Incidence Of non-Hodgkin Lymphoma Research Articles

Связь активности Солнца и дыма с трендами гемобластозов в России

ematological malignancies, which include leukemia, Hodgkin's lymphoma (HL), non-Hodgkin's lymphomas (NHL) and multiple myeloma, amount 6.6% of the global incidence of malignant ne-oplasms, and 4.7% in Russia. A significant number of studies indicate the involvement of envi-ronmental factors in the occurrence of hematological malignancies. The role of electromagnetic waves in the origin of NHL is indicated by data on the increased risk of developing them in occu-pations associated with electricity. Leukemia in children is positively associated with vehicle smoke. There are indications of a role in the emergence of HL of tobacco smoke. Previously, the authors established a links between the incidence of NHL and leukemia in cohorts of young chil-dren with the activity of the Sun, and in leukemia a correlation with the smoke of forest fires was also found. In this work has been investigated the relations between the trends in the incidence of hematological malignancies in the population of Russia in 1993-2018 with smoke and solar activity. There was a tendency towards an increase in the incidence of hematological malignancies (p<0.001) by 2.8% per year. The incidence of leukemia (p=0.004), NHL (p<0.001), and multiple myeloma (p<0.001) significantly increased. This trend is presumably related to the increase in the number of cars in the country. The incidence of HL, on the contrary, is characterized by a downward trend (p=0.019). A link was found between the activity of the Sun and the incidence of leukemia (r=0.708, p=0.010, lag 2 years), NHL (r=0.689, p=0.013, lag 2 years), multiple myeloma (r=0.657, p=0.020, lag 2 years) and LH (r=0.606, p=0.037, lag 7 years). The data obtained sug-gest a significant contribution of smoke and solar activity to the occurrence of hematological ma-lignancies in children and adults. Based on the role of environmentally related oxidative stress in oncogenesis, it is recommended for the prevention of hematological malignancies to consume a sufficient amount of vitamins, regularly include in the diet fresh vegetables, fruits, foods to stimulate autophagy and Transfer Factor.

Incidence, Treatment, and Outcome of HIV-Associated Hematologic Malignancies in People Living with HIV in Sweden.

People living with HIV (PLHIV) have an increased risk of hematologic malignancies (HMs). We aimed to characterize HMs among PLHIV at Karolinska University Hospital, Stockholm, Sweden. We studied all PLHIV receiving care at our center between 2004 and 2018. Data were retrieved retrospectively from InfCareHIV database and medical records. Around 3,484 patients received HIV care for a total of 22,903 person-years (py) with median follow-up of 7.6 years. HMs were identified in 43 patients with 30 cases of non-Hodgkin lymphoma (NHL), 9 cases of Hodgkin lymphoma (HL), 2 multicentric Castleman's disease, and 1 case each of myeloma and myelodysplastic syndrome. The incidence rate of NHL was 88/105 py and HL 39.6/105 py. The incidence of NHL declined 2004-2010 versus 2011-2018 (180.8 vs. 40.1/105 py; p = .001). Median time from HIV diagnosis to malignancy was shorter in NHL compared with HL (1.2 years vs. 8.9 years; p = .01) and effective HIV treatment was less common in NHL (33% vs. 100%; p < .001). The 5-year survival rate of NHL was 59% and HL 43%, significantly lower compared with lymphoma survival in the general population in Sweden. In the era of effective antiretroviral therapy (ART), the incidence rate of lymphoma was more than five times higher in PLHIV and 5-year survival significantly inferior. Efforts for earlier identification of HIV-infected individuals are likely to affect the incidence of NHL. Additionally, an effective screening for clinical and laboratory signs of HL in PLHIV on ART should be introduced to improve identification and survival of HL in this population.

Understanding Factors That Determine Clinical Trial Enrollment for African American Patients with Lymphoma

