Ionising radiation as a risk factor for lymphoma: a review

The ability of ionising radiation to induce lymphoma is unclear. Here, we present a narrative review of epidemiological evidence of the risk of lymphoma, including chronic lymphocytic leukaemia (CLL) and multiple myeloma (MM), among various exposed populations including atomic bombing survivors, ind...

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Autores: Harbron, Richard W., Pasqual, Elisa, 1989-
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/53268
Acceso en línea:http://hdl.handle.net/10230/53268
http://dx.doi.org/10.1088/1361-6498/abbe37
Access Level:acceso abierto
Palabra clave:Chronic lymphocytic leukaemia
Ionising radiation
Lymphoma
Multiple myeloma
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spelling Ionising radiation as a risk factor for lymphoma: a reviewHarbron, Richard W.Pasqual, Elisa, 1989-Chronic lymphocytic leukaemiaIonising radiationLymphomaMultiple myelomaThe ability of ionising radiation to induce lymphoma is unclear. Here, we present a narrative review of epidemiological evidence of the risk of lymphoma, including chronic lymphocytic leukaemia (CLL) and multiple myeloma (MM), among various exposed populations including atomic bombing survivors, industrial and medical radiation workers, and individuals exposed for medical purposes. Overall, there is a suggestion of a positive dose-dependent association between radiation exposure and lymphoma. The magnitude of this association is highly imprecise, however, with wide confidence intervals frequently including zero risk. External comparisons tend to show similar incidence and mortality rates to the general population. Currently, there is insufficient information on the impact of age at exposure, high versus low linear energy transfer radiation, external versus internal or acute versus chronic exposures. Associations are stronger for males than females, and stronger for non-Hodgkin lymphoma and MM than for Hodgkin lymphoma, while the risk of radiation-induced CLL may be non-existent. This broad grouping of diverse diseases could potentially obscure stronger associations for certain subtypes, each with a different cell of origin. Additionally, the classification of malignancies as leukaemia or lymphoma may result in similar diseases being analysed separately, while distinct diseases are analysed in the same category. Uncertainty in cell of origin means the appropriate organ for dose response analysis is unclear. Further uncertainties arise from potential confounding or bias due to infectious causes and immunosuppression. The potential interaction between radiation and other risk factors is unknown. Combined, these uncertainties make lymphoma perhaps the most challenging malignancy to study in radiation epidemiology.IOP Publishing Ltd.202220222020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/53268http://dx.doi.org/10.1088/1361-6498/abbe37reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésJ Radiol Prot. 2020 Nov 20;40(4)Original content from this work may be used under the terms of the Creative Commons Attribution 4.0 license. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/532682026-06-12T07:21:37Z
dc.title.none.fl_str_mv Ionising radiation as a risk factor for lymphoma: a review
title Ionising radiation as a risk factor for lymphoma: a review
spellingShingle Ionising radiation as a risk factor for lymphoma: a review
Harbron, Richard W.
Chronic lymphocytic leukaemia
Ionising radiation
Lymphoma
Multiple myeloma
title_short Ionising radiation as a risk factor for lymphoma: a review
title_full Ionising radiation as a risk factor for lymphoma: a review
title_fullStr Ionising radiation as a risk factor for lymphoma: a review
title_full_unstemmed Ionising radiation as a risk factor for lymphoma: a review
title_sort Ionising radiation as a risk factor for lymphoma: a review
dc.creator.none.fl_str_mv Harbron, Richard W.
Pasqual, Elisa, 1989-
author Harbron, Richard W.
author_facet Harbron, Richard W.
Pasqual, Elisa, 1989-
author_role author
author2 Pasqual, Elisa, 1989-
author2_role author
dc.subject.none.fl_str_mv Chronic lymphocytic leukaemia
Ionising radiation
Lymphoma
Multiple myeloma
topic Chronic lymphocytic leukaemia
Ionising radiation
Lymphoma
Multiple myeloma
description The ability of ionising radiation to induce lymphoma is unclear. Here, we present a narrative review of epidemiological evidence of the risk of lymphoma, including chronic lymphocytic leukaemia (CLL) and multiple myeloma (MM), among various exposed populations including atomic bombing survivors, industrial and medical radiation workers, and individuals exposed for medical purposes. Overall, there is a suggestion of a positive dose-dependent association between radiation exposure and lymphoma. The magnitude of this association is highly imprecise, however, with wide confidence intervals frequently including zero risk. External comparisons tend to show similar incidence and mortality rates to the general population. Currently, there is insufficient information on the impact of age at exposure, high versus low linear energy transfer radiation, external versus internal or acute versus chronic exposures. Associations are stronger for males than females, and stronger for non-Hodgkin lymphoma and MM than for Hodgkin lymphoma, while the risk of radiation-induced CLL may be non-existent. This broad grouping of diverse diseases could potentially obscure stronger associations for certain subtypes, each with a different cell of origin. Additionally, the classification of malignancies as leukaemia or lymphoma may result in similar diseases being analysed separately, while distinct diseases are analysed in the same category. Uncertainty in cell of origin means the appropriate organ for dose response analysis is unclear. Further uncertainties arise from potential confounding or bias due to infectious causes and immunosuppression. The potential interaction between radiation and other risk factors is unknown. Combined, these uncertainties make lymphoma perhaps the most challenging malignancy to study in radiation epidemiology.
publishDate 2020
dc.date.none.fl_str_mv 2020
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/53268
http://dx.doi.org/10.1088/1361-6498/abbe37
url http://hdl.handle.net/10230/53268
http://dx.doi.org/10.1088/1361-6498/abbe37
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv J Radiol Prot. 2020 Nov 20;40(4)
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv IOP Publishing Ltd.
publisher.none.fl_str_mv IOP Publishing Ltd.
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
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