Ethnic variation in medical and lifestyle risk factors for B cell non-Hodgkin lymphoma: A case-control study among Israelis and Palestinians

Geffen Kleinstern, Rania Abu Seir, Riki Perlman, Areej Khatib, Ziad Abdeen, Husein Elyan, Ronit Nirel, Gail Amir, Asad Ramlawi, Fouad Sabatin, Paolo Boffetta, Eldad J. Dann, Meirav Kedmi, Martin Ellis, Arnon Nagler, Dina Ben Yehuda, Ora Paltiel

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Abstract

Background: Risk factors for B-cell non-Hodgkin lymphoma (B-NHL) have not been assessed among Palestinian Arabs (PA) and Israeli Jews (IJ). Methods: In a case-control study we investigated self-reported medical and lifestyle exposures, reporting odds ratios (ORs) and 95% confidence intervals [CIs], by ethnicity, for overall B-NHL and subtypes. Results: We recruited 823 cases and 808 healthy controls. Among 307 PA/516 IJ B-NHL cases (mean age at diagnosis = 51 [±17] versus 60 [±15] years, respectively) subtype distributions differed, with diffuse large B-cell lymphoma (DLBCL) being prominent among PA (71%) compared to IJ (41%); follicular lymphoma (FL), was observed in 14% versus 28%, and marginal zone lymphoma, in 2% versus 14%, respectively. Overall B-NHL in both populations was associated with recreational sun exposure OR = 1.43 [CI:1.07-1.91], black hair-dye use OR = 1.70 [CI:1.00-2.87], hospitalization for infection OR = 1.68 [CI:1.34-2.11], and first-degree relative with hematopoietic cancer, OR = 1.69 [CI:1.16-2.48]. An inverse association was noted with alcohol use, OR = 0.46 [CI:0.34-0.62]. Subtype-specific exposures included smoking (FL, OR = 1.46 [CI:1.01-2.11]) and >monthly indoor pesticide use (DLBCL, OR = 2.01 [CI:1.35-3.00]). Associations observed for overall B-NHL in PA only included: gardening OR = 1.93 [CI:1.39-2.70]; history of herpes, mononucleosis, rubella, blood transfusion (OR>2.5, P<0.01 for all); while for IJ risk factors included growing fruits and vegetables, OR = 1.87 [CI:1.11-3.15]; and self-reported autoimmune diseases, OR = 1.99 [CI:1.34-2.95]. Conclusions: In these geographically proximate populations we found some unique risk factors for B-NHL. Heterogeneity in the observed associations by ethnicity could reflect differences in lifestyle, medical systems, and reporting patterns, while variations by histology infer specific etiologic factors for lymphoma subtypes.

Original languageEnglish (US)
Article numbere0171709
JournalPloS one
Volume12
Issue number2
DOIs
StatePublished - Feb 1 2017

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non-Hodgkin lymphoma
B-Cell Lymphoma
case-control studies
Non-Hodgkin's Lymphoma
odds ratio
B-lymphocytes
lifestyle
Case-Control Studies
Life Style
risk factors
confidence interval
Odds Ratio
Cells
Confidence Intervals
lymphoma
Hair Dyes
Jews
Arabs
Histology
Vegetables

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Ethnic variation in medical and lifestyle risk factors for B cell non-Hodgkin lymphoma : A case-control study among Israelis and Palestinians. / Kleinstern, Geffen; Seir, Rania Abu; Perlman, Riki; Khatib, Areej; Abdeen, Ziad; Elyan, Husein; Nirel, Ronit; Amir, Gail; Ramlawi, Asad; Sabatin, Fouad; Boffetta, Paolo; Dann, Eldad J.; Kedmi, Meirav; Ellis, Martin; Nagler, Arnon; Yehuda, Dina Ben; Paltiel, Ora.

In: PloS one, Vol. 12, No. 2, e0171709, 01.02.2017.

