Multicentre Hospital-based Case-control Study of Diffuse Large B-cell Lymphoma in Shanghai, China

Background: Several potential risk factors have been identified for diffuse large B-cell lymphoma (DLBCL);however, epidemiological studies investigating the association between these risk factors and DLBCL haveyielded inconsistent results.
Objectives: To investigate potential medical, lifestyle, and environmental riskfactors of DLBCL in Shanghai, China through a hospital-based case-control study.
Method: One-hundredand-forty-seven newly diagnosed DLBCL patients and 294 sex- and age-matched controls were recruited from11 hospitals in Shanghai between 2003 and 2007. A standardized structured questionnaire was used to obtainpatient data on demographics, medical history, family history, lifestyle, and environmental exposures. Conditionallogistic regression models were used to estimate odds ratios (ORs), with 95% confidence intervals (CIs), for riskassociated with each data category.
Results: History of tuberculosis (TB) infection and “living on a farm” werepositively associated with DLBCL (TB: OR=3.05, 95% CI: 1.19-7.80; farm: OR=1.82, 95% CI: 1.21-2.73). Incontrast, taking traditional Chinese medicine was negatively associated with DLBCL (OR=0.36, 95% CI: 0.14-0.89). No significant correlation with DLBCL risk was found for any of the other potential risk factors (p>0.05),including but not limited to hair dyes, alcohol drinking, smoking, and home/workplace renovation within oneyear.
Conclusions: Consistent with results from previous studies in other DLBCL case populations, traditionalChinese medicine appeared to have a direct or indirect protective effect against DLBCL. However, this studyalso identified a possible predisposition for DLBCL in TB sufferers and farmers.