American Journal of Epidemiology Vol. 134, No. 1: 22-28
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
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Antigenic Stimulation and the Occurrence of Chronic Lymphocytic Leukemia
1 Department of Epidemiology, University of Washington Seattle, WA.
2 Fred Hutchmson Cancer Research Center Seattle, WA.
3 Division of Epidemiology, Department of Family and Community Medicine, University of Utah Medical Center Salt Lake City, UT.
4 Michigan State University, College of Human Medicine East Lansing, MI.
5 Department of Epdemiology and Biostattstics, Emory University School of Medicine Atlanta, GA.
Reprint requests to Dr Thomas D. Koepsell, Department of Epidemiology SC-36, University of Washington, Seattle, WA 98195.
Data from a population-based case-control study of chronic lymphocytic leukemia were analyzed to assess the possible etiologic role of chronic antigenic stimulation. The study, conducted in four geographic areas of the United States (the metropolitan areas surrounding Seattle, Washington, Salt Lake City, Utah, Detroit, Michigan, and Atlanta, Georgia) sought to identify all incident cases (n = 430) among residents diagnosed between July 1, 1977 and December 31, 1981. The responses of these cases to questions about possible sources of antigenic stimulation were compared with the responses of controls selected from the populations of these areas. Little difference between cases and controls was present for a history of most forms of viral and bacterial infection and for a history of allergies or allergy treatment. However, a relation was observed with antecedent syphilis infection (odds ratio (OR) = 5.0, 95% confidence interval (Cl) 2.0–12.9). Associations of smaller magnitude were observed with a history of tuberculosis (OR = 1.9, 95% Cl 1.0–3.7) and of urinary tract infection (OR = 1.4, 95% Cl 1.1–1.9). Overall, however, the authors found little evidence of a relation between chronic antigenic stimulation and the occurrence of chronic lymphocytic leukemia. Nonetheless, because the measure of prior antigenic stimulation was restricted to that obtained through interviews and undoubtedly was an insensitive one, these negative results should not be interpreted as ruling out antigenic stimulation as a possible cause of some cases of chronic lymphocytic leukemia. Am J Epidemiol 1991; 134: 22–8.
communicable diseases; leukemia; lymphocytic
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