Research output: Contribution to journalArticle

Kleinstern, G, Seir, RA, Perlman, R, Khatib, A, Abdeen, Z, Elyan, H, Nirel, R, Amir, G, Ramlawi, A, Sabatin, F, Boffetta, P, Dann, EJ, Kedmi, M, Ellis, M, Nagler, A, Yehuda, DB & Paltiel, O 2017, 'Ethnic variation in medical and lifestyle risk factors for B cell non-Hodgkin lymphoma: A case-control study among Israelis and Palestinians', PloS one, vol. 12, no. 2, e0171709. https://doi.org/10.1371/journal.pone.0171709
Kleinstern, Geffen ; Seir, Rania Abu ; Perlman, Riki ; Khatib, Areej ; Abdeen, Ziad ; Elyan, Husein ; Nirel, Ronit ; Amir, Gail ; Ramlawi, Asad ; Sabatin, Fouad ; Boffetta, Paolo ; Dann, Eldad J. ; Kedmi, Meirav ; Ellis, Martin ; Nagler, Arnon ; Yehuda, Dina Ben ; Paltiel, Ora. / Ethnic variation in medical and lifestyle risk factors for B cell non-Hodgkin lymphoma : A case-control study among Israelis and Palestinians. In: PloS one. 2017 ; Vol. 12, No. 2.
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abstract = "Background: Risk factors for B-cell non-Hodgkin lymphoma (B-NHL) have not been assessed among Palestinian Arabs (PA) and Israeli Jews (IJ). Methods: In a case-control study we investigated self-reported medical and lifestyle exposures, reporting odds ratios (ORs) and 95{\%} confidence intervals [CIs], by ethnicity, for overall B-NHL and subtypes. Results: We recruited 823 cases and 808 healthy controls. Among 307 PA/516 IJ B-NHL cases (mean age at diagnosis = 51 [±17] versus 60 [±15] years, respectively) subtype distributions differed, with diffuse large B-cell lymphoma (DLBCL) being prominent among PA (71{\%}) compared to IJ (41{\%}); follicular lymphoma (FL), was observed in 14{\%} versus 28{\%}, and marginal zone lymphoma, in 2{\%} versus 14{\%}, respectively. Overall B-NHL in both populations was associated with recreational sun exposure OR = 1.43 [CI:1.07-1.91], black hair-dye use OR = 1.70 [CI:1.00-2.87], hospitalization for infection OR = 1.68 [CI:1.34-2.11], and first-degree relative with hematopoietic cancer, OR = 1.69 [CI:1.16-2.48]. An inverse association was noted with alcohol use, OR = 0.46 [CI:0.34-0.62]. Subtype-specific exposures included smoking (FL, OR = 1.46 [CI:1.01-2.11]) and >monthly indoor pesticide use (DLBCL, OR = 2.01 [CI:1.35-3.00]). Associations observed for overall B-NHL in PA only included: gardening OR = 1.93 [CI:1.39-2.70]; history of herpes, mononucleosis, rubella, blood transfusion (OR>2.5, P<0.01 for all); while for IJ risk factors included growing fruits and vegetables, OR = 1.87 [CI:1.11-3.15]; and self-reported autoimmune diseases, OR = 1.99 [CI:1.34-2.95]. Conclusions: In these geographically proximate populations we found some unique risk factors for B-NHL. Heterogeneity in the observed associations by ethnicity could reflect differences in lifestyle, medical systems, and reporting patterns, while variations by histology infer specific etiologic factors for lymphoma subtypes.",
author = "Geffen Kleinstern and Seir, {Rania Abu} and Riki Perlman and Areej Khatib and Ziad Abdeen and Husein Elyan and Ronit Nirel and Gail Amir and Asad Ramlawi and Fouad Sabatin and Paolo Boffetta and Dann, {Eldad J.} and Meirav Kedmi and Martin Ellis and Arnon Nagler and Yehuda, {Dina Ben} and Ora Paltiel",
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T1 - Ethnic variation in medical and lifestyle risk factors for B cell non-Hodgkin lymphoma

T2 - A case-control study among Israelis and Palestinians

AU - Kleinstern, Geffen

AU - Seir, Rania Abu

AU - Perlman, Riki

AU - Khatib, Areej

AU - Abdeen, Ziad

AU - Elyan, Husein

AU - Nirel, Ronit

AU - Amir, Gail

AU - Ramlawi, Asad

AU - Sabatin, Fouad

AU - Boffetta, Paolo

AU - Dann, Eldad J.

