A population-based case-control interview study of 486 adult leukemia cases and 502 healthy controls was carried out in Shanghai, People's Republic of China during 1987–89 to evaluate the etiologic role of prior medical conditions, medications, and diagnostic X-rays. Risks were examined separately for 236 cases with acute non-lymphocytic leukemia (ANLL), 79 with chronic myeloid leukemia (CML), 81 with acute lymphocytic leukemia (ALL), and 21 with chronic lymphocytic leukemia (CLL). Little difference was found between cases and controls for prior history of diabetes, hypertension, allergic conditions, most medications, and diagnostic X-rays. A few significant associations were observed for appendectomy, tuberculosis, and for several other chronic disorders with specific leukemia cell types, but the odds ratio estimates for most of these ranged from two to three and, with the exception of the two specified above, were based generally on five or fewer exposed controls. In contrast to an association with childhood leukemia in Shanghai, prior use of chloramphenicol was not linked with ANLL or other forms of adult leukemia. Further research is needed to clarify the relation of specific medical conditions and exposures with particular subtypes of leukemia, and to examine reasons for the low incidence of CLL in China and other Asian populations.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Wiernik PH. Acute leukemia. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology (3rd edition). Philadelphia: Lippincott JB Co. 1989: 1809–24.
Cartwright RA, Staines A. Acute leukaemias. In: Fleming AF, ed. Epidemiology of Haematological Disease: Part 1. London: Baillière/Tindal, 1992: 1–26.
Finch SC, Linet MS. Chronic leukaemias. In: Fleming AF, ed. Epidemiology of Haematological Disease: Part I. London: Baillière/Tindal, 1992: 27–56.
Yin SN, Li GL, Tain FD, et al. A retrospective cohort study of leukemia and other cancers in benzene workers. Environ Health Perspect 1989; 82: 207–13.
Wang JX, Inskip PD, Boice JDJr, et al. Cancer incidence among medical diagnostic X-ray workers in China, 1950 to 1985. Int J Cancer 1990; 45: 889–95.
Muir C, Waterhouse J, Mack T, Powell J, Whelan S. Cancer Incidence in Five Continents. Vol V. Lyon, France: International Agency for Research on Cancer, 1987; IARC Sci. Pub. No. 88.
World Health Organization. International Classification of Diseases. Ninth Revision. Geneva: WHO, 1977.
Breslow NE, Day NE. Statistical Methods in Cancer Research: Analysis of Case-Control Studies. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32.
Doody MM, Linet MS, Glass AG, et al. Risk of hematopoietic malignancies following selected infectious, autoimmune, allergic, and musculoskeletal conditions. Cancer Causes Control 1992; 3: 449–56.
Rosenblatt KA, Koepsell TD, Daling JR, et al. Antigenic stimulation and the occurrence of chronic lymphocytic leukemia. Am J Epidemiol 1991; 134: 22–8.
Viadana E, Bross JDJ. Use of the medical history to prediet the future occurrence of leukemia in adults. Prev Med 1974; 3: 165–70.
Davis FG, Boice JDJr, Hrubec Z, Monson RR. Cancer mortality in a radiation-exposed cohort of Massachusetts tuberculosis patients. Cancer Res 1989; 49: 6130–6.
Howe GR, Lindsay J, Coppock E, Miller HB. Isoniazid exposure in relation to cancer incidence and mortality in a cohort of tuberculosis patients. Int J Epidemiol 1979; 8: 305–12.
Daniel TM, Tuberculosis. In: Wilson JD, Braunwald E, Isselbacher KJ, et al. Harrison's Principles of Internal Medicine (Twelth Edition). New York: McGraw-Hill, Inc., 1991: 637–45.
Brown LM, Gibson R, Blair A, et al. Smoking and risk of leukemia. Am J Epidemiol 1992; 135: 763–8.
Hoffman DA, McConahey WM, Fraumeni JFJr, Kurland LT. Cancer incidence following treatment of hyperthyroidism. Int J Epidemiol 1982; 11: 218–24.
Munoz JM, Gorman CA, Elveback LR, Wentz JR. Incidence of malignant neoplasms of all types in patients with Graves' disease. Arch Int Med 1978; 138: 944–7.
Hall P, Boice JDJr, Berg G, et al. Leukaemia incidence after iodine-131 exposure. Lancet 1992; 340: 1–4.
