JCO Early Release, published online ahead of print Jul 7 2008
Journal of Clinical Oncology, 10.1200/JCO.2007.14.6571
Received October 23, 2007
Accepted May 14, 2008
Survival Patterns Among Lymphoma Patients With a Family History of Lymphoma
Lesley A. Anderson,* Ruth M. Pfeiffer, Joshua S. Rapkin, Gloria Gridley, Lene Mellemkjaer, Kari Hemminki, Magnus Björkholm, Neil E. Caporaso, and Ola Landgren
From the Division of Cancer Epidemiology and Genetics; Cancer Prevention Fellowship Program, Office of Preventive Oncology, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD; Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen, Denmark; Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany; Center for Family and Community Medicine, Karolinska Institutet, Huddinge; and the Department of Medicine, Division of Hematology, Karolinska Institutet, Stockholm, Sweden.
* To whom correspondence should be addressed. E-mail: l.anderson{at}qub.ac.uk
Purpose: Genetic factors are important in the etiology and pathogenesis of chronic lymphocytic leukemia (CLL), Hodgkin's lymphoma (HL), and non-Hodgkin's lymphoma (NHL). Only a few small studies have assessed clinical characteristics and prognosis for familial patients, with inconsistent findings.
Methods: Using population-based registries from Sweden and Denmark, 7,749 patients with CLL, 7,476 patients with HL, and 25,801 patients with NHL with linkable first-degree relatives were identified. Kaplan-Meier curves were constructed to compare survival in patients with lymphoma with and without a family history of lymphoma. The risk of dying was assessed using adjusted Cox proportional hazard models.
Results: We found 85 patients with CLL (1.10%), 95 patients with HL (1.28%), and 206 patients with NHL (0.80%) with a family history of any lymphoma. Five-year mortality was similar for patients with CLL (hazard ratio [HR], 1.28; 95% CI, 0.95 to 1.72), HL (HR, 0.78; 95% CI, 0.49 to 1.25), and NHL (HR, 0.91; 95% CI, 0.74 to 1.12) versus without a family history of any lymphoma. Mortality was also similar for patients with versus without a family history of the same lymphoma. T-cell/anaplastic lymphoma patients with a family history of NHL had poorer outcome 5-years after diagnosis (HR, 5.38; 95% CI, 1.65 to 17.52). Results were similar for 10 years of follow-up.
Conclusion: With the exception of T-cell/anaplastic lymphoma, survival patterns for patients with CLL, HL, and NHL with a family history of lymphoma were similar to those for sporadic patients, suggesting that most familial lymphomas do not have an altered clinical course. Our findings provide no evidence to modify therapeutic strategies for patients with CLL, HL, or NHL based solely on family history.