Background: Although the incidence of non-Hodgkin lymphoma (NHL) is lower in minority populations, there is a difference in presentation, survivorship and participation in clinical trials (Becnel et al., 2017). African American patients with diffuse large B-cell lymphoma (DLBCL) present with more aggressive features including higher lactate dehydrogenase, increased frequency of B-symptoms, and higher rate of HIV co-infection, while also presenting at a younger age than other patients. (Tiu et al., 2020). Given the association of race with lymphoma presentation and outcomes, minority participation in clinical trials is of vital importance when developing novel therapies. There have been efforts to increase participation of African Americans in cancer clinical trials including patient navigation outreach which resulted in improvement of 9% to 16% of patients approached (Fouad et al., 2016). However, a recent study illustrated that for DLBCL, acute myeloid leukemia, and acute lymphoblastic leukemia, individuals of African descent represented 1.5%, 2.3%, and 6.7% of clinical trial participants, respectively (Gopishetty et al., 2020). We are conducting the current study to identify factors that influence decisions regarding clinical trial participation in African American patients with NHL.Methods: We are identifying African American patients with diffuse large B cell lymphoma and follicular lymphoma who enrolled in a therapeutic clinical trial at Emory University between 2010-2020. We will utilize the electronic medical record to identify patient characteristics such as distance from medical facility, insurance status, type of insurance, comorbidities, education status, type of diagnosis, and race of diagnosing physician. This data will compare African American patients who participated in clinical trials to those who did not participate as part of their initial treatment, specifically comparing baseline characteristics of interest between the groups. Furthermore, the data mention above will be compared between African American and white patients. We are also conducting interviews with a selected group of African American patients that have opted to participate in therapeutic clinical trials to gain a thorough understanding of the barriers and benefits they endured during their experience. The interview questions are based on prior knowledge of clinical trials, distance to facility, religious/ spiritual belief, trust of the physician, additional expenses, and time corresponded to treatment. Patients are asked to rate the importance each factor in their decision to participate and elaborate on points most specific to them. In addition, the interview allows for discussion of possible factors that challenged their participation in clinical trials which may allow for insight on low participation levels nationally. Furthermore, we are going to target patients who enrolled on clinical trials and will subsequently identify patients who did not participate in studies to identify differences in perception of treatment and clinical investigation. This project is partnered with Accounting for the High Enrollment of African Americans in Winship Cancer Institute's Clinical Trials, at Emory University.Conclusions:This study is currently enrolling patients and will answer key questions related to clinical trial participation in African American patients with lymphoma. We aim for the data collected from this study to assist in creating lymphoma clinical trials that better cater to the unique needs and considerations of African Americans. DisclosuresCohen: Genentech, Takeda, BMS/Celgene, BioInvent, LAM, Astra Zeneca, Novartis, Loxo/Lilly: Research Funding; Janssen, Adaptive, Aptitude Health, BeiGene, Cellectar, Adicet, Loxo/Lilly, AStra ZenecaKite/Gilead: Consultancy.

Effect of Pesticide Exposure on Non-Hodgkin Lymphoma Incidence and Survival in California

Introduction:While previous studies propose pesticide exposure to be a risk factor for non-Hodgkin lymphoma (NHL) development, results are inconclusive. In addition, the impact of pesticide exposure on NHL survival is not well-established. Therefore, we identified NHL patients from the California Cancer Registry and linked these patients with the statewide pesticide use reporting database to determine the impact of pesticide exposure on NHL-related incidence and outcomes.Methods:Using the California Cancer Registry, we identified patients with a first primary diagnosis of NHL from 2010-2016 and linked these patients with CalEnviroScreen 3.0 to obtain production agriculture pesticide exposure to 70 chemicals from the state mandated Pesticide Use Reporting (PUR) by census tract from 2012-2014. In addition, data from PUR was integrated into a geographic information system that employs land use data to estimate cumulative exposure to specific pesticides previously associated with NHL (glyphosate, organophosphorus, carbamate, phenoxyherbicide and 2,4-dimethylamine salt) between 10 years prior up to 1 year after NHL diagnosis. SEER*Stat software was used to calculate NHL subtype incidence rates by census tract pesticide use level. Multivariable cox proportional hazards regression models were used to evaluate the impact of total pesticide exposure from CalEnviroScreen 3.0 and individual pesticide exposure from geographic land use data on lymphoma-specific and overall survival.Results:Among 35,808 NHL patients identified, 44.2% were exposed to pesticide in their census tract of residence. Pesticide exposure was higher in Hispanic/Latino (46.5%) and non-Hispanic white (45.6%) then Asian/Pacific Islander (37.2%) and African American (34.9%) patients with NHL. Glyphosate, organophosphorus, carbamate, phenoxyherbicide and 2,4-dimethylamine salt exposure was reported in 34.1%, 26.0%, 10.6%, 14.0% and 12.8% of NHL patients, respectively. Pesticide exposure was not associated with increased NHL incidence by NHL subtype or subgroups defined by sociodemographic factors. Total pesticide exposure at time of diagnosis was not associated with lymphoma-specific or overall survival. In addition, no association was consistently found between glyphosate, organophosphorus, carbamate, phenoxyherbicide and 2,4 dimethylamine salt exposure and lymphoma-specific or overall survival.Conclusion:In this large population-based study of neighborhood agricultural pesticide exposure, pesticide exposure was noted to be prevalent among patients diagnosed with NHL, with high pesticide exposure particularly observed in Hispanics/Latinos and non-Hispanic whites. However, pesticide exposure was not consistently associated with increased NHL incidence or worse NHL lymphoma-specific or overall survival. DisclosuresPoh: Acrotech: Honoraria; Incyte: Research Funding; Morphosys: Consultancy. Tuscano: BMS: Research Funding; Seattle Genetics: Research Funding; Takeda: Research Funding; Acrotech: Research Funding; Genentech: Research Funding; Pharmacyclics: Research Funding; Abbvie: Research Funding.

