Changes in the descriptive epidemiology of non-Hodgkin's lymphoma in Great Britain?

The problems associated with a diagnosis of non-Hodgkin's lymphoma are reviewed in the context of an apparent rise in incidence. It is concluded that a true rise exists and that further work is required to fully understand the significance of this.

Acute myeloid leukemia in adults: a case-control study in Yorkshire.

This paper reports the results of a case-control analysis of 161 cases of acute myeloid leukemia and 310 matched hospital controls. The patients were interviewed between 1982 and 1986. The study shows a weak association for cases with previous malignant disease. Furnace workers show excess risks. Urticaria and vertigo are in excess, as well as some aspects of family medical histories, including multiple sclerosis and cases of leukemia/lymphoma in blood relations.

The leukaemia research fund data collection survey: the incidence and geographical distribution of acute myeloid leukemia.

This paper reports on the 2,362 cases of acute myeloid leukemia (AML) accumulated by the Leukaemia Research Fund Data Collection Survey between January 1, 1984, and June 30, 1988 providing the recent geographical distribution and descriptive epidemiology of the AML group of conditions. Statistical approaches to this data set are described. The study shows sex differences in distribution for those aged under 55 years compared to older age groups, with variable male: female incidence in different age bands and a male excess in those over 55 years. A nonsignificant excess of females was noted in those under 5 years. The rates presented for 1984-1986 are higher than those previously described for England and Wales. Statistically significant variation in incidence was seen both between counties and districts. At electoral ward level regression analyses were suggestive of links between AML and higher social class and living close to estuaries.

The Leukaemia Research Fund Data Collection Study: descriptive epidemiology of acute lymphoblastic leukemia.

This paper reports on cases of acute lymphoblastic leukemia (ALL) recorded by a specialist registry of hematopoietic malignancies. The cases have been diagnosed since January 1, 1984, and originate from certain parts of the United Kingdom. The information is analyzed by age, sex, and area of residence at diagnosis. The age distribution shows a childhood peak but fails to show an adult peak previously reported in literature from abroad. At a broad geographic level the county of Cumbria is shown to display the highest rates of ALL in all ages both in the 3 years of formal analyses (1984-1986) and in the 2 recent years. The administrative districts of Copeland, Sedgemoor, and North Devon also show excesses in all ages with Copeland having the highest SRR and level of statistical significance. This is a new observation for Copeland, the district containing the Sellafield nuclear reprocessing facility in that the high rates are for all ages of ALL. These new data were not considered in earlier official reports about that area. A regression analysis at electoral ward level shows no statistically significant association but excesses of cases, which are mirrored in a larger "all leukemias" data set, occur in wards near estuaries (a new observation) and in the upper socioeconomic groups.

Leukaemia Research Fund Data Collection Survey: descriptive epidemiology of chronic myeloid leukaemia.

This paper describes the recent epidemiology of chronic myeloid leukaemia occurring in selected parts of England and Wales. The overall rates for the pooled sexes is 1.0/10(5) per year and the geographical distributions described in this paper show remarkable homogeneity at county, district and electoral ward level. The implication of these observations is discussed.

Acute lymphoblastic leukaemia incidence in the UK by immunophenotype.

The incidence of acute lymphoblastic leukaemia (ALL) is described for both children and adults for the three major immunophenotypes: null, CD10-positive (CD+) which includes both common and pre-B types, and T-cell (including pre-T variants). The data are derived from a population-based specialist registry of leukaemias and lymphomas covering approximately one-half of England and Wales. Null ALL predominates in those under 1 year old and CD10+ ALL in the 1-7 year olds. There is a male excess at all ages for T-cell disease, which is particularly prominent in adolescents and young adults. The effect of socioeconomic levels is seen most clearly for CD10+ ALL in the childhood peak, where B-cell precursor disease occurs more frequently in areas of higher socioeconomic status.

Identification of human herpesvirus 6-specific DNA sequences in two patients with non-Hodgkin's lymphoma.

Human herpesvirus 6 (HHV-6) is a recently discovered virus which has not been causally linked to any particular disease. In order to investigate the possible role of this virus in the pathogenesis of lymphoid malignancies, we examined tissue samples from 117 patients for the presence of HHV-6-specific DNA sequences. Two cases of non-Hodgkin's lymphoma were found to be positive. One patient had a T cell lymphoma and a preceding history of angioimmunoblastic lymphadenopathy; the other had a B cell lymphoma occurring in the context of Sjögren's syndrome. HHV-6 has been isolated previously from a patient with angioimmunoblastic lymphadenopathy, and viral sequences have been identified in another patient with Sjögren's syndrome and B cell lymphoma. The relationship between HHV-6 and these conditions therefore warrants further investigation.

Increased frequency of HLA-DPB1*0301 in Hodgkin's disease suggests that susceptibility is HVR-sequence and subtype-associated.

Hodgkin's disease (HD) is a complex lymphoma-like disease which occurs as four main subtypes, nodular sclerosing (NS), mixed cellularity (MC), lymphocyte predominant (LP) and lymphocyte depleted (LD). Suggestions from epidemiological studies that HD may represent an unusual response to infection imply that the lack of previous response could be due to genetic factors. Following recent reports suggesting that there is an increased frequency of HLA-DPB1*0301 in Hodgkins disease, we have studied DPB1 in two series of patients using molecular typing methods. One series is a retrospective group of 118 patients over the age of 15 years from a single centre, and the other is a multi-centre prospective group of 45 patients between the age of 16 and 24 years. In both series, the percentage of HD patients with DPB1*0301 is greater than in the controls, confirming that this seems to be an HD-susceptibility allele. However, extension of the analysis in relation to HD subtype shows that the increase in *0301 is present in nodular sclerosing (NS), mixed cellularity (MC) and lymphocyte predominant patients (LP) HD patients, but preliminary evidence suggests an increase in *0401, and possibly *0501 in MC- and LP-HD. The DPB1 hypervariable region (HVR) amino-acid motif Asp55, Glu56 (*0301-like, HVR-C) is increased in NS compared with non-NS (ie MC+LP), whereas the frequency of Ala55, Ala56 (*0401-like) is increased in non-NS compared with NS. Conversely, Asp84, Glu85Ala86(*0301-like, HVR-F) motif is more frequent in NS than non-NS patients, but there is no increase in Gly84, Gly855, Pro86 (*0401-like). These findings suggest that genetic susceptibility in HD may reside at the level of HVR-encoded DPB1 peptide-binding residues, rather than with a specific allele, and that this may in some way influence the HD subtype.

Distribution of leukemia, lymphoma, and allied disease in parts of Great Britain: analysis by administrative districts and simulations of adjacencies. Leukaemia Research Fund 1984 Data Collection Group.

An analysis is presented of the distribution of cases of leukemia and allied disorders occurring in 151 administrative districts from England, Wales, and Scotland during 1984. The age-adjusted rates for certain conditions present an unusual pattern highlighting excessively high and low rates in parts of the country, some of which share contiguous boundaries. In particular, high rates for non-Hodgkin's lymphoma are found in rural Yorkshire districts, whereas leukemias and primary polycythemias are much more common in the Midland districts.

Leukaemia epidemiology and radiation risks.

This review deals with the associations between exposure to ionising and non-ionising irradiation and the risks of leukaemia. A systematic approach is adopted to enable the reader to disentangle the different types of exposure and their resultant effects (if any) on leukaemogenesis.