Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Cancer Causes Control. 2021 Mar;32(3):241-250. doi: 10.1007/s10552-020-01378-x. Epub 2021 Jan 4.
Myelodysplastic syndromes (MDS) are classified as de novo and therapy-related (tMDS). We evaluated associations between MDS risk factors separately for de novo and tMDS.
The study population included 346 de novo MDS cases, 37 tMDS cases and 682 population controls frequency matched by age and sex. Polytomous logistic regression was performed to calculate odds ratios (OR) and 95% confidence intervals (CI).
After adjustment, former smoking status (OR = 1.45, 95% CI: 1.10-1.93), personal history of autoimmune disease (OR = 1.34, 95% CI: 0.99-1.82) and exposure to benzene (OR = 1.48, 95% CI: 1.00-2.19) were associated with de novo MDS. Risk estimates for the associations between smoking, autoimmune disease, and benzene exposure were similar in magnitude but non-significant in tMDS cases. Among individuals with a previous diagnosis of cancer, de novo MDS cases and controls were more likely to have had a previous solid tumor, while tMDS cases more commonly had a previous hematologic malignancy.
We observed similar associations between smoking, history of autoimmune disease and benzene exposure in de novo and tMDS although estimates for tMDS were imprecise due to small sample sizes. Future analyses with larger sample sizes will be required to confirm whether environmental factors influence risk of tMDS.
骨髓增生异常综合征(MDS)分为初发型和治疗相关性(tMDS)。我们分别评估了初发型和 tMDS 中 MDS 危险因素之间的关联。
研究人群包括 346 例初发型 MDS 病例、37 例 tMDS 病例和 682 例按年龄和性别频率匹配的人群对照。采用多分类逻辑回归计算比值比(OR)和 95%置信区间(CI)。
调整后,既往吸烟状况(OR=1.45,95%CI:1.10-1.93)、自身免疫性疾病个人史(OR=1.34,95%CI:0.99-1.82)和苯暴露(OR=1.48,95%CI:1.00-2.19)与初发型 MDS 相关。吸烟、自身免疫性疾病和苯暴露与 MDS 相关性的风险估计值在初发型 MDS 病例中相似,但在 tMDS 病例中不显著。在有癌症既往诊断的个体中,初发型 MDS 病例和对照组更有可能有既往实体瘤,而 tMDS 病例更常见既往血液恶性肿瘤。
尽管由于样本量小,tMDS 的估计值不精确,但我们观察到吸烟、自身免疫性疾病史和苯暴露与初发型和 tMDS 之间存在相似的关联。未来需要更大样本量的分析来确认环境因素是否会影响 tMDS 的风险。