A Registry-Based Geodemographic Assessment of Non-Hodgkin Lymphoma Subtypes in North Carolina

Background: Non-Hodgkin lymphoma (NHL) is the most common hematologic malignancy in the United States. NHL comprises a heterogeneous group of over 40 histological subtypes, each of which has distinct genetic, morphologic and clinical features. While NHL epidemiology as a single entity has been well-characterized using population-based cancer registry data, the epidemiology of NHL subtypes is not well understood and even less data are available for rarer subtypes. We aimed to determine geodemographic correlates for NHL subtypes in North Carolina to provide rarely reported epidemiologic characterization of each distinct malignancy.Methods: Demographic data were obtained on all NHL subtypes reported in persons >18 years of age from 2009-2019 from the North Carolina Central Cancer Registry (NCCCR). NHL subtypes were determined based on World Health Organization International Classification of Diseases for Oncology,Third Edition (ICD-O-3) Morphology codes provided by NCCCR. Crude incidence and mortality rates were estimated per 100,000 persons for the 10-year period using 2019 population data from the U.S Census Bureau. Urban and rural residence designations were based on zip code using rural-urban commuting codes developed by the Rural Health Research Center. County tier designations were used as markers of economic prosperity, with 3 being most prosperous, and provided by the North Carolina Department of Commerce. Data are being mapped using ESRI ArcMap 10.8.1.Results: A total of 25,627 incident cases of NHL and 9,930 associated deaths were reported between 2009 and 2019 in North Carolina. Therefore, the standard NHL incidence and mortality rates are 24.1 and 9.3 per 100,000 persons. For incident NHL cases, median age at diagnosis was 68 years (range 19-103), 55% were male and 45% female. Most (83%) identified as white, 14% as black, and 3% as other. Median age at death was 70 years (range 19-106). Twenty-eight NHL subtypes were identified with the four most common NHL subtypes being Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL), Diffuse Large B Cell Lymphoma (DLBCL), Follicular Lymphoma (FL), and Marginal Zone Lymphoma with 6.54, 6.42, 3.55, and 2.0 cases (per 100,000 persons), respectively. Least common subtypes included Intravascular Large B Cell Lymphoma, Primary Effusion Lymphoma, Primary Cutaneous Gamma Delta T-cell Lymphoma (PCGD-TCL) and Subcutaneous Panniculitis-Like T-cell Lymphoma, all with 0.01 cases per 100,000 persons (or 15, 14, 9 and 6 cases respectively). The distribution of NHL subtypes varied according to demographics with several notable findings. DLBCL had the highest crude mortality rate of 2.98 deaths/100,000 persons, followed by CLL (2.12 deaths/100,000 persons), FL (0.98 deaths/100,000 persons) and Lymphoma NOS (0.51 deaths/100,00 persons). Mediastinal Large B-cell Lymphoma (MLBCL) was diagnosed in the youngest individuals with median age of 36 (range 20-74), whereas PCGD-TCL occurred in the oldest with median age of 74 (range 31-99). Primary Effusion Lymphoma had the highest male predominance (93%) and MLBCL had the highest female predominance (73%). Mantle Cell Lymphoma had the highest predominance of persons who identify as white (90%), Anaplastic Large Cell Lymphoma (ALK+/-) with those who identify as black (66%), and Primary Effusion Lymphoma with those who identify as other (14%). Predominance of rurality and county tier designations varied by NHL subtype.Conclusions: A registry-based assessment of NHL subtypes illustrates the heterogeneous nature of this group of malignancies and highlights significant variation in the geodemographic features of each subtype. Evaluating geodemographic correlates deepens our understanding of NHL subtypes and can inform populations at risk for each unique NHL subtype. [Display omitted] DisclosuresDittus: BeiGene: Other: Advisory Board; Seattle Genetics: Research Funding; AstraZeneca: Research Funding; Genentech: Research Funding.

