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Hematopoietic Malignancies Associated with Viral and Alcoholic Hepatitis

¹ Division of Cancer Epidemiology and Genetics and ² Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; ³ Centre for Clinical and Population Sciences, Queen's University Belfast, Northern Ireland; and ⁴ Information Management Services, Rockville, Maryland

Requests for reprints: Eric A. Engels, Infections and Immunoepidemiology Branch Division of Cancer Epidemiology and Genetics National Cancer Institute, 6120 Executive Blvd, EPS 7076 Rockville, MD 20892. E-mail: engelse{at}mail.nih.gov

Hepatitis C virus (HCV) and hepatitis B virus (HBV) have been associated with hematopoietic malignancies, but data for many subtypes are limited. From the U.S. Surveillance, Epidemiology, and End Results-Medicare database, we selected 61,464 cases (67 years) with hematopoietic malignancies and 122,531 population-based controls, frequency-matched by gender, age, and year (1993-2002). Logistic regression was used to compare the prevalence of HCV, HBV, and alcoholic hepatitis in cases and controls, adjusted for matching factors, race, duration of Medicare coverage, and number of physician claims. HCV, HBV, and alcoholic hepatitis were reported in 195 (0.3%), 111 (0.2%), and 404 (0.7%) cases and 264 (0.2%), 242 (0.2%), and 798 (0.7%) controls, respectively. HCV was associated with increased risk of diffuse large B-cell lymphoma [odds ratio (OR) 1.52, 95% confidence interval (95% CI) 1.05-2.18], Burkitt lymphoma (OR 5.21, 95% CI 1.62-16.8), follicular lymphoma (OR 1.88, 95% CI 1.17-3.02), marginal zone lymphoma (OR 2.20, 95% CI 1.22-3.95), and acute myeloid leukemia (OR 1.54, 95% CI 1.00-2.37). In contrast, HBV was unrelated to any hematopoietic malignancies. Alcoholic hepatitis was associated with decreased risk of non–Hodgkin lymphoma overall, but increased risk of Burkitt lymphoma. In summary, HCV, but not other causes of hepatitis, was associated with the elevated risk of non–Hodgkin lymphoma and acute myeloid leukemia. HCV may induce lymphoproliferative malignancies through chronic immune stimulation. (Cancer Epidemiol Biomarkers Prev 2008;17(11):3069–75)