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. 2000 Dec;54(12):907–911. doi: 10.1136/jech.54.12.907

Delayed infection, family size and malignant lymphomas

P Vineis 1, L Miligi 1, P Crosignani 1, A Fontana 1, G Masala 1, O Nanni 1, V Ramazzotti 1, S Rodella 1, E Stagnaro 1, R Tumino 1, C Vigano 1, C Vindigni 1, A Costantini 1
PMCID: PMC1731607  PMID: 11076986

Abstract

BACKGROUND—The annual incidence of non-Hodgkin's lymphomas (NHL) is increasing by 3%-4% in different parts of the developed world. Excesses of NHL have been observed in populations exposed to immunosuppressants and to HIV, but these causes do not explain the increasing trends. It is suggested that delayed infection could explain NHL trends, through an impairment of the Th1/Th2 lymphocyte patterns.
METHODS—In a population-based study on 1388 patients with NHL, 354 with Hodgkin's disease (HD) and 1718 healthy controls, the age of first occurrence of bacterial and viral diseases was investigated. Clinical records were perused in one centre to check the anamnestic data.
FINDINGS—The age of occurrence of bacterial and viral diseases was significantly higher among NHL patients than in the controls. The association between later age at first bacterial or viral disease was limited to small families (OR= 1.95; 95% confidence intervals 1.26, 3.00, for age 4-8 at first infection; OR=1.91; 1.19, 3.06, for age 9+, compared with less than 4). The association was more obvious for bacterial diseases (possibly for the lower degree of misclassification). High grade lymphomas showed the strongest association. The later age of occurrence of bacterial or viral diseases in NHL patients is consistent with a higher incidence of lymphomas observed in higher social groups. No clear association was found between HD and age at first bacterial or viral diseases.
INTERPRETATION—It is proposed that delayed infection could explain the increasing NHL trends, through an impairment of the Th1/Th2 lymphocyte patterns. The model of delayed infection has been proposed also to explain increasing prevalence rates of asthma.



