Mele A, Szklo M, Visani G, Stazi M A, Castelli G, Pasquini P, Mandelli F
Istituto Superiore di Sanità, Laboratorio di Epidemiologia e Biostatistica, Rome, Italy.
Am J Epidemiol. 1994 Mar 15;139(6):609-19. doi: 10.1093/oxfordjournals.aje.a117050.
A case-control study was carried out to examine the relation of three subtypes of leukemia cells and refractory anemia with excess of blasts to selected behavioral and environmental factors. Cases aged 15 years or older were recruited in three hospitals located in Rome, Bologna, and Pavia, respectively. Outpatients who were either normal or had nonneoplastic hematologic disorders and were seen in the same hospitals as the cases were enrolled as controls. Two hundred fifty-two patients with acute myeloid leukemia, 100 with acute lymphocytic leukemia, 111 with refractory anemia with excess of blasts, 156 with chronic myeloid leukemia, and 1,161 controls were included in the study. Refractory anemia with excess of blasts and chronic myeloid leukemia were included because they are regarded as forms of pre-leukemia. Odds ratio estimates were generally imprecise, but associations were suggested between specific case subtypes and exposure to dark hair dye, selected occupations (shoemaker, painter, electrician, child care), residence in houses built with tuff, and smoking. Although the exploratory nature of the study and its limited statistical power preclude firm conclusions, its results are consistent with those of previous studies, and are in general biologically plausible.
开展了一项病例对照研究，以检验白血病细胞的三种亚型以及伴有原始细胞增多的难治性贫血与特定行为和环境因素之间的关系。15岁及以上的病例分别在罗马、博洛尼亚和帕维亚的三家医院招募。在与病例相同医院就诊的正常或患有非肿瘤性血液系统疾病的门诊患者被纳入为对照。该研究纳入了252例急性髓系白血病患者、100例急性淋巴细胞白血病患者、111例伴有原始细胞增多的难治性贫血患者、156例慢性髓系白血病患者以及1161名对照。伴有原始细胞增多的难治性贫血和慢性髓系白血病被纳入研究，因为它们被视为白血病前期形式。比值比估计值通常不精确，但提示特定病例亚型与接触深色染发剂、特定职业（鞋匠、油漆工、电工、儿童护理）、居住在用凝灰岩建造的房屋以及吸烟之间存在关联。尽管该研究具有探索性且统计效力有限，无法得出确凿结论，但其结果与先前研究一致，且总体上在生物学上是合理的。