No Association Observed between Coffee Intake and Risk of Non-Hodgkin Lymphoma among Postmenopausal Women

BackgroundSome preliminary studies indicate that components in coffee may have anticarcinogenic effects. However, the association between coffee-drinking habits and the risk of non-Hodgkin lymphoma (NHL) remain controversial. ObjectiveTo examine the relationship between coffee intake and NHL incidence in a large prospective study of postmenopausal US women. Design and participants/settingThe participants included 74,935 women from the Women’s Health Initiative Observational Study who were recruited from 1993 through 1998. Information about coffee-drinking habits was collected at baseline via self-administered questionnaires. Main outcome measuresNewly diagnosed NHL was validated by medical records and pathology records. Separate analyses were performed for the following three subtypes of NHL: diffuse large B-cell lymphoma (n = 244), follicular lymphoma (n = 166), and chronic lymphocytic leukemia/small lymphocytic lymphoma (n = 64). Statistical analyses performedAge-adjusted and multivariable-adjusted Cox proportional hazards models were used to determine associations of coffee intake (specifically, the total amount of coffee consumed daily, coffee types, and coffee preparation methods) with risk of NHL. ResultsA total of 851 women developed NHL during a median 18.34 years of follow-up (range = 0.01 to 24.30 years; ± 6.63 years). Overall, no associations were observed between coffee intake and risk of NHL regardless of the total amount of daily coffee intake (P value for trend = 0.90), caffeinated (P = 0.55) or decaffeinated coffee intake (P = 0.78), and filtered or unfiltered coffee intake (P = 0.91) after controlling for sociodemographic factors, lifestyle risk factors, and clinical risk factors/current medical conditions. No significant associations were observed between coffee intake with specific subtypes of NHL. A statistically significant interaction was found between alcohol intake, coffee intake, and incident NHL (P value for interaction = 0.02) based on the adjusted analysis. Specifically, among women who frequently consumed alcohol (> 7 drinks/week), those who had moderate coffee intake (2 to 3 c coffee/day) had a significantly reduced risk of developing NHL (hazard ratio 0.61, 95% CI 0.36 to 0.98), compared with those who did not drink coffee. ConclusionsThe findings from this study do not support an association between coffee consumption and NHL risk, irrespective of the total amount of daily coffee intake, coffee types, or coffee preparation methods.

Trends Analysis of Non-Hodgkin Lymphoma at the National, Regional, and Global Level, 1990-2019: Results From the Global Burden of Disease Study 2019.

Background: Non-Hodgkin lymphoma is a common hematologic malignancy. This article aimed to estimate the trends of non-Hodgkin lymphoma (NHL) globally from 1990 to 2019.Methods: Data on the NHL burden were explored from the Global Burden of Disease study 2019. The trends of NHL burden were estimated using age-standardized rate (ASR) and estimated annual percentage change (EAPC).Results: The ASR of NHL incidence showed an increasing trend worldwide from 1990 to 2019, with an EAPC of.56 [95% CI: 0.45–0.66]. Meanwhile, increasing trends were observed in both sexes and in most geographic regions, particularly East Asia (EAPC = 3.57, 95% CI: 3.29–3.86). The most pronounced increasing trends were seen in Georgia (EAPC = 4.7, 95% CI: 4.20–5.21), followed by Belarus and Uzbekistan. However, death and disability-adjusted life years (DALYs) caused by NHL showed decreasing trends globally, in which the respective EAPCs were −0.09 (95% CI: −0.17 to −0.02) and −0.28 (95% CI: −0.35 to −0.22). Decreasing trends were mainly seen in high and high-middle sociodemographic index (SDI) areas. At the national level, the largest increasing trends of death and DALYs were observed in Georgia, in which the respective EAPCs were 4.54 (95% CI: 4.01–5.07) and 4.97 (95% CI: 4.42–5.52).Conclusions: Decreasing trends of death and DALYs caused by NHL were observed worldwide from 1990 to 2019, but NHL remains a substantial challenge globally. The findings would inform the strategies for reducing the burden of NHL.

Cancer in Saudi Arabia (CSA): Web-Based Application to Study Cancer Data Among Saudis Using Waterfall Model.

BackgroundInformation technology (IT) has emerged as a promising enabler to address the issue of big data in health care. Despite the urgent need for an IT-based tool to tackle this issue, one is not available to specifically study the massive data related to cancer among Saudis.ObjectiveTo develop a web-based application, which we named “Cancer in Saudi Arabia (CSA)” to provide an interactive, quick, and easy method to reach, extract, compare, and visualize cancer data from Saudi Cancer Incidence Reports (SCIRs).MethodsWe used waterfall model to develop CSA. Next, we used CSA to study the data of non-Hodgkin lymphoma (NHL) in Saudis reported in the SCIRs (1999–2015).ResultsCSA-based analysis showed that NHL incidence rate increased with age and the disease was more common among males compared with females. In addition, NHL was most predominant in the regions of Riyadh and Eastern, while it was the least prevalent in Jazan Region. Interestingly, the largest proportion of NHL patients was diagnosed in the late stage, and malignant lymphoma, large B-cell diffuse, OS (DLBCL) were the most frequent subtypes of NHL.ConclusionAs a user-friendly application, we believe that CSA will be a useful tool for studying cancer data in Saudis and will make the data published in SCIRs more reachable and usable. Our findings of NHL provided an almost comprehensive view of the epidemiology of the disease in Saudis for 17 years.

