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Association of Occupational Pesticide Exposure With Immunochemotherapy Response and Survival Among Patients With Diffuse Large B-Cell Lymphoma

dc.rights.licenseopenen_US
dc.contributor.authorLAMURE, S.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorCARLES, Camille
dc.contributor.authorAQUEREBURU, Q.
dc.contributor.authorQUITTET, P.
dc.contributor.authorTCHERNONOG, E.
dc.contributor.authorPAUL, F.
dc.contributor.authorJOURDAN, E.
dc.contributor.authorWAULTIER, A.
dc.contributor.authorDEFEZ, C.
dc.contributor.authorBELHADJ, I.
dc.contributor.authorSANHES, L.
dc.contributor.authorBURCHERI, S.
dc.contributor.authorDONADIO, D.
dc.contributor.authorEXBRAYAT, C.
dc.contributor.authorSAAD, A.
dc.contributor.authorLABOUREY, J. L.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBALDI, Isabelle
dc.contributor.authorCARTRON, G.
dc.contributor.authorFABBRO-PERAY, P.
dc.date.accessioned2020-06-24T08:51:36Z
dc.date.available2020-06-24T08:51:36Z
dc.date.issued2019-04-05
dc.identifier.issn2574-3805en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/8132
dc.description.abstractEnImportance: Professional use of pesticides is a risk factor for non-Hodgkin lymphoma. The main biological mechanisms of pesticides and chemotherapy are genotoxicity and reactive oxygen species generation. Cellular adaptation among patients exposed to low doses of genotoxic and oxidative compounds might hinder chemotherapy efficiency in patients with lymphoma. Objective: To examine the association of occupational exposure to pesticides with immunochemotherapy response and survival among patients treated for diffuse large B-cell lymphoma. Design, Setting, and Participants: This retrospective cohort study assessed patients treated from July 1, 2010, to May 31, 2015, for diffuse large B-cell lymphoma, with a 2-year follow-up. The study took place at 6 university and nonuniversity hospitals in Languedoc-Roussillon, France. A total of 404 patients with newly diagnosed diffuse large B-cell lymphoma treated with anthracycline-based immunochemotherapy were included before the study began. Occupational history was reconstructed for 244 patients and analyzed with the PESTIPOP French job-exposure matrix to determine likelihood of occupational exposure to pesticides. Analysis of the data was performed from July 15, 2017, to July 15, 2018. Main Outcomes and Measures: Treatment failure (ie, partial response, stable disease, disease progression, or interruption for toxic effects) rate, 2-year event-free survival, and overall survival between exposed and nonexposed patients after adjustment for confounding factors. Results: A total of 244 patients (mean [SD] age, 61.3 [15.2] years; 153 [62.7%] male) had complete occupational data. Of these patients, 67 (27.4%) had occupational exposure to pesticides, with 38 exposed through agricultural occupations. Occupational exposure was not associated with clinical and biological characteristics at diagnosis. Occupationally exposed patients had a significantly higher treatment failure rate (22.4% vs 11.3%; P = .03; adjusted odds ratio [AOR] for confounding factors, 3.0; 95% CI, 1.3-6.9); this difference was higher among patients with exposing agricultural occupations compared with other patients (29.0% vs 11.7%; AOR, 5.1; 95% CI, 2.0-12.8). Two-year event-free survival was 70% in the occupationally exposed group vs 82% in the unexposed group (adjusted hazard ratio [AHR] for confounding factors, 2.2; 95% CI, 1.3-3.9). Among patients with exposing agricultural occupations compared with other patients, the difference was more pronounced (2-year event-free survival, 56% vs 83%; AHR, 3.5; 95% CI, 1.9-6.5). Similarly, 2-year overall survival was lower in the group of patients with exposing agricultural occupations compared with other patients (81% vs 92%; AHR, 3.9; 95% CI, 1.5-10.0). Conclusions and Relevance: This retrospective study showed that agricultural occupational exposure to pesticides was associated with treatment failure, event-free survival, and overall survival among patients with diffuse large B-cell lymphoma.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subject.enEPICENE
dc.title.enAssociation of Occupational Pesticide Exposure With Immunochemotherapy Response and Survival Among Patients With Diffuse Large B-Cell Lymphoma
dc.title.alternativeJAMA Netw Openen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1001/jamanetworkopen.2019.2093en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed31002318en_US
bordeaux.journalJAMA network openen_US
bordeaux.pagee192093en_US
bordeaux.volume2en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue4en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamEPICENE_BPH
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
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