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Allergic disease, corticosteroid use, and risk of Hodgkin lymphoma: A United Kingdom nationwide case-control study.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Rafiq, Meena 
Hayward, Andrew 
Warren-Gash, Charlotte 
Denaxas, Spiros 
Gonzalez-Izquierdo, Arturo 

Abstract

BACKGROUND: Immunodeficiency syndromes (acquired/congenital/iatrogenic) are known to increase Hodgkin lymphoma (HL) risk, but the effects of allergic immune dysregulation and corticosteroids are poorly understood. OBJECTIVE: We sought to assess the risk of HL associated with allergic disease (asthma, eczema, and allergic rhinitis) and corticosteroid use. METHODS: We conducted a case-control study using the United Kingdom Clinical Practice Research Datalink (CPRD) linked to hospital data. Multivariable logistic regression investigated associations between allergic diseases and HL after adjusting for established risk factors. Potential confounding or effect modification by steroid treatment were examined. RESULTS: One thousand two hundred thirty-six patients with HL were matched to 7416 control subjects. Immunosuppression was associated with 6-fold greater odds of HL (adjusted odds ratio [aOR], 6.18; 95% CI, 3.04-12.57), with minimal change after adjusting for steroids. Any prior allergic disease or eczema alone was associated with 1.4-fold increased odds of HL (aOR, 1.41 [95% CI, 1.24-1.60] and 1.41 [95% CI, 1.20-1.65], respectively). These associations decreased but remained significant after adjustment for steroids (aOR, 1.25 [95% CI, 1.09-1.43] and 1.27 [95% CI, 1.08-1.49], respectively). There was no effect modification by steroid use. Previous steroid treatment was associated with 1.4-fold greater HL odds (aOR, 1.38; 95% CI, 1.20-1.59). CONCLUSIONS: In addition to established risk factors (immunosuppression and infectious mononucleosis), allergic disease and eczema are risk factors for HL. This association is only partially explained by steroids, which are associated with increased HL risk. These findings add to the growing evidence that immune system malfunction after allergic disease or immunosuppression is central to HL development.

Description

Keywords

Allergic disease, Hodgkin lymphoma, allergic rhinitis, asthma, atopic dermatitis, corticosteroids, eczema, risk, Adolescent, Adrenal Cortex Hormones, Adult, Case-Control Studies, Child, Child, Preschool, Female, Hodgkin Disease, Humans, Hypersensitivity, Immediate, Immunocompromised Host, Immunosuppressive Agents, Male, United Kingdom, Young Adult

Journal Title

J Allergy Clin Immunol

Conference Name

Journal ISSN

0091-6749
1097-6825

Volume Title

145

Publisher

Elsevier BV