Access to Chimeric Antigen Receptor TCell Therapy for Diffuse Large BCell Lymphoma.

IntroductionGeographic access to novel oncology therapies, and the extent to which it may vary by potential sites of care, regions, and population characteristics, is poorly understood. We examined how expanding access to chimeric antigen receptor (CAR) T cell therapy administration sites impacts patient travel distances and time.MethodsWe used geographic information system techniques to calculate shortest travel distance and time between patients with relapsed/refractory diffuse large B cell lymphoma (DLBCL) and the nearest CAR T cell therapy administration site in three scenarios: academic hospitals; academic and community multispecialty hospitals; and academic and community multispecialty hospitals plus nonacademic specialty oncology network centers. Main outcome measures were differences in travel distance and time among the scenarios and the relationship between travel time and socioeconomic status, race, rural–urban areas, and non-Hodgkin lymphoma clusters. Non-Hodgkin lymphoma incidence, socioeconomic status, and administration centers were derived from governmental/publicly available data sources.ResultsOf 3922 patients eligible for CAR T cell therapy, more than 37% had to travel more than 1 h to the nearest academic hospital. Average travel time and distance were significantly reduced by 23% and 30% (P < 0.001), respectively, when access was expanded to include community hospitals plus a broader range of oncology specialty treatment centers. Compared to academic hospitals alone, increasing access to include community hospitals decreased time and distance by 7% and 8% (P < 0.01), respectively. In addition, there would be a lower proportion of sites operating as the only care provider within 25 miles if access was expanded outside of academic hospitals only. Longer travel time was associated with lower socioeconomic status.ConclusionMany patients with DLBCL have long travel times to an academic hospital that administers CAR T cell therapy. Expanding access to care through site-of-care planning will help address regional, rural–urban, and sociodemographic equity in the geographic allocation of CAR T cell therapy.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-021-01838-z.

177 Lu-Lilotomab Satetraxetan, a Novel CD37-Targeted Antibody-Radionuclide Conjugate in Relapsed Non-Hodgkin's Lymphoma (NHL): Updated Results of an Ongoing Phase I/II Study (LYMRIT 37-01)

177 Lu-Lilotomab Satetraxetan, a Novel CD37-Targeted Antibody-Radionuclide Conjugate in Relapsed Non-Hodgkin's Lymphoma (NHL): Updated Results of an Ongoing Phase I/II Study (LYMRIT 37-01)

Expression of Simian Virus 40 Large T-Antigen: A Case Control Study of Non-Hodgkin Lymphoma

Background: Cancer such as neoplasma lymphoma is related to the immune system. Of all lymphoma cases, about 90% are Non-Hodgkin Lymphoma (NHL). In the United Kingdom, NHL is among the five most frequently diagnosed cancer cases. In Indonesia, based on statistical data from the Dharmais Cancer Center Hospital in 2006, NHL was in the ten most commonly diagnosed cancers. The global incidence of NHL continues to increase annually in western countries, especially in Caucasian populations, men and the elderly. The etiology of NHL is uncertain. Viral infection is thought to be associated with the pathogenesis of NHL. One of them is the Simian 40 virus (SV 40) infection. In some studies, positive SV40 sequencing was found in the majority of NHL cases, but other research found no significant relationship between SV40 infection and NHL. Objective: This study aimed to identify the frequency of SV40 infection in NHL cases in Yogyakarta and to determine the relationship between SV40 infection in NHL cases and clinical patients. Methods: This study examined 102 samples of paraffin blocks from subjects diagnosed with NHL in the Anatomical Pathology Laboratory of Dr. Sardjito Hospital from 2014 through 2016. DNA extraction was done and the results were used for PCR. SV40 genome primer sets were used for the PCR process to identify any positive cases. Results: In this study, all 102 subjects did not indicate genomic L-Tag positive cases of NHL. Conclusion: It cannot be proved that SV40 has a role in the pathogenesis of NHL in Indonesia.

