Menopausal estrogen therapy and non‐ H odgkin's lymphoma: A post‐hoc analysis of women's health initiative randomized clinical trial
Year: 2015
Type: article
Abstract: Estrogens are important immunomodulators, exerting significant effects on cell proliferation, apoptosis, cytokine production and differentiation of hematopoietic cells. Estrogen receptors are expressed on normal B and T lymphocytes, bone marrow and in leukemia and lymphoma cell lines. Epidemiologic evidence for the association of menopausal hormone use with risk of non-Hodgkin's lymphoma (NHL) has been mixed; however, all of the investigations have been observational. We analyzed the data from Women's Health Initiative hormone therapy trials where conjugated equine estrogens (CEE; 0.625 mg/d) plus medroxyprogesterone acetate (MPA; 2.5 mg/d) (n = 16,654) or CEE alone (women with prior hysterectomy) (n = 10,685) were tested against placebos and the intervention lasted a median of 5.6 years in the CEE + MPA trial and 7.2 years in the CEE alone trial. During 13 years of follow-up through September 20, 2013 383 incident NHL cases were identified. We used the intent-to-treat approach to calculate incidence rates of NHL, hazards ratios (HR) and 95% confidence intervals (CI) by treatment group. Incidence of NHL was virtually the same in the treatment and placebo groups. The HR was 1.02 (95%CI 0.74-1.39) for CEE alone, 0.98 (95% CI 0.76-1.28) for CEE+MPA, and 1.00 (95% CI 0.82-1.22) for both combined. There were no specific NHL subtypes associated with either type of the treatment, except a marginally decreased risk of plasma cell neoplasms (HR= 0.53 95% CI 0.27-1.03) in the CEE-alone group. These results do not support a role of estrogen alone or combined with progestin in the development of NHL among postmenopausal women.
Source: International Journal of Cancer
DOI: 10.1002/ijc.29819
Institutions: Wayne State University, University of California, Los Angeles, The Lundquist Institute, Northwestern University, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, University at Buffalo, State University of New York, Fred Hutch Cancer Center, Weill Cornell Medicine
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Amgen, Pfizer, Brigham and Women's Hospital, Ohio State University, Wake Forest University, University of Pittsburgh, Genomic Health, MedStar Health Research Institute, Novo Nordisk, National Institutes of Health, Genentech, U.S. Public Health Service, University at Buffalo, National Heart, Lung, and Blood Institute, National Cancer Institute
Awards: G2417273319, G257474614, G2852769941, G2868073770, G2880260212, G3544793024, G3642616392, COORDINATING CENTER FOR WOMEN'S HEALTH INITIATIVE, G443405440, G4454202622, G4484576498, G4560602636, G484043965, G4847987001, G4940723635, G5026349245, G5209003178, G5881391427, G603760282, G6604908402, G7582705761, G8178424689, G8399797517, G8780700017, G8934942062, CANCER CENTER SUPPORT GRANT, G999174792
OpenAlex ID: W1825637415