AU - Kedmi, Meirav

AU - Ellis, Martin

AU - Nagler, Arnon

AU - Yehuda, Dina Ben

AU - Paltiel, Ora

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background: Risk factors for B-cell non-Hodgkin lymphoma (B-NHL) have not been assessed among Palestinian Arabs (PA) and Israeli Jews (IJ). Methods: In a case-control study we investigated self-reported medical and lifestyle exposures, reporting odds ratios (ORs) and 95% confidence intervals [CIs], by ethnicity, for overall B-NHL and subtypes. Results: We recruited 823 cases and 808 healthy controls. Among 307 PA/516 IJ B-NHL cases (mean age at diagnosis = 51 [±17] versus 60 [±15] years, respectively) subtype distributions differed, with diffuse large B-cell lymphoma (DLBCL) being prominent among PA (71%) compared to IJ (41%); follicular lymphoma (FL), was observed in 14% versus 28%, and marginal zone lymphoma, in 2% versus 14%, respectively. Overall B-NHL in both populations was associated with recreational sun exposure OR = 1.43 [CI:1.07-1.91], black hair-dye use OR = 1.70 [CI:1.00-2.87], hospitalization for infection OR = 1.68 [CI:1.34-2.11], and first-degree relative with hematopoietic cancer, OR = 1.69 [CI:1.16-2.48]. An inverse association was noted with alcohol use, OR = 0.46 [CI:0.34-0.62]. Subtype-specific exposures included smoking (FL, OR = 1.46 [CI:1.01-2.11]) and >monthly indoor pesticide use (DLBCL, OR = 2.01 [CI:1.35-3.00]). Associations observed for overall B-NHL in PA only included: gardening OR = 1.93 [CI:1.39-2.70]; history of herpes, mononucleosis, rubella, blood transfusion (OR>2.5, P<0.01 for all); while for IJ risk factors included growing fruits and vegetables, OR = 1.87 [CI:1.11-3.15]; and self-reported autoimmune diseases, OR = 1.99 [CI:1.34-2.95]. Conclusions: In these geographically proximate populations we found some unique risk factors for B-NHL. Heterogeneity in the observed associations by ethnicity could reflect differences in lifestyle, medical systems, and reporting patterns, while variations by histology infer specific etiologic factors for lymphoma subtypes.

AB - Background: Risk factors for B-cell non-Hodgkin lymphoma (B-NHL) have not been assessed among Palestinian Arabs (PA) and Israeli Jews (IJ). Methods: In a case-control study we investigated self-reported medical and lifestyle exposures, reporting odds ratios (ORs) and 95% confidence intervals [CIs], by ethnicity, for overall B-NHL and subtypes. Results: We recruited 823 cases and 808 healthy controls. Among 307 PA/516 IJ B-NHL cases (mean age at diagnosis = 51 [±17] versus 60 [±15] years, respectively) subtype distributions differed, with diffuse large B-cell lymphoma (DLBCL) being prominent among PA (71%) compared to IJ (41%); follicular lymphoma (FL), was observed in 14% versus 28%, and marginal zone lymphoma, in 2% versus 14%, respectively. Overall B-NHL in both populations was associated with recreational sun exposure OR = 1.43 [CI:1.07-1.91], black hair-dye use OR = 1.70 [CI:1.00-2.87], hospitalization for infection OR = 1.68 [CI:1.34-2.11], and first-degree relative with hematopoietic cancer, OR = 1.69 [CI:1.16-2.48]. An inverse association was noted with alcohol use, OR = 0.46 [CI:0.34-0.62]. Subtype-specific exposures included smoking (FL, OR = 1.46 [CI:1.01-2.11]) and >monthly indoor pesticide use (DLBCL, OR = 2.01 [CI:1.35-3.00]). Associations observed for overall B-NHL in PA only included: gardening OR = 1.93 [CI:1.39-2.70]; history of herpes, mononucleosis, rubella, blood transfusion (OR>2.5, P<0.01 for all); while for IJ risk factors included growing fruits and vegetables, OR = 1.87 [CI:1.11-3.15]; and self-reported autoimmune diseases, OR = 1.99 [CI:1.34-2.95]. Conclusions: In these geographically proximate populations we found some unique risk factors for B-NHL. Heterogeneity in the observed associations by ethnicity could reflect differences in lifestyle, medical systems, and reporting patterns, while variations by histology infer specific etiologic factors for lymphoma subtypes.

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