Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.442
Filtrar
1.
Medicine (Baltimore) ; 99(7): e19015, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049797

RESUMO

Non-Hodgkin lymphoma (NHL) can co-exist with autoimmune hemolytic anemia (AIHA), a phenomenon known as AIHA-associated NHL (AIHA/NHL). However, few studies have reported AIHA/NHL incidence or its clinical characteristics. We conducted a retrospective analysis of 20 AIHA/NHL patients treated at our hospital from 2009 to 2018. AIHA/NHL was presented by only 0.91% of the NHL and 9.8% of the AIHA patients. In addition, AIHA occurred most frequently with angioimmunoblastic T-cell lymphoma (AITL) (7.31%), followed by marginal zone B-cell lymphoma (MZBL) (6.25%), B-cell lymphoma-unclassified (BCL-U) (4.25%), chronic lymphocytic leukemia/small lymphocyte lymphoma (CLL/SLL) (2.50%), and mantle cell lymphoma (MCL) (2.30%). In addition to the CLL/SLL patients with impaired bone marrow, 66.7% of the AIHA/NHL patients had lymphoma bone marrow infiltration (LBMI), of which 4 patients presented LBMI in bone marrow smears (BMS) but not in bone marrow biopsy (BMB) and 6 were positive for BMB but not BMS. The 1-, 3- and 5-year survival rates of AIHA/NHL patients were 70%, 30% and 20%, respectively, and they responded poorly to chemotherapy. In conclusion, AIHA can co-exist with various NHLs and the defining clinical characteristic of AIHA/NHL is the high incidence of LBMI. However, both BMS and BMB should be performed to avoid missed diagnosis.


Assuntos
Anemia Hemolítica Autoimune/epidemiologia , Medula Óssea/patologia , Linfoma não Hodgkin/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Hemolítica Autoimune/patologia , Biópsia , Feminino , Humanos , Incidência , Linfoma não Hodgkin/classificação , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida
2.
Med Lav ; 111(1): 63-73, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32096774

RESUMO

OBJECTIVE: We carried out a systematic review and meta-analysis of epidemiologic studies on the association between occupational exposure to glyphosate and risk of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). METHODS: We conducted a systematic search of the literature, and identified 18 relevant publications, from which we extracted results from seven non-overlapping studies of NHL and three of MM. We performed random-effects meta-analyses for ever-exposure to glyphosate, dose-response, and risk of specific NHL subtypes. RESULTS: The meta-relative risk (RR) of NHL was 1.03 (95% confidence interval [CI] 0.86-1.21), that of MM was 1.04 (95% CI 0.67-1.41). The meta-RR of NHL for highest category of exposure was 1.49 (95% CI 0.37-2.61; 3 studies). The meta-RR for diffuse large B-cell lymphoma (DLBCL) was 1.31 (95% CI 0.93-1.75); that for follicular lymphoma was 0.82 (95% CI 0.93-1.70), and that for chronic lymphocytic leukemia was 0.85 (95% CI 0.20-1.49). There was indication of publication bias for studies on NHL. CONCLUSIONS: Our meta-analysis provided no overall evidence of an increased risk for both NHL and MM in subjects occupationally exposed to glyphosate. In secondary analyses we detected a small increase in risk for the category with highest level of exposure as well as for DLBCL. The evidence of publication bias suggests caution in the interpretation of the results.


Assuntos
Glicina/análogos & derivados , Linfoma não Hodgkin , Mieloma Múltiplo , Exposição Ocupacional , Glicina/toxicidade , Humanos , Linfoma não Hodgkin/epidemiologia , Mieloma Múltiplo/epidemiologia , Fatores de Risco
3.
Int J Cancer ; 146(4): 977-986, 2020 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-31077355

RESUMO

Since 1960, incidence of non-Hodgkin's lymphoma (NHL) has been increasing in most industrialized countries, but causes of this trend remain unclear. A role of the decreased exposure to infectious agents during childhood has been proposed. Our study evaluates the association between common childhood infectious diseases and the risk of NHL and its major subtypes by a reanalysis of the Italian multicenter case-control study. After exclusion of next-of-kin interviews, 1,193 cases, diagnosed between 1990 and 1993, and 1,708 population-based controls were included in the analyses. OR estimates were obtained by logistic regression, adjusting for gender, age, residence area, education, smoking habit and exposure to radiations, pesticides and aromatic hydrocarbons. Among B-cell lymphomas (n = 1,102) an inverse association was observed for rubella (OR = 0.80, 95% CI: 0.65-0.99), pertussis (OR = 0.74, 95% CI: 0.62-0.88) and any infection (OR = 0.75, 95% CI: 0.61-0.93). A negative trend by number of infections was observed, which was more evident among mature B-cell lymphoma (OR = 0.66 for three infections or more, 95% CI: 0.48-0.90). Our results indicate a potential protective role of common childhood infections in the etiology of B-cell NHL.