Extranodal primary non hodgkin lymphoma of breast: Multimodal approach to diagnosis

The primary Non-Hodgkin’s lymphoma of breast is rare. The primary lymphomas of breast are bilateral in younger age group and unilateral in older age group. We report a rare case of primary Non-Hodgkin’s lymphoma (NHL) diffuse large B cell type of right breast with multimodal approach for diagnosis. Features of undifferentiated carcinoma were seen on fine needle aspiration cytology, histopathology with gold standard method for diagnosis showed features of aggressive malignant diffuse large cell lymphoma. Immunohistochemistry positive for CD20, MUM1 and Bcl6 provided the evidence to the histopathological diagnosis and guided us towards the poor prognosis of the malignancy by subtyping. We compare the incidence of NHL of breast at our institute with the available literature. Keywords: Primary Non-Hodgkin’s lymphoma of breast, diffuse large B cell type, Fine needle aspiration cytology, Immunohistochemistry.

Pathogenetic Mechanisms Implicated in Sjögren's Syndrome Lymphomagenesis: A Review of the Literature.

Sjögren’s Syndrome (SS) is a chronic autoimmune disorder characterized by focal mononuclear cell infiltrates that surround the ducts of the exocrine glands, impairing the function of their secretory units. Compared to other autoimmune disorders, SS is associated with a notably high incidence of non-Hodgkin lymphoma (NHL) and more frequently mucosa associated lymphoid tissue (MALT) lymphoma, leading to increased morbidity and mortality rates. High risk features of lymphoma development include systemic extraepithelial manifestations, low serum levels of complement component C4 and mixed type II cryoglobulinemia. The discrimination between reactive and neoplastic lymphoepithelial lesion (LEL) is challenging, probably reflecting a continuum in the evolution from purely inflammatory lymphoid infiltration to the clonal neoplastic evolution. Early lesions display a predominance of activated T cells, while B cells prevail in severe histologic lesions. This strong B cell infiltration is not only a morphologic phenomenon, but it is also progressively associated with the presence of ectopic germinal centers (GCs). Ectopic formation of GCs in SS represents a complex process regulated by an array of cytokines, adhesion molecules and chemokines. Chronic antigenic stimulation is the major driver of specific B cell proliferation and increases the frequency of their transformation in the ectopic GCs and marginal zone (MZ) equivalents. B cells expressing cell surface rheumatoid factor (RF) are frequently detected in the salivary glands, suggesting that clonal expansion might arise from antigen selection of RF-expressing B cells. Abnormal stimulation and incomplete control mechanisms within ectopic lymphoid structures predispose RF MZ like cells to lymphoma development. Immunoglobulin recombination, somatic mutation and isotype switching during B cell development are events that may increase the translocation of oncogenes to immunoglobulin loci or tumor suppressor gene inactivation, leading to monoclonal B cell proliferation and lymphoma development. Concerning chronic antigenic stimulation, conclusive data is so far lacking. However immune complexes containing DNA or RNA are the most likely candidates. Whether additional molecular oncogenic events contribute to the malignant overgrowth remains to be proved.

Plasmablastic lymphoma in Johannesburg, South Africa, in the era of widescale antiretroviral therapy use.

Plasmablastic lymphoma (PBL) is a clinically aggressive lymphoma which has a predilection for extranodal sites and is frequently HIV-associated. The incidence of non-Hodgkin lymphoma is thought to be reduced by widescale antiretroviral therapy (ART) coverage, but the literature is sparse as regards the impact of ART on the incidence of PBL and its outcomes in South Africa (SA). This study aimed to compare factors of interest in cases of PBL diagnosed before and after the widespread availability of ART in Johannesburg, SA. All cases of PBL diagnosed in the state sector hospitals of Johannesburg in 2007 and 2017 (before and after the widespread availability of ART, respectively) were extracted from the laboratory information system, and factors of interest compared. The majority (>95%) of cases of PBL were seen among people with HIV infection (PWH) at both time-points, and the proportion of patients on ART and with virological suppression (VS) increased significantly in 2017. However, the number of cases of PBL did not differ significantly between the twoyears assessed, comprising 46/397 (11.6%) and 53/582 (9.6%) of all lymphomas in 2007 and 2017, respectively (P=0.23). Ongoing risk for PBL among PWH with virological control and immunological recovery was evident in 2017, as 18.9% of the patients had both VS and CD4 counts >200 cells/μL at diagnosis. Inferior survival times were associated with elevated lactate dehydrogenase (LDH) levels and Epstein Barr virus (EBV) negativity, but were not influenced by the presence of AIDS, ART or VS. EBV negativity was significantly associated with VS, and appeared to flag a particularly aggressive form of the disease. Widescale ART coverage has not reduced the incidence of PBL in Johannesburg, and an ongoing risk for this disease among PWH with adequate virological control and immunological recovery persists.

Clinical characteristics and outcomes of HIV positive patients with lymphoma in an oncological reference center in Mexico City.

