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Dietary Factors of One-Carbon Metabolism in Relation to Non-Hodgkin Lymphoma and Multiple Myeloma in a Cohort of Male Smokers

¹ Nutritional Epidemiology Branch and ² Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, Maryland; ³ Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute; and ⁴ Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland

Requests for reprints: Rachael Stolzenberg-Solomon, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, EPS 320, Rockville, MD 20852. E-mail: stolzenr{at}mail.nih.gov

Reported associations between genetic polymorphisms in folate-metabolizing enzymes and lymphoid malignancies suggest etiologic involvement of one-carbon metabolism and its related dietary exposures. We examined dietary factors of one-carbon metabolism in relation to non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) among 27,111 healthy male smokers who completed baseline dietary questionnaires in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study cohort. During a follow-up of up to 16.4 years (1985-2001), 195 NHL and 32 MM cases were ascertained. Cox proportional hazard models were used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (95% CI). There was no significant association between dietary folate and NHL (HR comparing fourth to first quartile, 1.03; 95% CI, 0.68-1.55). Dietary vitamin B₁₂ was inversely associated with NHL (HR, 0.61; 95% CI, 0.37-1.00; P_trend = 0.06). The inverse association of vitamin B₁₂ was evident for diffuse subtype but did not reach statistical significance. There were no significant associations of dietary vitamin B₆ or B₂, methionine, or alcohol with NHL. None of the dietary or supplemental one-carbon nutrients were associated with MM, although the power of these analyses was limited. Our results suggest that high intake of vitamin B₁₂ among heavy smokers may be protective against NHL but warrant further studies, including among nonsmokers. (Cancer Epidemiol Biomarkers Prev 2006;15(6):1109–14)

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