Assuntos
/epidemiologia , Linfoma não Hodgkin/epidemiologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Varicela/epidemiologia , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Sarampo/epidemiologia , Pessoa de Meia-Idade , Caxumba/epidemiologia , Risco , Rubéola (Sarampo Alemão)/epidemiologia , Coqueluche/epidemiologia , Adulto Jovem
4.
Support Care Cancer ; 28(1): 113-122, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30993450

RESUMO

PURPOSE: Limited information is available regarding elderly patients experiencing febrile neutropenia (FN). This study evaluated FN-related care among elderly cancer patients who received high/intermediate FN-risk chemotherapy and experienced ≥ 1 FN episodes. METHODS: We used Medicare data to identify patients aged ≥ 66 years who initiated high/intermediate FN-risk chemotherapy between 1 January 2008 and 31 August 2015 to treat breast cancer (BC), lung cancer (LC), or non-Hodgkin lymphoma (NHL) and had ≥ 1 FN episodes. We identified within-cycle FN episodes for each chemotherapy cycle on Part A inpatient claims or outpatient or Part B claims. We described the FN-related care setting (inpatient hospital, outpatient emergency department [ED], or outpatient non-ED) and reported mean total cost of FN-related care per episode overall and by care setting (adjusted to 2015 US$). RESULTS: We identified 2138, 3521, and 2862 patients with BC, LC, and NHL, respectively, with ≥ 1 FN episodes (total episodes: 2407, 3840, 3587, respectively). Most FN episodes required inpatient care (BC, 88.1%; LC, 93.0%; NHL, 93.2%) with mean hospital length of stay (LOS) 6.2, 6.5, and 6.8 days, respectively. Intensive care unit admission was required for 20.4% of BC, 29.0% of LC, and 25.7% of NHL hospitalizations (mean LOS: 4.7, 4.7, 5.5 days, respectively). The mean total cost of FN care per episode was $11,959 BC, $14,388 LC, and $15,006 NHL, with inpatient admission the costliest care component ($11,826; $14,294; and $14,873; respectively). CONCLUSIONS: Among elderly patients with BC, LC, or NHL who experienced FN, most FN episodes required costly hospital care, highlighting the FN burden on healthcare systems.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Neutropenia Febril Induzida por Quimioterapia/economia , Neutropenia Febril Induzida por Quimioterapia/terapia , Custos de Cuidados de Saúde , Neoplasias Pulmonares/tratamento farmacológico , Linfoma não Hodgkin/tratamento farmacológico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/economia , Neoplasias da Mama/epidemiologia , Neutropenia Febril Induzida por Quimioterapia/epidemiologia , Custos e Análise de Custo , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Serviços de Saúde para Idosos/economia , Serviços de Saúde para Idosos/estatística & dados numéricos , Humanos , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Neoplasias Pulmonares/economia , Neoplasias Pulmonares/epidemiologia , Linfoma não Hodgkin/economia , Linfoma não Hodgkin/epidemiologia , Masculino , Medicare/economia , Estudos Retrospectivos , Estados Unidos/epidemiologia
5.
Int J Cancer ; 146(3): 839-849, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31001807

RESUMO

Specific organochlorines (OCs) have been associated with non-Hodgkin lymphoma (NHL) with varying degrees of evidence. These associations have not been evaluated in Asia, where the high exposure and historical environmental contamination of certain OC pesticides (e.g., dichlorodiphenyltrichloroethane [DDT], hexachlorocyclohexane [HCH]) are different from Western populations. We evaluated NHL risk and prediagnostic blood levels of OC pesticides/metabolites and polychlorinated biphenyl congeners in a case-control study of 167 NHL cases and 167 controls nested within three prospective cohorts in Shanghai and Singapore. Conditional logistic regression was used to analyze lipid-adjusted OC levels and NHL risk. Median levels of p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), the primary DDT metabolite, and ß-HCH were up to 12 and 65 times higher, respectively, in samples from the Asian cohorts compared to several cohorts in the United States and Norway. An increased risk of NHL was observed among those with higher ß-HCH levels both overall (3rd vs. 1st tertile OR = 1.8, 95%CI = 1.0-3.2; ptrend = 0.049) and after excluding cases diagnosed within 2 years of blood collection (3rd vs. 1st tertile OR = 2.0, 95%CI = 1.1-3.9; ptrend = 0.03), and the association was highly consistent across the three cohorts. No significant associations were observed for other OCs, including p,p'-DDE. Our findings provide support for an association between ß-HCH blood levels and NHL risk. This is a concern because substantial quantities of persistent, toxic residues of HCH are present in the environment worldwide. Although there is some evidence that DDT is associated with NHL, our findings for p,p'-DDE do not support an association.


