Due to the poorly understood aetiology of Non-lymphoma, Hodgkin’s identifying risk factors for NHL is difficult (NHL). However, research has shown that certain clinical and environmental factors, as well as genetic factors, are linked to an increased risk of NHL.
Non-Hodgkin’s lymphoma (NHL) includes all lymphomas except Hodgkin’s lymphoma. There have been frequent reports of an increase in the incidence of NHL worldwide over the last 30 years1. The etiology of NHL is a poorly understood and complicating the process of identifying NHL risk factors.
Some of the known risk factors for the development of NHL are as follows.
Clinical and environmental risk factors
Studies have reported a higher incidence in immunocompromised individuals (those receiving immunosuppressive therapy, organ transplants, and HIV / AIDS treatment) and in individuals with certain autoimmune disorders. However, the above conditions and factors are relatively rare in the general population and may explain only a small proportion of NHL cases.
Epidemiological studies suggest that some environmental and occupational exposure and lifestyle factors may be associated with NHL risk. Smoking increases the risk of follicular lymphoma, which is especially true in the case of current smokers compared to former smokers2. Alcohol consumption was reported to be associated with a lower risk of NHL and had the least protective effect against Burkitt’s lymphoma3. An increased risk of FL and chronic lymphocytic leukemia / small lymphocytic lymphoma (CLL / SLL) has been reported in women who started using hair dye before 19804.
A meta-analysis of prospective studies has shown a positive association between BMI and the risk of diffuse large B-cell lymphoma (DLBCL)5. Moreover, exposure to organic solvents at work is thought to be associated with an increased risk of NHL6. Several studies have also looked at dietary intake and the risk of NHL. While high consumption of protein and fat is associated with an increased risk of NHL, high fruit and vegetable consumption is reported to be associated with a lower risk of NHL7,8.
Genetic and genomic risk factors
There is growing evidence of genetic polymorphisms associated with increased NHL risk9. Furthermore, studies have reported that some polymorphisms in the Th1 / Th2 cytokine pathway genes (IL10 and TNF) increase the risk of B-cell lymphoma compared to control groups10. Studies have also reported that toll-like receptor genes, such as TLR2 and TLR4, are associated with a risk of NHL subtypes11. A hospital study examined polymorphisms in 12 genes (TRAF1, BAT2, RIPK3, TLR6, DUSP2, MAP3K5, CREB1, SELPLG, B3GNT3, LSP1, ITGB3, FGG) that are associated with NHL risk12.
Single Nucleotide Polymorphisms
Several epidemiological studies have reported an increased risk of NHL associated with single nucleotide polymorphisms in the GPX1, SOD2, NOS2A, CYBA, and AKR1A1 genes13,14.
Chromosome translocations of t (3,22) translocation of DLBCL and the t (14,18) translocation of FL are characteristic of NHL15. Polymorphisms in DNA repair genes may alter repair ability and alter NHL risk. Several population-based case-controlled studies have shown an increased risk of NHL associated with genetic polymorphisms in DNA repair genes, including ERCC5, RAG1, WRN, LIG4, XRCC1, and MGMT16.
Several epidemiologic studies reported an increased risk of NHL associated with SNPs (single nucleotide polymorphisms) in genes of GPX1, NOS2A, SOD2, AKR1A1, and CYBA16.
Various Chromosomal translocations, such as t(3, 22) translocation in DLBCL and t(14,18) translocation in FL, are a hallmark of NHL. Polymorphisms in DNA repair genes may modify repair capacity and alter the risk of NHL. Several population-based case-control studies have found an increased risk of NHL associated with genetic polymorphisms in DNA repair genes, including RAG1, LIG4, ERCC5, WRN, MGMT, and XRCC116.
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