Allergic Diseases and Risk of Hematopoietic Malignancies in a Cohort of Postmenopausal Women: A Report from the Iowa Women's Health Study

Abstract

Background Allergic diseases signify immune dysregulation attributable to underlying genetics and environmental exposures. Associations between various allergies and hematopoietic cancers have been observed, albeit inconsistently, however few prospective studies have examined the risk, and even fewer among older adults. Methods We examined risk of incident hematopoietic cancers in those reporting allergic diseases in a population-based cohort of 22,601 older women (Iowa Women’s Health Study). Self-reported allergic status, including asthma, hay fever, eczema and/or other allergies, was determined via questionnaire in 1997 (mean age=72 years, range 63–81 years). Incident cancers were ascertained by linkage with the Iowa Cancer Registry from 1997–2011. Cox proportional hazards regression was performed to estimate multivariate-adjusted hazard ratios (HR) and 95% confidence intervals (CIs) for myeloid (N=177) and lymphoid (N=437) malignancies, respectively. Results Allergic diseases were not associated with risk of myeloid (HR=1.00, 95% CI: 0.72–1.37) or lymphoid (HR=0.99, 95% CI: 0.81–1.22) malignancies overall, or for most allergic and malignant subtypes examined. Self-reported asthma was positively associated with development of myelodysplastic syndrome (MDS, HR=2.00, 95% CI: 0.93–4.32). In addition, there was a 30–40% decrease in risk of both lymphoid and myeloid cancers in those reporting rural residences but no association in those reporting urban residences; the interaction between residence and allergy was statistically significant for lymphoid malignancies (Pinteraction=0.05). Conclusions and Impact These results suggest asthma may contribute to the pathogenesis of MDS, a finding consistent with the chronic antigen stimulation hypothesis. Susceptibility differences by location of residence are concordant with the hygiene hypothesis and merit additional exploration.

Asthma and risk of myelodysplastic syndromes: a population-based cohort study

“…These findings are in line with the study by Linabery et al (2014). They reported no association between allergic diseases other than asthma and haematological malignancies.…”

“…Outcomes were MDS and other incident haematological malignancies identified in the State Health Registry of Iowa (Linabery et al , 2014). Although the underlying mechanism is unknown, immune dysregulation in MDS is evident, as some subtypes respond to the treatment with immunosuppressive or immunomodulatory agents (Saunthararajah et al , 2003; List et al , 2005; Mollgard et al , 2011; Duong et al , 2012).…”

Farm Characteristics, Allergy Symptoms, and Risk of Non-Hodgkin Lymphoid Neoplasms in the Agricultural Health Study

“…In the Vitamins and Lifestyle (VITAL) cohort (17), self-reported plant, tree, or pollen allergies at baseline were associated with increased future risk of mature B-cell neoplasms (excluding CLL/SLL and MM). Consistent with our findings, a recent report from the Iowa Women’s Health Study found that self-reported allergic diseases were associated with a reduced risk of lymphoid neoplasms among those living in rural areas; no association was observed among residents in urban areas (18). …”

“…Findings from cohort studies in the general population have been inconsistent, although the definitions of allergies and NHL/subtypes varied between studies (13, 15–18). In a nested case-control study within the Finnish Maternity Cohort (13), risk of NHL was reduced in relation to specific IgE seropositivity in samples collected shortly prior to NHL diagnosis but not in samples collected ≥10 years before diagnosis.…”

“…Having a history of allergic conditions has been associated with a reduced risk of NHL in several large case-control studies (12–14). However, results from prospective general population cohort studies have been inconsistent, with some finding no association between allergies and NHL (13, 15) and others observing an increased risk in certain population subgroups or for specific subtypes of hematologic malignancies (16–18). Notably, a recent cohort study found a reduced risk of lymphoid neoplasms in relation to allergic diseases among those living in rural areas, but not among those in urban areas (18).…”