Assuntos
Poluentes Ambientais/sangue , Hidrocarbonetos Clorados/sangue , Linfoma não Hodgkin/epidemiologia , Praguicidas/sangue , Idoso , Estudos de Casos e Controles , China/epidemiologia , Poluentes Ambientais/efeitos adversos , Feminino , Seguimentos , Humanos , Hidrocarbonetos Clorados/efeitos adversos , Linfoma não Hodgkin/sangue , Linfoma não Hodgkin/etiologia , Masculino , Pessoa de Meia-Idade , Praguicidas/efeitos adversos , Estudos Prospectivos , Fatores de Risco , Singapura/epidemiologia
6.
Chemosphere ; 235: 969-975, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31561313

RESUMO

Polychlorinated biphenyls (PCB) have been classified by the International Agency for Research on Cancer (IARC) in Group 1 as carcinogenic to human, based on sufficient evidence in humans of an increased risk of cutaneous malignant melanoma and limited evidence for non-Hodgkin lymphoma (NHL). However present findings on the association of PCB exposure and NHL are still controversial. This study examined the relationship between PCB serum levels and risk of NHL in a Northern Italy area (Brescia province), where a chemical factory produced PCBs from 1938 to 1984, causing human contamination. A case-control study of 215 NHL patients and 215 control subjects was conducted. Cases and controls were assayed for serum levels of 33 PCB congeners. No associations were found between risk of NHL and serum levels of total PCBs (OR = 0.51; 95% CI: 0.25-1.04 for highest vs lowest quartile) or specific PCB congeners. The study confirmed a strong association of NHL with HCV infection (OR = 3.60; 95% CI: 1.30-10.02). This case-control study does not support the hypothesis of an association between current serum levels of PCBs and NHL development in the general population.


Assuntos
Poluentes Ocupacionais do Ar/sangue , Hospitais/estatística & dados numéricos , Linfoma não Hodgkin/sangue , Linfoma não Hodgkin/etiologia , Exposição Ocupacional/efeitos adversos , Bifenilos Policlorados/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Itália/epidemiologia , Linfoma não Hodgkin/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
7.
Eur Arch Otorhinolaryngol ; 276(10): 2873-2879, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286184

RESUMO

PURPOSE: We aimed to investigate the frequency and clinicopathological features of oral NHL in our institution as well as to compare the data gathered from other oral pathology and general pathology services published in the literature. METHODS: Clinical records of patients diagnosed with NHL exclusively affecting the oral cavity were reviewed from 1997 to 2017. Additionally, a review of the literature over a 20-year period was conducted aiming to examine articles on oral NHLs. RESULTS: Oral NHLs represented 0.1% (n = 98) of the total number of biopsies (68,229) received during the period evaluated (1997-2017). The mean age at the diagnosis was 47 years. Most patients were white (67.3%). A nodular lesion was the most frequent presentation (54.9%) and pain was described in 47.1% of the cases. The most common diagnosis was diffuse large B cell lymphoma (42%) followed by plasmablastic lymphoma (24%). Only 19 articles were included in the review of the literature. CONCLUSIONS: Although NHLs are rare in the oral cavity, clinicians and surgeons have an important role in promptly diagnosing lymphomatous lesions to refer the patient to a proper treatment.


Assuntos
Linfoma Difuso de Grandes Células B , Linfoma não Hodgkin , Neoplasias Bucais , Boca/patologia , Linfoma Plasmablástico , Adulto , Biópsia/métodos , Brasil/epidemiologia , Detecção Precoce de Câncer , Feminino , Humanos , Linfoma Difuso de Grandes Células B/epidemiologia , Linfoma Difuso de Grandes Células B/patologia , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/patologia , Linfoma Plasmablástico/epidemiologia , Linfoma Plasmablástico/patologia , Estudos Retrospectivos , Literatura de Revisão como Assunto
8.
Medicine (Baltimore) ; 98(26): e16129, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261533

