Autoimmune diseases, infections, use of antibiotics and the risk of acute myeloid leukaemia: a national population-based case-control study

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  • Lene S G Østgård
  • Mette Nørgaard
  • Lars Pedersen
  • René D Østgård
  • Bruno C Medeiros, Stanford University
  • ,
  • Ulrik M Overgaard, University of Copenhagen
  • ,
  • Claudia Schöllkopf, Department of Haematology, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
  • ,
  • Marianne Severinsen, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Haematology, Aalborg University Hospital, Aalborg, Denmark.
  • ,
  • Claus W Marcher, Department of Haematology, Odense University Hospital, Odense, Denmark.
  • ,
  • Morten K Jensen, Department of Haematology, Roskilde University Hospital, Roskilde, Denmark.

Previous studies reported increased risk of acute myeloid leukaemia (AML) in individuals with inflammatory conditions. However, it is unclear whether this association is explained by preceding cytotoxic therapy or haematological diseases. We conducted a nationwide case-control study that included 3053 AML patients, diagnosed in Denmark between 2000 and 2013, and 30 530 sex- and age-matched population controls. We retrieved information on autoimmune disease, infections, and use of antibiotics and computed odds ratios for AML (conditional logistic regression). Results were stratified by AML type, sex, and age. Autoimmune diseases were associated with an overall increased risk of AML {odds ratio [OR] 1·3 [95% confidence interval (CI) = 1·1-1·5]}. However, the risk was confined to patients with previous haematological disease or cytotoxic therapy exposure [secondary/therapy-related AML (sAML/tAML0) OR 2·0 (95% CI = 1·6-2·6)] and not de novo AML [OR 1·1 (95% CI = 0·9-1·3)]. Similarly, any prior infection requiring hospitalization was associated with a higher risk of AML [OR 1·3 (95% CI = 1·1-1·4)]. Again, this association was evident for sAML/tAML [OR 1·8 (95% CI = 1·5-2·2)], and not de novo AML [OR 1·1 (95% CI = 1·0-1·2)]. In conclusion, autoimmune diseases and infections were associated with an increased AML risk only in subjects with prior haematological disease and/or cytotoxic treatment. These observations suggest, that inflammation plays - if any - a minor role for the development of de novo AML.

Original languageEnglish
JournalBritish Journal of Haematology
Pages (from-to)205-214
Number of pages10
Publication statusPublished - Apr 2018

    Research areas

  • acute leukaemia, aetiology, epidemiology, inflammation, prognostic factors

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