TY - JOUR
T1 - Prediagnostic plasma concentrations of organochlorines and risk of B-cell non-Hodgkin lymphoma in envirogenomarkers
T2 - a nested case-control study
AU - Kelly, Rachel S.
AU - Kiviranta, Hannu
AU - Bergdahl, Ingvar A.
AU - Palli, Domenico
AU - Johansson, Ann-Sofie
AU - Botsivali, Maria
AU - Vineis, Paolo
AU - Vermeulen, Roel
AU - Kyrtopoulos, Soterios A.
AU - EnviroGeno Markers Project, incl. Kleinjans J., Hebels D., de Kok, T.
AU - Kleinjans, Joseph
AU - de Kok, Theodorus
AU - Hebels, Dennie
AU - Chadeau-Hyam, Marc
PY - 2017/2/16
Y1 - 2017/2/16
N2 - Background: Evidence suggests a largely environmental component to non-Hodgkin's lymphoma (NHL). Persistent organic pollutants (POPs) including polychlorinated biphenyls (PCBs), DDE and HCB have been repeatedly implicated, but the literature is inconsistent and a causal relationship remains to be determined.Methods: The EnviroGenoMarkers study is nested within two prospective cohorts EPIC-Italy and the Northern Sweden Health and Disease Study. Six PCB congeners, DDE and HCB were measured in blood plasma samples provided at recruitment using gas-chromatography mass spectrometry. During 16 years follow-up 270 incident cases of B-cell NHL (including 76 cases of multiple myeloma) were diagnosed. Cases were matched to 270 healthy controls by centre, age, gender and date of blood collection. Cases were categorised into ordered quartiles of exposure for each POP based on the distribution of exposure in the control population. Logistic regression was applied to assess the association with risk, multivariate and stratified analyses were performed to identify confounders or effect modifiers.Results: The exposures displayed a strong degree of correlation, particularly amongst those PCBs with similar degrees of chlorination. There was no significant difference (p <0.05) in median exposure levels between cases and controls for any of the investigated exposures. However under a multivariate model PCB138, PCB153, HCB and DDE displayed significant inverse trends (Wald test p-value <0.05). Under stratified analyses these were determined to be driven by males and by the Diffuse Large B-Cell Lymphoma subtype. When considering those in the highest levels of exposure (>90(th) percentile) the association was null for all POPsConclusion: We report no evidence that a higher body burden of PCBs, DDE or HCB increased the risk of subsequent NHL diagnosis. Significantly inverse associations were noted for males with a number of the investigated POPs. We hypothesize these unexpected relationships may relate to the subtype composition of our population, effect modification by BMI or other unmeasured confounding. This study provides no additional support for the previously observed role of PCBs, DDE and HCB as risk factors for NHL.
AB - Background: Evidence suggests a largely environmental component to non-Hodgkin's lymphoma (NHL). Persistent organic pollutants (POPs) including polychlorinated biphenyls (PCBs), DDE and HCB have been repeatedly implicated, but the literature is inconsistent and a causal relationship remains to be determined.Methods: The EnviroGenoMarkers study is nested within two prospective cohorts EPIC-Italy and the Northern Sweden Health and Disease Study. Six PCB congeners, DDE and HCB were measured in blood plasma samples provided at recruitment using gas-chromatography mass spectrometry. During 16 years follow-up 270 incident cases of B-cell NHL (including 76 cases of multiple myeloma) were diagnosed. Cases were matched to 270 healthy controls by centre, age, gender and date of blood collection. Cases were categorised into ordered quartiles of exposure for each POP based on the distribution of exposure in the control population. Logistic regression was applied to assess the association with risk, multivariate and stratified analyses were performed to identify confounders or effect modifiers.Results: The exposures displayed a strong degree of correlation, particularly amongst those PCBs with similar degrees of chlorination. There was no significant difference (p <0.05) in median exposure levels between cases and controls for any of the investigated exposures. However under a multivariate model PCB138, PCB153, HCB and DDE displayed significant inverse trends (Wald test p-value <0.05). Under stratified analyses these were determined to be driven by males and by the Diffuse Large B-Cell Lymphoma subtype. When considering those in the highest levels of exposure (>90(th) percentile) the association was null for all POPsConclusion: We report no evidence that a higher body burden of PCBs, DDE or HCB increased the risk of subsequent NHL diagnosis. Significantly inverse associations were noted for males with a number of the investigated POPs. We hypothesize these unexpected relationships may relate to the subtype composition of our population, effect modification by BMI or other unmeasured confounding. This study provides no additional support for the previously observed role of PCBs, DDE and HCB as risk factors for NHL.
KW - Non Hodgkin lymphoma
KW - Polychlorinated biphenyls
KW - DDE
KW - HCB
KW - Organochlorines
KW - EnviroGenoMarkers
KW - CHRONIC LYMPHOCYTIC-LEUKEMIA
KW - POLYCHLORINATED-BIPHENYLS
KW - ADIPOSE-TISSUE
KW - CANCER-RISK
KW - EXPOSURE
KW - DIOXIN
KW - GENE
KW - POLYMORPHISMS
KW - MORTALITY
KW - EPIDEMIOLOGY
U2 - 10.1186/s12940-017-0214-8
DO - 10.1186/s12940-017-0214-8
M3 - Article
C2 - 28202064
SN - 1476-069X
VL - 16
JO - Environmental Health
JF - Environmental Health
M1 - 9
ER -