RESUMO

Individuals infected with human immunodeficiency virus (HIV) have higher morbidity and mortality due to cancer, which is the third most common cause of death in this group, despite the high effectiveness of antiretroviral therapy (ART). We describe the clinical and laboratory characteristics, initial staging and outcome of HIV-related lymphoma.We included 18 patients in the study, of whom 61.1% were male, mean age 41 years. Nine of the 18 patients (50%) had a diagnosis of HIV infection concurrent with the diagnosis of lymphoma.The most common histological types were diffuse non-Hodgkin B-cell lymphoma, 8 patients (44.4%); and Burkitt lymphoma, 5 (27.8%) cases. The Cotswold revision of the Ann Arbor staging classification in 14 patients (77.7%) was between III and IV. B Symptoms were present in 11 patients (61.1%), bulky mass was observed in 11 cases (61.1%) and had extra-nodal involvement in 8 patients (44.4%).Of the 18 cases analyzed, 8 followed on to second-line treatment, wherein the CODOX-M/IVAC scheme (cyclophosphamide, adriamycin, vincristine, methotrexate/ifosfamide, etoposide, and cytosine arabinoside) was used in 3 of the cases. The second most common scheme was etoposide, doxorubicin, vincristine and cyclophosphamide (EPOCH), used in 2 cases (25%), while in single cases (12.5% each) cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (CHOEP), ifosfamide, etoposide, and carboplatin (ICE) and dexamethasone, cisplatin, and cytarabine (DHAP) were used.In this series, we observed very high mortality, equivalent to 44.4%, and a complete response in only 11.1%, much lower than that observed by other authors.We found that patients diagnosed with lymphoma associated with HIV had an advanced early clinical staging, and evolved with low response rates to chemotherapy.


Assuntos
Linfoma Relacionado a AIDS/epidemiologia , Linfoma Relacionado a AIDS/terapia , Adulto , Antineoplásicos/uso terapêutico , Linfoma de Burkitt/epidemiologia , Linfoma de Burkitt/patologia , Linfoma de Burkitt/terapia , Feminino , Humanos , Linfoma Relacionado a AIDS/patologia , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/terapia , Masculino , Estadiamento de Neoplasias , Estudos Retrospectivos
9.
Rev Epidemiol Sante Publique ; 67(5): 319-327, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31327522

RESUMO

BACKGROUND: Non-Hodgkin's lymphomas (NHL) are the seventh most commonly diagnosed cancer in France. Nord-Pas-de-Calais is ranked as the region with the highest incidence of cancers and deaths by cancer in France. With its rich industrial past and its contrasted population densities between urban and rural territories, Nord-Pas-de-Calais represents a geographic area of interest to study the overall incidence of NHL and examine spatial variation of NHL incidence between the 170 cantons of the region. METHODS: LYMPHONOR was a population-based multicentre retrospective study of patients residing in the Nord-Pas-de-Calais region and diagnosed with NHL between January 2001 and December 2005. Spatial distribution of NHL incidence in Nord-Pas-de-Calais was explored using two complementary approaches: adjusted smoothed standardised incidence ratio (SIR) and spatial scan statistics (detection of atypical clusters). RESULTS: Between 2001 and 2005, 2132 new cases of NHL were diagnosed in the Nord-Pas-de-Calais region. In 2005, age-standardised NHL incidence rates were 10.2 and 7.0 cases per 100,000 person-years in male and female residents, respectively. No significant spatial disparities in NHL incidence were found within the Nord-Pas-de-Calais region. The age-adjusted smoothed SIR varied from 0.82 to 1.25 between cantons. Consistently, spatial scan statistics did not detect any significant atypical cluster of high NHL incidence. CONCLUSION: Comparison with national data collected during the same period does not show an overincidence of NHL in the Nord-Pas-de-Calais region. In addition, no evidence for spatial heterogeneity and clustering of NHL incidence was found within this region. Future epidemiological research using large-scale registries is needed to better appraise spatial variation of NHL incidence in France and to investigate possible reasons for significant clusters.


Assuntos
Linfoma/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , França/epidemiologia , Humanos , Incidência , Lactente , Linfoma não Hodgkin/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Análise Espacial , Adulto Jovem
10.
BMC Res Notes ; 12(1): 418, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307540

RESUMO

OBJECTIVE: Non-Hodgkin lymphomas (NHL) are a group of neoplastic lymphoproliferative disorders, in which, its clinical spectrum, primary extra nodal variety, histopathology and Immunohistochemistry, remain lacking in Saudi Arabia. We aimed to assess the clinicopathologic patterns of NHL and the utility and diagnostic role of IHC immunophenotyping. RESULTS: Patients > 60 years of age had the highest incidence of NHL; male: female ratio was 1.27:1. The incidence of NHL has shown a steady increase in the Aseer region from 2011 to 2014. Twenty-Five percent of our patients presented with advanced disease (Stage IV). A total of 52% of patients presented with constitutional symptoms, while 43% showed generalized lymphadenopathy. Nearly half of our patients (49%) had primary NHL of extra nodal variety, where the stomach was the most commonly involved organ (13 cases). Diffuse large B cell lymphoma was the most common subtype of NHL in our population (59%). Most patients (82%) were positive for CD20 surface marker, while 60% were positive for CD45.


