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Blood Transfusion and Non-Hodgkin Lymphoma: Lack of Association

Johanna Adami, MD, MPH; Olof Nyren, MD; Reinhold Bergstrom, PhD; Anders Ekbom, MD; Joseph K. McLaughlin, PhD; Claes Hogman, MD; Joseph F. Fraumeni Jr., MD; and Bengt Glimelius, MD
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From Karolinska Institute, Stockholm, Sweden; Uppsala University, Uppsala, Sweden; Harvard School of Public Health, Boston, Massachusetts; the International Epidemiology Institute, Rockville, Maryland; and the National Cancer Institute, Bethesda, Maryland. Grant Support: In part by grants from the Lions Cancer Foundation (Uppsala, Sweden), the Swedish Cancer Society (Stockholm, Sweden), and the National Cancer Institute (Bethesda, Maryland). Requests for Reprints: Johanna Adami, MD, MPH, Department of Medical Epidemiology, Karolinska Institute, Box 281, S-17177, Stockholm, Sweden. Current Author Addresses: Drs. Adami, Nyren, Bergstrom, and Ekbom: Department of Medical Epidemiology, Karolinska Institute, Box 281, S-17177, Stockholm, Sweden. Current Author Addresses: Drs. Adami, Nyren, Bergstrom, and Ekbom: Department of Medical Epidemiology, Karolinska Institute, Box 281, S-17177, Stockholm, Sweden.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;127(5):365-371. doi:10.7326/0003-4819-127-5-199709010-00004
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Background: Non-Hodgkin lymphoma is the seventh most commonly diagnosed malignant condition world-wide, and its incidence has increased markedly in recent decades. Blood transfusions have been implicated as a possible risk factor for non-Hodgkin lymphoma.

Objective: To determine whether blood transfusions are associated with an elevated risk for non-Hodgkin lymphoma.

Design: Population-based, nested case–control study.

Setting: Nationwide cohort in Sweden.

Patients: 361 patients with non-Hodgkin lymphoma and 705 matched controls, nested within a population-based cohort of 96 795 patients at risk for blood transfusion between 1970 and 1983. Prospectively collected information on exposure was retrieved from computerized transfusion registries.

Measurements: Odds ratios obtained from conditional logistic regression models were used as measures of relative risks.

Results: No association was found between blood transfusions and the risk for non-Hodgkin lymphoma when patients who had received transfusions were compared with patients who had not received transfusions (odds ratio, 0.93 [95% CI, 0.71 to 1.23]). A reduction in risk was seen among persons who received transfusion of blood without leukocyte depletion (odds ratio, 0.72 [CI, 0.53 to 0.97]). Risk was not related to number of transfusions, and no interaction was seen with latency after transfusion.

Conclusion: The findings in this study do not support previous observations of an association between blood transfusions and the risk for non-Hodgkin lymphoma.





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