Study of Lymphoma in Asia
Study of Lymphoma in Asia
Background:

 - Lymphoma rates in Asia have been lower than in the West, but rates have been rising in
 recent years. Most studies of lymphoma patients have been conducted in the West. Less
 information is available about the factors that might contribute to the rise of lymphoma in
 Asia. Researchers want to collect medical and personal histories and samples from people who
 have recently been diagnosed with lymphoma. This information will help them study possible
 reasons for this increase.

 Objectives:

 - To collect samples and histories as part of an introductory study of lymphoma in Asia.

 Eligibility:

 -  People between 18 and 79 years of age who have entered study hospitals in Hong Kong,
 Taiwan, and mainland China for treatment for any type of lymphoma.

 -  Healthy volunteers between 18 and 79 who have never had lymphoma.

 Design:

 -  Participants will be screened with a physical exam and medical history.

 -  They will provide blood samples and cheek cell samples for testing.

 -  Participants will complete a questionnaire about their personal health history. They
 will answer questions about exposures to chemicals like pesticides. They will also be
 asked about family medical history and work and residential history. Finally they will
 answer questions about lifestyle factors like diet and exercise.

 -  They will give permission for the researchers to see their medical records. Researchers
 will also have access to any tumor samples collected as part of treatment.
The contribution of environmental, occupational and genetic factors to lymphoma has generated
 a series of novel findings in studies of Caucasians. However, none of the chemical
 associations have been conclusively established and the identification of the key, functional
 alleles in gene regions associated with risk of NHL requires further elucidation. Further,
 the ability to follow-up, confirm, and extend these observations is limited by the low
 prevalence and limited range of several important chemical exposures and the high to complete
 linkage disequilibrium among key candidate genetic loci in Western populations. To optimize
 the ability to build on and clarify these findings, it is necessary to investigate
 populations that differ from Caucasians in both exposure patterns and underlying genetic
 structure. A multidisciplinary case-control study of lymphoma in Asia provides an opportunity
 to replicate and extend recent and novel observations made in studies among Caucasians in a
 population that is distinctly different with regard to patterns of key risk factors,
 including range of exposures, prevalence of exposures, correlations between exposures, and
 variation in gene regions of particular interest. Thus, a hospital-based case-control study
 of lymphoma in Eastern Asia (i.e., AsiaLymph) of 4,200 cases and 4,200 controls to be
 enrolled over a three-year period will be conducted. In addition, 2,000 cases of myeloid
 leukemias and an additional 2,400 cases with less common lymphoma subtypes will be enrolled
 as well. The major postulated risk factors for evaluation in this study are chemical
 exposures (i.e., organochlorines, trichloroethylene, and benzene) and genetic susceptibility.
 Other factors potentially related to NHL, such as viral infections, UV exposure, medical
 conditions, and other lifestyle factors will also be explored. A particularly noteworthy
 aspect of AsiaLymph is central pathology review with immunophenotyping by two of the world s
 leading lymphoma pathologists, which will enable accurate analysis of findings by molecular
 and histologic subtypes. AsiaLymph represents the optimal next step in the DCEG lymphoma
 portfolio. AsiaLymph should confirm and extend previous findings, and yield novel insights
 into the causes of lymphoma and leukemia in both Asia and the West.
-  INCLUSION CRITERIA:

 Eligible cases will be patients at a participating hospital who are between 18 and 79 years
 of age at time of initial diagnosis and admitted or treated with incident diagnoses of any
 lymphoid or myeloid neoplasm including all NHL and Hodgkin disease. Although it is
 important to understand the etiology of lymphoma in children as well, this undertaking
 would require additional hospitals, instruments, expertise, and funding that are not
 currently available to our research team. Adults over the age of 80 are generally among the
 sickest patients in the hospital and often have multiple comorbidities, which may preclude
 their participation in an interview of this length. Cases will be permanent residents of
 the general geographic region that is served by the hospital at the time of diagnosis.
 Cases will include chronic lymphocytic leukemia/small lymphocytic lymphoma, Waldenstrom
 macroglobulinemia, plasmacytoma, multiple myeloma, aggressive NK cell leukemia, cutaneous
 lymphomas, myeloid neoplasms, and immunosuppression-associated cases (such as HIV, post
 transplant, Methotrexate use).

 2,400 lymphoid neoplasm cases will be enrolled with less common subtypes in Asian
 populations including Hodgkin disease, multiple myeloma, chronic lymphocytic leukemia, and
 NK/T, T, follicular and marginal zone lymphoma, in order to increase statistical power to
 study risk factors for these tumors.

 EXCLUSION CRITERIA:

 Cases with previous diagnosis of lymphoma, such as acute lymphoblastic lymphoma, multiple
 myeloma, chronic lymphocytic leukemia, and non-Hodgkin lymphoma, are ineligible.