Assuntos
Linfoma não Hodgkin/patologia , Neoplasias Gástricas/patologia , Adolescente , Adulto , Antígenos CD20/metabolismo , Criança , Pré-Escolar , Feminino , Humanos , Imuno-Histoquímica , Imunofenotipagem , Incidência , Lactente , Recém-Nascido , Antígenos Comuns de Leucócito/metabolismo , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/metabolismo , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Arábia Saudita/epidemiologia , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/metabolismo , Adulto Jovem
11.
Hematology ; 24(1): 527-532, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31262228

RESUMO

Background: Diabetes mellitus (DM) is considered to be a risk factor in the prognosis of many types of cancer, but the effect of DM on the risk of non-Hodgkin lymphoma (NHL) is still under dispute. We performed this study to examine the association between DM and subsequent NHL risk. Methods: A systematically search had been performed in PubMed, EmBase, and the Cochrane Library to identify eligible studies from inception to September 2018. Results: Thirteen cohort studies were included, with a total of 9024761 participants. The results showed that DM was associated with an increased risk of NHL (RR = 1.15, 95%CI: 1.02, 1.30, P = .03). Subgroup analyses suggested that DM was significantly associated with patients aged less than 60 years old (RR = 1.65, 95%CI: 1.31, 2.09, P < .0001), follow-up duration within 8 years (RR = 1.23, 95%CI: 1.02, 1.48, P = .03), and studies adjusted for body mass index (RR = 1.35, 95%CI: 1.01, 1.79, P = .04). The analyses within DM patients indicated that DM men were more likely to develop NHL than DM women (RR = 1.31, 95%CI: 1.04, 1.65, P = .02). Conclusions: These results indicated that DM patients have significantly increased risk of NHL compared nondiabetics. Male DM patients were more likely to develop NHL compared with female. However, further large-scale studies are required to eliminate miscellaneous factors in all included studies.


Assuntos
Diabetes Mellitus/epidemiologia , Linfoma não Hodgkin/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Suscetibilidade a Doenças , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Risco , Fatores Sexuais
12.
Cancer Causes Control ; 30(8): 889-900, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31165419

RESUMO

PURPOSE: To conduct a pooled analysis assessing the association of blood transfusion with risk of non-Hodgkin lymphoma (NHL). METHODS: We used harmonized data from 13 case-control studies (10,805 cases, 14,026 controls) in the InterLymph Consortium. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression, adjusted for study design variables. RESULTS: Among non-Hispanic whites (NHW), history of any transfusion was inversely associated with NHL risk for men (OR 0.74; 95% CI 0.65-0.83) but not women (OR 0.92; 95% CI 0.83-1.03), pheterogeneity = 0.014. Transfusion history was not associated with risk in other racial/ethnic groups. There was no trend with the number of transfusions, time since first transfusion, age at first transfusion, or decade of first transfusion, and further adjustment for socioeconomic status, body mass index, smoking, alcohol use, and HCV seropositivity did not alter the results. Associations for NHW men were stronger in hospital-based (OR 0.56; 95% CI 0.45-0.70) but still apparent in population-based (OR 0.84; 95% CI 0.72-0.98) studies. CONCLUSIONS: In the setting of a literature reporting mainly null and some positive associations, and the lack of a clear methodologic explanation for our inverse association restricted to NHW men, the current body of evidence suggests that there is no association of blood transfusion with risk of NHL.


Assuntos
Transfusão de Sangue , Linfoma não Hodgkin/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Adulto Jovem
13.
Diabetes Metab ; 45(5): 458-464, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31129317

RESUMO

BACKGROUND: Whether metformin use might affect the risk of non-Hodgkin lymphoma (NHL) remained to be answered. METHODS: A total of 610,089 newly diagnosed type 2 diabetes patients with 2 or more times of prescription of antidiabetic drugs during 1999-2009 were enrolled from Taiwan's National Health Insurance database. They were followed up for NHL incidence until December 31, 2011. Both intention-to-treat and per-protocol analyses were conducted. Cox regression incorporated with the inverse probability of treatment-weighting using propensity scores was used to estimate hazard ratios. RESULTS: There were 414,783 metformin initiators and 195,306 non-metformin initiators within the initial 12-month of prescriptions of antidiabetic drugs. After a median follow-up of 5.07 years in metformin initiators and 6.78 years in non-metformin initiators, 1076 and 755 patients were diagnosed of new-onset NHL, respectively. The respective incidence was 47.74 and 57.68 per 100,000 person-years and the hazard ratio for metformin initiators versus non-metformin initiators was 0.849 (95% confidence interval 0.773-0.932) in the intention-to-treat analysis. In the per-protocol analysis, the hazard ratio was 0.706 (95% confidence interval 0.616-0.808). Sensitivity analyses after excluding patients with irregular follow-up, with an extension of minimal observation periods of 24 or 36 months, with incretin-based therapies, or in patients enrolled during 2 different periods (i.e., 1999-2003 and 2004-2009) consistently showed a lower risk among metformin initiators in both the intention-to-treat and the per-protocol analyses. CONCLUSIONS: Metformin use is associated with a lower risk of NHL compared with non-metformin antidiabetics.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Hipoglicemiantes/uso terapêutico , Linfoma não Hodgkin/epidemiologia , Metformina/uso terapêutico , Adulto , Idoso , Comorbidade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Taiwan/epidemiologia
14.
PLoS One ; 14(4): e0216284, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31034511