The epidemiology of lymphomas has changed since the use of antiretroviral therapy. The incidence of Non-Hodgkin Lymphomas (NHL) has significantly decreased in high income countries but not in low and middle-income countries where AIDS-related events remain high. This observational study describes the characteristics, infectious complications and main outcomes of patients diagnosed with HIV and lymphoma at the Instituto Nacional de Cancerología.All adults >18 years diagnosed with HIV and lymphoma from January 2010 to December 2017 were included. Information on HIV and lymphoma was collected, as well as the occurrence of co-infections at diagnosis and during therapy. Multiple regression was done with NHL patients to evaluate independent variables associated to death.One hundred fifty three patients were included: 127 patients with NHL (83%) and 26 (17%) with Hodgkin lymphoma (HL). Of the NHL, 49 (38%) were diffuse large B cell Lymphomas (DLBCL), 35 (27%) plasmablastic, 28 (23%) Burkitt, 10 (8%) primary DLBCL of Central Nervous system, 3 (2%) T-cell lymphomas, and 2 (2%) pleural effusion lymphoma. Most patients were diagnosed in an advanced stage: 70% of NHL had a high International Prognostic Index (IPI); 68% of patients had <200 cells/mm. Almost 25% of NHL patients had an opportunistic infection at lymphoma diagnosis. During chemotherapy, 60% of all patients presented with at least 1 serious non-opportunistic infectious complication, and 50% presented 2 or more infectious complications, mostly bacterial infections. Thirty six percent of NHL and 23% of HL died. After adjusting for confounders, the variables associated with death were IPI and lymphoma type.HIV positive patients with lymphoma in our institution are diagnosed with an advanced stage and a high burden of infections complications. Death remains high and the variables strongly associated with death are those related to lymphoma prognosis such as lymphoma type and IPI.

The incidence of non-Hodgkin lymphoma is increased in patients with obstructive sleep apnea

Obstructive sleep apnea (OSA) is known to be associated with several cancers, but studies assessing the association between OSA and lymphoma have not been conducted yet. This study aimed to investigate the associations between OSA and non-Hodgkin lymphoma, which accounts for the majority of lymphoma, using the Korea National Health Insurance Service database. This retrospective cohort study analyzed the data from the Korea National Health Insurance Service database. A total of 198,574 patients aged ≥ 20 years who were newly diagnosed with OSA between 2007 and 2014 were included. The control group comprising 992,870 subjects was selected using propensity score matching by age and sex. The mean follow-up duration was 4.8 ± 2.3 years. The primary endpoint was newly diagnosed non-Hodgkin lymphoma. The hazard ratio [95 % confidence interval] of OSA for the incidence of non-Hodgkin lymphoma was calculated based on Cox proportional hazard model. The incidence of non-Hodgkin lymphoma among patients with OSA was significantly higher than that among the controls (1.40 [1.16–1.69]). In particular, the incidence was higher in women than that in men (1.62 vs. 1.28). There was no difference in hazard ratio by age. In conclusion, OSA may be a risk factor for non-Hodgkin lymphoma.

HIV-Related Lymphoproliferative Diseases in the Era of Combination Antiretroviral Therapy.

HIV-positive patients have a 60- to 200-fold increased incidence of Non-Hodgkin Lymphomas (NHL) because of their impaired cellular immunity. Some NHL are considered Acquired Immunodeficiency Syndrome (AIDS) defining conditions. Diffuse large B-cell Lymphoma (DLBC) and Burkitt Lymphoma (BL) are the most commonly observed, whereas Primary Effusion Lymphoma (PEL), Central Nervous System Lymphomas (PCNSL), Plasmablastic Lymphoma (PBL) and classic Hodgkin Lymphoma (HL) are far less frequent. Multicentric Castleman disease (MCD) is an aggressive lymphoproliferative disorder highly prevalent in HIV-positive patients and strongly associated with HHV-8 virus infection. In the pre-Combination Antiretroviral Therapy (CART) era, patients with HIV-associated lymphoma had poor outcomes with median survival of 5 to 6 months. By improving the immunological status, CART extended the therapeutic options for HIV positive patients with lymphomas, allowing them to tolerate standard chemotherapies regimen with similar outcomes to those of the general population. The combination of CART and chemotherapy/ immuno-chemotherapy treatment has resulted in a remarkable prolongation of survival among HIV-infected patients with lymphomas. In this short communication, we briefly review the problems linked with the treatment of lymphoproliferative diseases in HIV patients. Combination Antiretroviral Therapy (CART) not only reduces HIV replication and restores the immunological status improving immune function of the HIV-related lymphomas patients but allows patients to deal with standard doses of chemotherapies. The association of CART and chemotherapy allowed to obtain better results in terms of overall survival and complete responses. In the setting of HIV-associated lymphomas, many issues remain open and their treatment is complicated by the patient’s immunocompromised status and the need to treat HIV concurrently.

