A meta-analysis of Hodgkin lymphoma reveals 19p13.3 TCF3 as a novel susceptibility locus.

Recent genome-wide association studies (GWAS) of Hodgkin lymphoma (HL) have identified associations with genetic variation at both HLA and non-HLA loci; however, much of heritable HL susceptibility remains unexplained. Here we perform a meta-analysis of three HL GWAS totaling 1,816 cases and 7,877 controls followed by replication in an independent set of 1,281 cases and 3,218 controls to find novel risk loci. We identify a novel variant at 19p13.3 associated with HL (rs1860661; odds ratio (OR)=0.81, 95% confidence interval (95% CI) = 0.76-0.86, P(combined) = 3.5 × 10(-10)), located in intron 2 of TCF3 (also known as E2A), a regulator of B- and T-cell lineage commitment known to be involved in HL pathogenesis. This meta-analysis also notes associations between previously published loci at 2p16, 5q31, 6p31, 8q24 and 10p14 and HL subtypes. We conclude that our data suggest a link between the 19p13.3 locus, including TCF3, and HL risk.

Patterns of second primary malignancy risk in multiple myeloma patients before and after the introduction of novel therapeutics.

Recent studies have reported an increased risk of second primary malignancies (SPM) following multiple myeloma (MM) diagnosis associated with novel anti-myeloma treatments. We evaluated the risk of SPM among 36 491 MM cases reported to the Surveillance, Epidemiology, and End Results program (SEER) between 1973 and 2008. We calculated overall and site-specific standardized incidence ratio (SIR) and 95% confidence intervals (CI) for 2012 SPM cases diagnosed within the 35-year follow-up. There was no significant overall risk of SPM (SIR=0.98; 95% CI=0.94-1.02); however, there were multiple site-specific risk patterns. The risk of breast and prostate cancer was significantly decreased overall and across age, latency and the year of diagnosis strata. There was an ∼50% increased risk of colorectal cancer 5 years after MM diagnosis (Ptrend<0.001). The risk of hematological malignancies was significantly increased, notably for acute myeloid leukemia (AML; SIR=6.51; 95% CI=5.42-7.83). There was a significant decreasing trend for AML over time, particularly for patients 65. However, no significant change in risk was noted after the introduction of autologous stem cell transplant among younger patients (<65 years). On the basis of observed trends for overall SPM as well as AML, no association between the introduction of novel therapies and SPM following MM has emerged in this large population-based study.

Some calculations on the prevalence of dementia in Canada.

The epidemiology of dementia in Canada is not known. However, we report figures on the frequency of dementia in institutions in Ontario based upon the use of a multidimensional observation scale for the assessment of the elderly. These findings on institutionalized patients can be extrapolated to the whole elderly population, but the procedure is clearly too conservative by comparison with findings in other countries and in the light of the known occurrence of numbers of demented patients outside institutions. Ratios in different studies for the numbers of patients with dementia outside institutions and within institutions range from 1:1 to 6:1. Using a ratio of 2:1 and applying it to age specific population figures, a prevalence of dementia in Canada of 222,324 for those over 65 is obtained with a rate of 9.4% in that age group. When the figures projected in this way are compared with five epidemiological studies for the rate of dementia elsewhere, the Canadian figure which we have obtained ranks fourth out of six. This estimate provides potential figures on which to base the planning of services, provided that the inferential nature of the estimates is fully recognized.