RESUMO

PURPOSE: This meta-analysis aimed to extensively investigate the association between various measures of vitamin D status and non-Hodgkin lymphoma (NHL) and its subtypes. METHODS: We searched MEDLINE (PubMed), Embase, and the Cochrane Library in February 2018. Two authors independently reviewed and selected articles based on predetermined criteria. RESULTS: A total of 30 studies with 56,458 NHL cases were finally selected, with 24, 9, and 3 studies on sunlight/ultraviolet radiation (UVR) exposure, dietary intake, and serum/plasma 25-hydroxyvitamin D levels, respectively. Significant protective effects of overall sunlight/UVR exposure on NHL and subtypes were observed, with summary relative risks (RRs) ranging from 0.67-0.80 (RR for NHL = 0.80; 95% confidence interval [CI]: 0.71-0.90) among subjects with high exposure compared to those with low exposure. The results were consistent with various classifications of sunlight/UVR exposure. In contrast, when exposure measures of dietary vitamin D intake (RR for NHL = 1.03; 95% CI: 0.90-1.19) and serum/plasma 25-hydroxyvitamin D levels (RR for NHL = 0.97; 95% CI: 0.82-1.15) were used, risk estimates were inconsistent or non-significant for NHL and the subtypes. CONCLUSION: While risk estimates varied by different measures of vitamin D status, a protective effect of sunlight/UVR exposure on NHL incidence was verified, across most of the tested subtypes as well as exposure categories.


Assuntos
Linfoma não Hodgkin/sangue , Linfoma não Hodgkin/epidemiologia , Vitamina D/sangue , Humanos , Incidência , Fatores de Risco , Raios Ultravioleta
15.
Am J Clin Oncol ; 42(5): 454-458, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30950860

RESUMO

INTRODUCTION: Primary pancreatic lymphoma (PPL) is an extranodal manifestation of non-Hodgkin lymphoma originating in the pancreas, which constitutes <1% of all pancreatic neoplasms. Because of the rarity of the disease, most data on PPL are derived from case reports and small case series. To provide better insight into the epidemiology, treatment, and outcomes of these patients, we conducted an analysis of patients with PPL from the Surveillance, Epidemiology and End Results (SEER) database, which is presented in this study. METHODS: Patients with PPL were identified using the International Classification of Disease for Oncology, third edition histology codes for lymphoma (9590/3-9734/3), with pancreas (C25.0-C25.9) listed as the primary disease site. We collected data on patient demographics, year of diagnosis, primary tumor site, histology, first line of treatment received, and survival until death or last follow-up for the period 1973-2014. RESULTS: Overall, 835 patients were included. The median (range) age of the study population was 67 (2 to 98) years. The median (95% confidence interval) overall survival for the cohort was 53 (37 to 73) months. On univariable analyses, age, stage, and use of chemotherapy were statistically associated with improved overall survival. Besides these factors, white race was associated with improved cause-specific survival on multivariable analysis. CONCLUSIONS: This large population-based series describes PPL in detail. Younger age, white race, early stage, and initial treatment with chemotherapy are associated with improved survival in patients with PPL.


Assuntos
Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/patologia , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/patologia , Adulto , Idoso , Terapia Combinada , Bases de Dados Factuais , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Linfoma não Hodgkin/terapia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Neoplasias Pancreáticas/terapia , Prevalência , Prognóstico , Modelos de Riscos Proporcionais , Medição de Risco , Programa de SEER , Análise de Sobrevida , Estados Unidos , Adulto Jovem
16.
Cancer Causes Control ; 30(5): 477-488, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30888569

