 1.08-2.51), respectively. The overall meta-odds ratio suggests that there is a significantly positive association between occupational exposure to pesticides and all hematopoietic cancers as well as NHL. A major limitation of our meta-analysis is the lack of sufficient data about exposure information and other risk factors for hematopoietic cancer (genetic predisposition, ethnic origin, immunodepression...). In addition, data concerning specific subtypes of hematopoietic cancers are often confusing. Thus, future epidemiological studies should undertake a major effort to assess the identity and the level of pesticides exposure and should control for the most likely potential confounders.

Aspartame Consumption and Incidence of Hematopoietic and Brain Cancers

To the Editors: Lim et al. (1), using data from the 1995 to 1996 NIH-AARP Diet and Health Study, tested the hypothesis that aspartame consumption is associated with risk of hematopoietic cancers or gliomas (2). However, inappropriateness of subjects and study protocols renders any conclusions drawn from the Lim et al. study meaningless.Basic flaws are each significant enough to invalidate the study. (a) Estimates of aspartame consumption were based on reports of beverage consumption. Chewing gum, pharmaceuticals, and foods listed by the Aspartame Information Center (3) as containing aspartame were not considered for either supposed aspartame users or non-aspartame users. (b) Estimated average aspartame consumption for aspartame-consuming subjects was equivalent to approximately one 12 oz can of diet soda per day. Thus, we know that few, if any, heavy users of aspartame were included. (c) Subjects, AARP members over 50 years old, are not representative of the at-risk population. In addition, 52,887 responders with histories of cancer or with only death reports of cancer were excluded by Lim et al. (d) Estimates of aspartame consumption were based on answers to questions about beverage consumption during a 12-month period. Aspartame consumption during subjects' other 49+ years was not considered. (e) Given the variability among subjects (2); the limited number of subjects who claimed to have consumed the equivalent of three, 12 oz cans or more of aspartame-containing beverages a day; and use of multivariate analyses on data wherein there were few subjects in a large number of subgroups; it is to be expected that the variability within the various groups and subgroups would be more than sufficient to obscure any difference between aspartame users and non-users (i.e., we would not expect Lim et al. to find statistically significant differences in incidence of cancers according to aspartame intake levels).In addition to the study's inherent flaws is the authors' claim that their findings “are in direct contradiction with [Soffritti et al.]…” who showed that aspartame is a multipotential carcinogenic compound. But, whereas Soffritti et al. (4) fed and observed subjects over a lifetime beginning at 8 weeks, Lim et al. estimated aspartame consumption in subjects 50 years and older and observed them for no more than one tenth of their lifetimes.Inappropriateness of subjects and study protocols renders any conclusion drawn from this study meaningless. To claim that their findings “are in direct contradiction with [the work of Soffritti et al.]…” is deceptive and misleading.

Consumption of Aspartame-Containing Beverages and Incidence of Hematopoietic and Brain Malignancies

In a few animal experiments, aspartame has been linked to hematopoietic and brain cancers. Most animal studies have found no increase in the risk of these or other cancers. Data on humans are sparse for either cancer. Concern lingers regarding this widely used artificial sweetener. We investigated prospectively whether aspartame consumption is associated with the risk of hematopoietic cancers or gliomas (malignant brain cancer). We examined 285,079 men and 188,905 women ages 50 to 71 years in the NIH-AARP Diet and Health Study cohort. Daily aspartame intake was derived from responses to a baseline self-administered food frequency questionnaire that queried consumption of four aspartame-containing beverages (soda, fruit drinks, sweetened iced tea, and aspartame added to hot coffee and tea) during the past year. Histologically confirmed incident cancers were identified from eight state cancer registries. Multivariable-adjusted relative risks (RR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression that adjusted for age, sex, ethnicity, body mass index, and history of diabetes. During over 5 years of follow-up (1995-2000), 1,888 hematopoietic cancers and 315 malignant gliomas were ascertained. Higher levels of aspartame intake were not associated with the risk of overall hematopoietic cancer (RR for >/=600 mg/d, 0.98; 95% CI, 0.76-1.27), glioma (RR for >/=400 mg/d, 0.73; 95% CI, 0.46-1.15; P for inverse linear trend = 0.05), or their subtypes in men and women. Our findings do not support the hypothesis that aspartame increases hematopoietic or brain cancer risk.

Risk of Haematopoietic Cancer in Patients With Inflammatory Bowel Disease

Risk of Haematopoietic Cancer in Patients With Inflammatory Bowel Disease