Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
THE EPIDEMIOLOGY OF CHRONIC LYMPHOCYTIC LEUKEMIA
Chronic Lymphocytic Leukemia. Polliack A, Catovsky D, eds. New York, Harwood Academic Publishers, p. 11-32, 1988.. Unique Identifier : AIDSLINE ICDB/89656261 Linet MS; Blattner WA; Dept. of Epidemiology, Johns Hopkins Univ. Sch. of Hygiene and; Public Health, Baltimore, MD 21205
Abstract:
Epidemiologic findings, coupled with examination of immunologic and immunopathologic characteristics, suggest etiologic similarity for the morphologically and clinically different B-cell chronic lymphocytic leukemia (CLL) and B-cell non-Hodgkin's lymphoma. Thus, epidemiologic studies of CLL, coupled with laboratory-based approaches, are expanding understanding of the pathogenesis and etiology of B-cell tumors in general. Methodologic issues in epidemiologic studies, demographic characteristics, genetic factors in CLL, chronic antigenic stimulation, occupational factors, second malignancies, T-CLL, and human T-lymphotropic virus (HTLV)-I-positive CLL are discussed. CLL incidence increases dramatically with age. CLL is largely a disease of Caucasians, particularly Jews of Eastern European extraction. Some geographic variation within countries has been noted. Time-trend analyses suggest an increase in the male-to-female ratio in both England and Wales and in Olmstead County, Minnesota. The reasons may be related to changing occupational exposures or a decrease in incidence/mortality from competing conditions. CLL is the leukemia that most consistently demonstrates the familial aggregation of leukemia and other lymphoproliferative malignancies. A substantial excess of leukemia (2- to 7-fold) has been shown consistently in first-degree relatives of CLL patients compared with controls. A number of explanations have been postulated (consanguinity, familial chromosomal abnormalities, and immunogenic abnormalities), but none has been examined in large case-control studies in which detailed family histories are obtained and validated. Chronic antigenic stimulation was postulated as an etiologic factor, but one large analytical study did not support this hypothesis. In fact, preceding allergic and lymphoid tissue surgical excision appeared to be protective. Farmers residing in counties with high levels of soybean production, cattle raising, dairy production, and herbicide use are at increased risk of CLL. Rubber workers also appear to have increased risk of CLL. CLL has been linked to occupational exposure to benzene, xylene, coal-based solvents, carbon disulfide, and carbon tetrachloride. Follow-up studies of second malignancies have generally shown an increased incidence of malignant melanoma, connective tissue neoplasms, lung cancer, and rectal cancer subsequent to CLL diagnosis. Very recent work indicates a possible indirect role for HTLV-I in the etiology of B-CLL. (159 Refs)
Keywords: Adult Aged Aged, 80 and over Antigens/IMMUNOLOGY Cross-Sectional Studies Female Human Leukemia-Lymphoma, T-Cell, Acute, HTLV-I-Associated/EPIDEMIOLOGY Leukemia, B-Cell, Chronic/EPIDEMIOLOGY Leukemia, Lymphocytic, Chronic/*EPIDEMIOLOGY/ETIOLOGY/GENETICS Leukemia, T-Cell, Chronic/EPIDEMIOLOGY Male Middle Age Neoplasms, Multiple Primary/EPIDEMIOLOGY Risk Factors United States MONOGRAPH REVIEW REVIEW, TUTORIAL 891230
M89C0828
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