RESUMO

PURPOSE: Primary central nervous system lymphoma (PCNSL) in patients living with HIV (PLWH) is a distinct entity; however, the management is adopted from patients without HIV. The study aims to examine the differences in presentation, treatment, and outcomes of PCNSL patients with or without HIV. METHODS: We retrospectively compared the characteristics of 144 patients with PCNSL with and without HIV, and analyzed factors associated with overall and progression-free survival. Results were compared to the Central Brain Tumor Registry of the United States (CBTRUS) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) system. RESULTS: Among all patients with PCNSL, 19% had HIV. PLWH were younger (38 vs. 63 years; p < 0.01) and more likely to be African American (59% vs. 7%; p < 0.01) and male (74% vs. 49%; p = 0.02) than patients without HIV. PLWH were more likely to have multiple lesions (67% vs. 43%; p = 0.02), hemorrhage (59 vs. 37%; p = 0.03), and peripheral rim enhancement (57% vs. 7%; p < 0.01) on imaging; to receive palliative care (15% vs. 2%) or whole brain radiation (63% vs. 3%); and less likely to receive chemotherapy (22% vs. 95%) (p < 0.01). Twenty-four patients, none PLWH, underwent stem cell transplant. Not receiving transplant was an independent factor in mortality and disease progression. Our cohort of patients, compared to the national database, were younger (60 vs. 65 years), 58% were white vs. 75%, and had longer median overall survival 43 vs. 25 months. CONCLUSION: Epidemiology, imaging, and treatment options for patients with PCNSL with and without HIV differ, but HIV was not an independent factor of mortality or disease progression. More efforts are needed to improve access to research and treatment options for PLWH with PCNSL.


Assuntos
Neoplasias Encefálicas/epidemiologia , Neoplasias do Sistema Nervoso Central/epidemiologia , Infecções por HIV/epidemiologia , Linfoma não Hodgkin/epidemiologia , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Sistema de Registros , Estudos Retrospectivos , Estados Unidos/epidemiologia
17.
Infez Med ; 27(1): 53-57, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30882379

RESUMO

We report the sharp reduction in the incidence of AIDS defining cancers in a multicentric, retrospective study carried out since 1991 and involving six Infectious Diseases Units spread across Italy. However, due to the parallel increase in non-AIDS defining cancers, cancer incidence was not reduced. Focusing on predictors of death in HIV-positive patients with neoplastic disease, multivariate models revealed that males as well as drug abusers were independently associated with a poor clinical outcome.


Assuntos
Síndrome de Imunodeficiência Adquirida/complicações , Neoplasias/epidemiologia , Adulto , Análise de Variância , Neoplasias do Ânus/epidemiologia , Carcinoma Hepatocelular/epidemiologia , Estudos de Casos e Controles , Neoplasias do Sistema Nervoso Central/epidemiologia , Feminino , Infecções por HIV/complicações , Sobreviventes de Longo Prazo ao HIV , Humanos , Incidência , Itália/epidemiologia , Leucemia/epidemiologia , Neoplasias Hepáticas/epidemiologia , Linfoma/epidemiologia , Linfoma não Hodgkin/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Sarcoma de Kaposi/epidemiologia , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias , Neoplasias do Colo do Útero/epidemiologia
18.
Hematol Oncol ; 37(3): 261-269, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30916804

RESUMO

Survival rates of patients with non-Hodgkin lymphoma (NHL) have improved over the last decade. However, cardiotoxicities remain important adverse consequences of treatment with chemotherapy and radiation, although the burden of cardiovascular mortality (CVM) in such patients remains unknown. We conducted a retrospective cohort study of patients greater than or equal to 20 years of age diagnosed with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) between 2000 and 2013 using data extracted from the United States Surveillance, Epidemiology, and End Results (SEER) database. Our primary endpoint was CVM. The association between NHL and CVM was evaluated using multivariable Cox regression analysis after adjusting for other patient characteristics. We calculated standardized mortality ratios (SMRs) for CVM, comparing NHL patients with the general population. We identified 153 983 patients who met the inclusion criteria (69 329 with DLBCL, 48 650 with CLL/SLL, and 36 004 with FL). The median follow-up was 37 months (interquartile range, 10-78 months); the mean patient age was 66.24 (±14.69) years; 84 924 (55.2%) were men; 134 720 (87.5%) were White, and 131 912 (85.7%) did not receive radiation therapy. Overall, 9017 patients (5.8%) died from cardiovascular disease, and we found that NHL patients had a higher risk of CVM than the general population, after adjusting for age (SMR 15.2, 95% confidence interval: 14.89-15.52). The rates of CVM were 5.1%, 8%, and 4.4% in patients with DLBCL, CLL/SLL, and FL, respectively. Furthermore, across all NHL subtypes, older age, higher stage at the time of diagnosis (particularly stage 4), male sex, and living in the south were associated with higher risks of CVM. Our data suggest that risk assessment and careful cardiac monitoring are recommended for NHL patients, particularly those with the CLL/SLL subtypes.


