Am J Epidemiol 2003; 158:190.
Copyright © 2003 by Johns
Hopkins Bloomberg School of Public Health
LETTERS TO THE EDITOR |
RE: "ANTHROPOMETRIC CHARACTERISTICS, PHYSICAL ACTIVITY, AND RISK OF NON-HODGKIN’S LYMPHOMA SUBTYPES AND B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA: A PROSPECTIVE STUDY"
1 Department of Biometry and Epidemiology, Medical University of South Carolina, Charleston, SC 29425-0835
2 Department of Pathology, Medical University of South Carolina, Charleston, SC 29425-0835
We read with interest the recent Journal report by Cerhan et al. (1) of their prospective study of the association of anthropometric characteristics with non-Hodgkin’s lymphoma (NHL), including small lymphocytic lymphoma (SLL), and B-cell chronic lymphocytic leukemia (CLL). The authors were puzzled by their finding of an inverse association of body mass index with SLL, coupled with a direct association of body mass index with CLL. As the authors noted, SLL and CLL are categorized together in the World Health Organization classification of tumors. SLL and CLL are essentially identical malignancies, differing only in where the malignant cells are found. If the malignant cells are confined to the lymph nodes, it is called SLL even though circulating tumor cells can be detected in most patients and most patients will eventually present with CLL. Conversely, if the malignant cells are circulating in peripheral blood, it is called CLL (2, 3).
We offer a possible explanation for the contrasting association of SLL and CLL with body mass index: lymphadenopathy is more readily detected by palpation in thinner patients, who will therefore be more likely to present with SLL. In obese patients, lymphadenopathy is easily overlooked, and the malignancy is more likely to be detected in peripheral blood as an incidental laboratory finding. It would be of interest to know whether bone marrow was obtained to determine whether SLL patients had bone marrow involvement or whether peripheral blood was assessed for the presence of circulating tumor cells.
Editor’s note: In accordance with Journal policy, Cerhan et al. were asked whether they wanted to respond to this letter, but they chose not to do so.
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REFERENCES |
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 TOP REFERENCES |
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- Cerhan JR, Janney CA, Vachon CM, et al. Anthropometric characteristics, physical activity, and risk of non-Hodgkin’s lymphoma subtypes and B-cell chronic lymphocytic leukemia: a prospective study. Am J Epidemiol 2002;156:527–35.
[Abstract/Free Full Text] - Ben-Ezra J. Small lymphocytic lymphoma. In: Knowles D, ed. Neoplastic hematopathology. Baltimore, MD: Williams & Wilkins, 1992.
- Jaffe ES, Harris NL, Stein H, et al. World Health Organization classification of tumours. Pathology and genetics of tumours of haematopoietic and lymphoid tissues. Lyon, France: IARC Press, 2001.
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