Researchers have confirmed an association between blood transfusion and risk of non-Hodgkin lymphoma (NHL), and have identified multiple surgical procedures and anesthesia as additional risk factors, which have not previously been reported.
"The incidence of NHL has increased dramatically since at least the 1950s, and during this timeframe there has been a major increase in the use of blood transfusions, invasive surgical procedures and anesthesia, all of which can impact immune function," Dr. James R. Cerhan, of Mayo Clinic College of Medicine, Rochester, Minnesota, and colleagues write.
In a multicenter, population-based, case-control study, the researchers examined the association between transfusion, anesthesia or surgery and NHL in 759 patients and 589 frequency-matched controls. In-person interviews were conducted to collect data on risk factors. The results appear in the August 15th issue of the International Journal of Cancer.
A history of transfusion was associated with a 26% higher risk of NHL. The authors report that the increased risk was specific to transfusions given 5 to 29 years before the reference date (odds ratio = 1.69) and transfusions given for a medical condition (OR = 2.09).
Compared with subjects who previously had 0 to 6 surgeries or dental procedures, those who had at least 26 procedures had a 53% higher risk of developing NHL. Participants with 24 or more exposures to general or local/regional anesthesia had a 35% increased risk of NHL compared to those with 0 to 6 exposures.
The associations were not weakened when the authors combined transfusion and surgery or transfusion and anesthesia. All of the results were consistent for both diffuse large B-cell lymphoma and follicular NHL subtypes.
"Beyond replication of these findings, future studies should also focus on the indication and timing of transfusion, medical record validation of these exposures and interactions of these exposures with host genetic susceptibility," Dr. Cerhan's team concludes.
Int J Cancer 2008;123:888-894.
Reviewed by Ramaz Mitaishvili, MD
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