Assuntos
Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/mortalidade , Linfoma não Hodgkin/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/epidemiologia , Leucemia Linfocítica Crônica de Células B/mortalidade , Linfoma Folicular/complicações , Linfoma Folicular/epidemiologia , Linfoma Folicular/mortalidade , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/epidemiologia , Linfoma Difuso de Grandes Células B/mortalidade , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/mortalidade , Masculino , Pessoa de Meia-Idade , Mortalidade , Estadiamento de Neoplasias , Estudos Retrospectivos , Medição de Risco , Programa de SEER , Resultado do Tratamento , Estados Unidos , Adulto Jovem
19.
Vet J ; 245: 70-76, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30819429

RESUMO

Lymphoma is one of the most common neoplasms in dogs and it is one of the top five causes of cancer-related deaths, similar to human lymphoma. Companion animal epidemiological studies define dogs as sentinels of potential risk factors for human health, mainly due to shared environments, shorter disease latencies, and spontaneous disease. The aims of this study were to describe human and canine epidemiologic features of non-Hodgkin's lymphoma (NHL) and their similarities, and to investigate a possible geographical association in the incidence risks in the Greater Porto area, in north-western Portugal. The postal codes of human NHL patients diagnosed between 2005 and 2010 residing in the Greater Porto, Portugal, were obtained from North and Central Region Cancer Registries of Portugal. Available data from dogs diagnosed with lymphoma between 2005 and 2016 from several veterinary centres were also collected. Descriptive epidemiology, mapping cases, and age-standardised risks of NHL incidence (ASR) were determined for both species. The results showed a higher risk (P<0.05) of NHL in men (ASR men: 18.1 cases/100,000 inhabitants; women: 14.2 cases/100,000 inhabitants) and in male dogs (ASR males: 82 cases/100,000 dogs; females: 70 cases/100,000 dogs). The geographical distribution of human and canine ASR was well correlated (r=0.664, P<0.05), with the highest values for human and canine ASR detected in the same urban municipalities of the Greater Porto: Porto, Matosinhos and Maia. These findings suggest the existence of exposure similarities, supporting the relevance of cancer surveillance in pet animals as efficient tools to predict health hazards for humans.


Assuntos
Doenças do Cão/epidemiologia , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/veterinária , Adolescente , Adulto , Fatores Etários , Idoso , Animais , Criança , Pré-Escolar , Cães , Feminino , Humanos , Imunofenotipagem , Lactente , Recém-Nascido , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Portugal/epidemiologia , Sistema de Registros , Fatores de Risco , Fatores Sexuais , População Urbana
20.
Saudi Med J ; 40(3): 277-286, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30834424

RESUMO

OBJECTIVES: To describe the trends in the incidence rates of 5 most common cancers, communicable diseases, and non-communicable diseases in Saudi Arabia over the last decade.  Methods: The incidence rates of cancers (2001-2014), communicable diseases (2003-2016), and non-communicable diseases (1990-2017) were retrieved, classified, and analyzed retrospectively during November 2017, based on data available with the Ministry of Health and were analyzed at the Imam Abdulrahman Bin Faisal University in Dammam, Kingdom of Saudi Arabia. Results: Age-standardized incidence rate (ASR) (per 100,000 population) of breast cancer among women increased dramatically from 11.8 in 2001 to 22.7 in 2014, indicating a 92.4% increase over the decade. Colorectal cancer incidence was the highest among men, and its ASR per 100,000 population increased from 5.0 to 10.6 in men and from 5.0 to 8.2 in women. Among communicable diseases, incidences of hepatitis B, measles, chickenpox, and brucellosis decreased while dengue fever increased. An alarming increase was observed in the incidence rate of non-communicable diseases namely, obesity, diabetes, and hypertension. Conclusion: The incidence rate of non-communicable diseases increased over the decade and was associated with increased mortality and disability, reduced quality of life, and increased health-care costs, indicating an urgent need to establish prevention and control programs. The rising trend in the incidence of cancers may also become a health care issue in Saudi Arabia in the coming years.


Assuntos
Doenças Transmissíveis/epidemiologia , Neoplasias/epidemiologia , Doenças não Transmissíveis/epidemiologia , Neoplasias da Mama/epidemiologia , Brucelose/epidemiologia , Varicela/epidemiologia , Neoplasias Colorretais/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Dengue/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Hepatite B/epidemiologia , Humanos , Hipertensão/epidemiologia , Incidência , Leucemia/epidemiologia , Pneumopatias/epidemiologia , Linfoma não Hodgkin/epidemiologia , Masculino , Sarampo/epidemiologia , Obesidade/epidemiologia , Arábia Saudita/epidemiologia , Fatores Sexuais , Neoplasias da Glândula Tireoide/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA