NSAID consumption and risk of acute myeloid leukemia: a national population-based case-control study
Received 14 February 2018
Accepted for publication 29 May 2018
Published 29 October 2018 Volume 2018:10 Pages 5043—5051
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Kenan Onel
Lene Sofie Granfeldt Østgård,1–3 Mette Nørgaard,2 Lars Pedersen,2 René Østgård,4 Lone Smidstrup Friis,5 Claudia Schöllkopf,6 Marianne Tang Severinsen,7,8 Claus Werenberg Marcher,9 Bruno C Medeiros,10 Morten Krogh Jensen11
1Department of Hematology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 3Department of Medicine, Holstebro Regional Hospital, Holstebro, Denmark; 4Diagnostic Center, Silkeborg Regional Hospital, Silkeborg, Denmark; 5Department of Hematology, The University Hospital Rigshospitalet, Copenhagen, Denmark; 6Department of Hematology, Herlev University Hospital, Herlev, Denmark; 7Department of Hematology, Aalborg University Hospital, Aalborg, Denmark; 8Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 9Department of Hematology, Odense University Hospital, Odense, Denmark; 10Stanford University, School of Medicine, Stanford, CA, USA; 11Department of Hematology, Roskilde University Hospital, Roskilde, Denmark
Background: Most cases of acute leukemia arise without identifiable risk factors. Studies investigating the impact of autoimmune diseases and infections on leukemogenesis have revealed conflicting results. If inflammation increases the risk of acute myeloid leukemia (AML), nonsteroidal anti-inflammatory drug (NSAID) use may decrease the risk of leukemia.
Methods: We conducted a case-control study of 3,053 patients with AML diagnosed between 2000 and 2013, who were registered in the Danish National Acute Leukemia Registry, and 30,530 population controls matched on sex and age. We identified prescriptions through the Danish National Health Service Prescription Database. We used conditional logistic regression analysis to compute ORs associating AML with NSAID use overall, in patients with inflammatory diseases, and for specific AML subtypes (de novo AML, AML related to previous hematological disease, ie, secondary AML [sAML], or therapy-related AML [tAML; exposed to previous cytotoxic therapy]).
Results: Overall, NSAID use was not associated with a lower risk of AML (OR 1.1, 95% CI=1.0–1.2), de novo AML (OR 1.0, 95% CI=0.9–1.1), and sAML/tAML (OR 1.3, 95% CI=1.1–1.5). In addition, in patients with known inflammatory diseases, NSAIDs did not affect AML risk (OR 0.9, 95% CI=0.5–1.6). Number of prescriptions, type of NSAID, age, or sex did not influence the results.
Conclusion: In line with our recent findings that showed no association between autoimmune diseases and infections and de novo AML, NSAID use was not found to reduce the risk of AML.
Keywords: acute myeloid leukemia, population controls, population-based, risk, NSAIDs, inflammation
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