Saenger EL, Thomas GE, Tompkins EA. Incidence of leukemia following treatment of hyperthyroidism. Preliminary report for the Cooperative Thyrotoxicosis Therapy Follow-Up Study. JAMA 1968; 205: 855–62.
Goldman MB, Monson RR, Maloof F. Cancer mortality in women with thyroid disease. Cancer Res 1990: 50: 2283–9.
Stern RS, Zierler S, Parrish JA. Psoriasis and the risk of cancer. J Invest Dermatol 1982; 78: 147–9.
Stern RS, Lange R, and members of the photochemotherapy follow-up study. Cardiovascular disease, cancer, and cause of death in patients with psoriasis: 10 years prospective experience in a cohort of 1,380 patients. J Invest Dermatol 1988; 91: 197–201.
Linet MS, McCaffrey LD, Humphrey RL, et al. Chronic lymphocytic leukemia and acquired disorders affecting the immune system: A case-control study. JNCI 1986; 77: 371–8.
Cartwright RA, Bernard SM, Bird CC, et al. Chronic lymphocytic leukemia: Case-control epidemiological study in Yorkshire. Br J Cancer 1987; 56: 79–82.
Symmons DPM. Neoplasia in rheumatoid arthritis. J Rheumatol 1988; 15: 1319.
Hakulinen T, Isomaki H, Knekt P. Rheumatoid arthritis and cancer studies based on linking nationwide registries in Finland. Am J Med 1985; 78: 29–32.
Prior P. Cancer and rheumatoid arthritis: Epidemiologic considerations. Am J Med 1985; 78: 15–21.
Taylor HG, Nixon N, Sheeran TP, et al. Rheumatoid arthritis and chronic lymphatic leukaemia. Clin Exp Rheumatol 1989; 7: 529–32.
Gridley G, McLaughlin JK, Ekbom H, et al. Incidence of cancer among patients with rheumatoid arthritis. JNCI 1993; 85: 307–11.
Gibson R, Graham S, Lilienfeld A, Schuman L, Levin M, Swanson M. Epidemiology of diseases in adult males with leukemia. JNCI 1976; 56: 891–8.
Insel PA. Analgesic-antipyreties and antiinflammatory agents: Drugs employed in the treatment of rheumatoid arthritis and gout. In: Goodman A, Gilman TW, Tall AS, et al, eds. The Pharmacologic Basis of Therapeutics (Eighth Edition). New York: Pergamon Press, 1990: 647–8.
Thun MJ, Namboodiri MM, Heath CW. Aspirin use and reduced risk of fatal colon cancer. N Engl J Med 1991: 325: 1593–6.
Shu XO, Gao YT, Brinton LA, et al. A population-based case-control study of childhood leukemia in Shanghai. Cancer 1988; 62: 635–44.
Wallerstein RO, Codit PK, Kasper CK, Brown JW, Morrison FR. Statewide study of chloramphenicol therapy and fatal aplastic anemia. JAMA 1969; 208: 2045–50.
Schmitt-Graff A. Chloramphenicol-induced aplastic anemia terminating with acute nonlymphocytic leukemia. Acta Haematol 1981; 66: 267–8.
Fraumeni JFJr. Bone marrow depression induced by chloramphenicol or phenylbutazone. JAMA 1967; 201: 823–34.
Davis FG, Boice JDJr, Kelsey JL, Monson RR. Cancer mortality in a radiation-exposed cohort of Massachusetts tuberculosis patients. Cancer Res 1989; 49: 6130–6.
Hoffman DA, Lonstein JE, Morin MM, Visscher W, Harris BSH, Boice JDJr. Breast cancer in women with scoliosis exposed to multiple diagnostic X-rays. JNCI 1989; 81: 1307–12.
Yang CL, Zhang XB. Incidence survey of leukemia in China. Chin Medi Sci J 1991; 6: 65–70.
Author information
Authors and Affiliations
Additional information
This study was supported by a research grant from the Young Scientist Foundation, Chinese Ministry of Public Health.
Rights and permissions
About this article
Cite this article
Zheng, W., Linet, M.S., Shu, XO. et al. Prior medical conditions and the risk of adult leukemia in Shanghai, People's Republic of China. Cancer Causes Control 4, 361–368 (1993). https://doi.org/10.1007/BF00051339
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00051339