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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barrios C., Brawand P., Berney M., Brandt C., Lambert P. H., Siegrist C. A. Neonatal and early life immune responses to various forms of vaccine antigens qualitatively differ from adult responses: predominance of a Th2-biased pattern which persists after adult boosting. Eur J Immunol. 1996 Jul;26(7):1489–1496. doi: 10.1002/eji.1830260713. [DOI] [PubMed] [Google Scholar]
  2. COHEN B. M., SMETANA H. F., MILLER R. W. HODGKIN'S DISEASE: LONG SURVIVAL IN A STUDY OF 388 WORLD WAR II ARMY CASES. Cancer. 1964 Jul;17:856–866. doi: 10.1002/1097-0142(196407)17:7<856::aid-cncr2820170706>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  3. Cartwright R., McNally R., Staines A. The increasing incidence of non-Hodgkin's lymphoma (NHL): the possible role of sunlight. Leuk Lymphoma. 1994 Aug;14(5-6):387–394. doi: 10.3109/10428199409049694. [DOI] [PubMed] [Google Scholar]
  4. Cookson W. O., Moffatt M. F. Asthma: an epidemic in the absence of infection? Science. 1997 Jan 3;275(5296):41–42. doi: 10.1126/science.275.5296.41. [DOI] [PubMed] [Google Scholar]
  5. Cortes J., Kurzrock R. Interleukin-10 in non-Hodgkin's lymphoma. Leuk Lymphoma. 1997 Jul;26(3-4):251–259. doi: 10.3109/10428199709051774. [DOI] [PubMed] [Google Scholar]
  6. D'Elios M. M., Manghetti M., Almerigogna F., Amedei A., Costa F., Burroni D., Baldari C. T., Romagnani S., Telford J. L., Del Prete G. Different cytokine profile and antigen-specificity repertoire in Helicobacter pylori-specific T cell clones from the antrum of chronic gastritis patients with or without peptic ulcer. Eur J Immunol. 1997 Jul;27(7):1751–1755. doi: 10.1002/eji.1830270723. [DOI] [PubMed] [Google Scholar]
  7. Gutensohn N. M., Shapiro D. S. Social class risk factors among children with Hodgkin's disease. Int J Cancer. 1982 Oct 15;30(4):433–435. doi: 10.1002/ijc.2910300409. [DOI] [PubMed] [Google Scholar]
  8. Gutensohn N. M. Social class and age at diagnosis of Hodgkin's disease: new epidemiologic evidence for the "two-disease hypothesis". Cancer Treat Rep. 1982 Apr;66(4):689–695. [PubMed] [Google Scholar]
  9. Gutensohn N., Cole P. Epidemiology of hodgkin's disease in the young. Int J Cancer. 1977 May 15;19(5):595–604. doi: 10.1002/ijc.2910190502. [DOI] [PubMed] [Google Scholar]
  10. Holt P. G., Yabuhara A., Prescott S., Venaille T., Macaubas C., Holt B. J., Björkstén B., Sly P. D. Allergen recognition in the origin of asthma. Ciba Found Symp. 1997;206:35-49; discussion 49-55, 106-10. doi: 10.1002/9780470515334.ch3. [DOI] [PubMed] [Google Scholar]
  11. Johnson C. C., Wilcosky T., Kvale P., Rosen M., Stansell J., Glassroth J., Reichman L., Wallace J., Markowitz N., Thompson J. E. Cancer incidence among an HIV-infected cohort. Pulmonary Complications of HIV Infection Study Group. Am J Epidemiol. 1997 Sep 15;146(6):470–475. doi: 10.1093/oxfordjournals.aje.a009300. [DOI] [PubMed] [Google Scholar]
  12. Kersey J. H., Shapiro R. S., Filipovich A. H. Relationship of immunodeficiency to lymphoid malignancy. Pediatr Infect Dis J. 1988 May;7(5 Suppl):S10–S12. [PubMed] [Google Scholar]
  13. Krämer U., Heinrich J., Wjst M., Wichmann H. E. Age of entry to day nursery and allergy in later childhood. Lancet. 1999 Feb 6;353(9151):450–454. doi: 10.1016/S0140-6736(98)06329-6. [DOI] [PubMed] [Google Scholar]
  14. Lindberg C., Andersen O., Vahlne A., Dalton M., Runmarker B. Epidemiological investigation of the association between infectious mononucleosis and multiple sclerosis. Neuroepidemiology. 1991;10(2):62–65. doi: 10.1159/000110248. [DOI] [PubMed] [Google Scholar]
  15. Lucey D. R., Clerici M., Shearer G. M. Type 1 and type 2 cytokine dysregulation in human infectious, neoplastic, and inflammatory diseases. Clin Microbiol Rev. 1996 Oct;9(4):532–562. doi: 10.1128/cmr.9.4.532. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Moyes C. D., Waldon J., Ramadas D., Crane J., Pearce N. Respiratory symptoms and environmental factors in schoolchildren in the Bay of Plenty. N Z Med J. 1995 Sep 8;108(1007):358–361. [PubMed] [Google Scholar]
  17. Osterholm M. T. Infectious disease in child day care: an overview. Pediatrics. 1994 Dec;94(6 Pt 2):987–990. [PubMed] [Google Scholar]
  18. PAFFENBARGER R. S., Jr, WILSON V. O. Previous tonsillectomy and current pregnancy as they affect risk of poliomyelitis attack. Ann N Y Acad Sci. 1955 Sep 27;61(4):856–868. doi: 10.1111/j.1749-6632.1955.tb42543.x. [DOI] [PubMed] [Google Scholar]
  19. Poskanzer D. C. Tonsillectomy and multiple sclerosis. Lancet. 1965 Dec 18;2(7425):1264–1266. doi: 10.1016/s0140-6736(65)92281-6. [DOI] [PubMed] [Google Scholar]
  20. Rook G. A., Stanford J. L. Give us this day our daily germs. Immunol Today. 1998 Mar;19(3):113–116. doi: 10.1016/s0167-5699(97)01204-8. [DOI] [PubMed] [Google Scholar]
  21. Shirakawa T., Enomoto T., Shimazu S., Hopkin J. M. The inverse association between tuberculin responses and atopic disorder. Science. 1997 Jan 3;275(5296):77–79. doi: 10.1126/science.275.5296.77. [DOI] [PubMed] [Google Scholar]
  22. Vineis P., Crosignani P., Sacerdote C., Fontana A., Masala G., Miligi L., Nanni O., Ramazzotti V., Rodella S., Stagnaro E. Haematopoietic cancer and medical history: a multicentre case control study. J Epidemiol Community Health. 2000 Jun;54(6):431–436. doi: 10.1136/jech.54.6.431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Vineis P., D'Amore F. The role of occupational exposure and immunodeficiency in B-cell malignancies. Working Group on the Epidemiology of Hematolymphopoietic Malignancies in Italy. Epidemiology. 1992 May;3(3):266–270. doi: 10.1097/00001648-199205000-00014. [DOI] [PubMed] [Google Scholar]
  24. Wald E. R., Dashefsky B., Byers C., Guerra N., Taylor F. Frequency and severity of infections in day care. J Pediatr. 1988 Apr;112(4):540–546. doi: 10.1016/s0022-3476(88)80164-1. [DOI] [PubMed] [Google Scholar]

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