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Familial risks identified across hematologic malignancies
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Individuals with a child, parent or sibling with a hematologic malignancy may be at higher risk for being diagnosed with the same disease, according to results of a retrospective study published in Blood.
Factors associated with increased risk for certain blood cancers include the number of first-degree relatives diagnosed and younger age at diagnosis, researchers noted.
“This information improves our understanding of the causes of — and potential inherited predisposition to — blood cancers and should inform the identification and characterization of genetic risk factors for blood cancer,” Amit Sud, MD, PhD, clinical research fellow in hematology at the Institute of Cancer Research in London, said in a press release. “The results should also encourage conversations among families, clinicians and patients about familial risk.”
Sud and colleagues sought to estimate familial relative risks (FRRs) for major hematologic malignancies and their potential interrelationships by analyzing more than 16 million people from the Swedish Family-Cancer Database. They identified 153,115 patients diagnosed with a primary hematologic malignancy between 1958 and 2015, and calculated
FRRs among their 391,131 first-degree relatives using standardized incident ratios.
Results showed familial cases represented 4.1% of all hematologic malignancy diagnoses, higher than pancreatic cancer (3%), kidney cancer (2.8%) and cancers of the nervous system (1.8%), but not as high as breast cancer (8.5%), colorectal cancer (10.1%) and prostate cancer (15.1%).
Most hematologic malignancies appeared associated with increased FRRs for the same type of tumor, with mixed cellularity Hodgkin lymphoma (SIR = 16.7), lymphoplasmacytic lymphoma (SIR = 15.8) and mantle cell lymphoma (SIR = 13.3) having the highest FRRs.
Researchers also observed increased FRRs for polycythemia vera (SIR = 7.7), hairy cell leukemia (SIR = 8.3) and nodular sclerosis Hodgkin lymphoma (SIR = 9.8).
There was no evidence of familial clustering of chronic myeloid leukemia, myelofibrosis and T-cell neoplasms.
FRRs were significantly higher for relatives of those diagnosed with Hodgkin lymphoma at age 28 years or younger vs. older than 28 years (SIR = 5.76; 95% CI, 4.2-7.7 vs. 3.36; 95% CI, 2.57-4.32) or chronic lymphocytic leukemia at age 63 years or younger vs. older than 63 years (SIR = 6.99; 95% CI, 5.91-8.21 vs. 4.83; 95% CI, 4.13-5.62).
FRRs also appeared significantly higher for siblings compared with parent-child relationships for non-Hodgkin lymphoma, Hodgkin lymphoma and CLL.
The findings may apply only to countries in the Western Hemisphere, which serves as the study’s primary limitation.
“We hope these robust data will be used to inform guidelines on genetic testing and screening,” Sud said. “Certainly there are a number of individuals, such as those with a relative diagnosed at a young age and/or with more than one affected first-degree relative, for whom counseling, genetic testing and surveillance may be appropriate.” – by John DeRosier
Disclosure s : The authors report no relevant financial disclosures.
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