Central nervous system lymphoma and radiofrequency radiation – A case report and incidence data in the Swedish Cancer Register on non-Hodgkin lymphoma

Earlier animal studies have provided evidence that non-Hodgkin lymphoma (NHL) may be caused by exposure to radiofrequency (RF) radiation. This was recently confirmed by the U.S. National Toxicology (NTP) study that showed an increased incidence of malignant lymphoma in female mice exposed to the GSM modulated or the CDMA modulated cell phone RF radiation. Primary central nervous system lymphoma (PCNSL) is a rare malignancy in humans with poor prognosis. An increasing incidence has been reported in recent years. Based on a case-report we present the hypothesis that use of the hand-held mobile phone may be a risk factor for PCNSL. The increasing incidence of non-Hodgkin lymphoma in Sweden is discussed in relation to etiologic factors.

The Association of Pre-diagnostic Inflammatory Markers and Adipokines and the Risk of Non-Hodgkin Lymphoma Development in Egypt

Non-Hodgkin lymphoma (NHL) is an etiologically, clinically, and histologically heterogeneous group of lymphoproliferative disorders. Immune dysfunction is a well-known risk factor and dysregulation of cytokines may mediate disease progression. Obesity is one of the important relations connecting immune system abnormalities and lymphomagenesis. We conducted a study to find out the association between obesity as measured by body mass index (BMI), and risk of non-Hodgkin lymphoma (NHL) development by assessment the of inflammatory cytokines levels, (IL-6, IL-10, IFN-gamma and CRP) and adipokines levels (leptin and adiponectin). Also, to predict the effect of higher BMI on the incidence of NHL. The study included 180 NHL patients and 172 healthy controls. The inflammatory markers (IL-6, IL-10, IFN-γ & CRP) together with adiponectin were assessed by ELISA technique. IL-6, IL-10, CRP, IFN-γ and Adiponectin were statistically higher in cases than control. A positive significant difference of Leptin (p-value 0.001) was found with higher levels in patients with BMI (≥ 25 kg/m2) than in patients with < 25 kg/m2. IL-6, IL-10, CRP, IFN-γ and Adiponectin could be implicated in lymphomagenesis in Egyptian NHL. The study results support the hypothesis that obesity has a major role in the development of NHL. An association between Leptin and NHL risk with higher levels in patients with BMI (≥ 25 kg/m2) was proved.

Long-term exposure to PM2.5 and its constituents and risk of Non-Hodgkin lymphoma in Denmark: A population-based case–control study

BackgroundParticulate matter (PM) air pollution is a complex mixture and the various PM constituents likely affect health differently. The literature on the relationships among specific PM constituents and the risk of cancer is sparse. In this study, we aimed to evaluate the association of PM2.5 and its constituents with the incidence of non-Hodgkin lymphoma (NHL) and the two main NHL subtypes. MethodsWe undertook a nationwide register-based case-control study including 20,847 cases registered in the Danish Cancer Registry with NHL between 1989 and 2014. Among the entire Danish population, we selected 41,749 age and sex-matched controls randomly from the Civil Registration System. We assessed modelled outdoor PM concentrations at addresses of cases and controls with a state-of-the-art multi scale air pollution modelling system and used conditional logistic regression to estimate odds ratios (ORs) adjusted for individual and neighborhood level socio-demographic variables. ResultsThe 10-year time-weighted average concentrations of PM2.5, primary carbonaceous particles (BC/OC), secondary inorganic aerosols (SIA), secondary organic aerosols (SOA) and sea salt were 17.4, 2.3, 7.8, 0.3, and 4.1 μg/m3, respectively among controls. The results showed higher risk for NHL in association with exposure to BC/OC (OR = 1.03; 95% CI: 1.00, 1.07, per interquartile range (IQR)) and SOA (OR = 1.54; 95% CI: 1.13, 2.09, per IQR). The results indicated a higher risk for follicular lymphoma in association with several PM components. Including PM2.5 (OR = 1.16; 95% CI: 0.98–1.38), BC/OC (OR = 1.05; 95% CI: 0.97–1.14), SIA (OR = 1.44; 95% CI: 0.80–1.08), SOA (OR = 4.52; 95% CI: 0.86–23.83) per IQR. ConclusionThis is the first study on PM constituents and the risk of NHL. The results indicated an association with primary carbonaceous and secondary organic PM. The results need replication in other settings before any firm conclusion can be reached.