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1621 Myeloproliferative Neoplasms: An in-Depth Case-Control (MOSAICC) Study

Myeloproliferative Syndromes: Clinical
Program: Oral and Poster Abstracts
Session: 634. Myeloproliferative Syndromes: Clinical: Poster I
Saturday, December 5, 2015, 5:30 PM-7:30 PM
Hall A, Level 2 (Orange County Convention Center)

Mary Frances McMullin, MD, FRCPath, FRCP1,2, Andrew Duncombe, MD, PhD3*, Glen J. Titmarsh, BSc4*, Frank de Vocht, PhD5*, Lin Fritschi, PhD6*, Ruben A. Mesa7, Mike Clarke, PhD8* and Lesley A. Anderson, PhD, MPH8*

1Queen's University Belfast, Belfast, United Kingdom
2Queens University of Belfast Belfast City Hospital, Belfast, United Kingdom
3Haematology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
4Centre for Public Health, Queen's University Belfast, Belfast, Antrim, United Kingdom
5School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
64Curtin University, Perth, Australia
7Mayo Clinic, Scottsdale, AZ
8Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom

Introduction

The Classic Myeloproliferative Neoplasms (MPNs), characterised by an over production of one or more cells of the myeloid lineage, are classified into polycythaemia vera (PV), essential thrombocythaemia (ET) and primary myelofibrosis (PMF). Despite the identification of numerous genetic mutations, a paucity of information relating to medical and lifestyle factors contributing to the aetiology of these diseases remains.

Methods

The MOSAICC Study was an exploratory case-control study of MPNs.  MPN patients were recruited between two sites, Belfast and Southampton, in preparation for a planned UK-wide investigation.  Population controls (identified by General Practitioners) and non-blood relative/friend controls were also recruited. Participants completed a telephone-based questionnaire seeking information on a range of medical, environmental, lifestyle and occupational risk factors.  Risk factors were assessed using unconditional logistic regression with adjustment for potential confounders.

Results

Risk factors identified included smoking [≥25 pack years vs. never: odds ratio (OR) 3.14, 95% confidence interval (CI) 1.26-7.87], increasing childhood household density [>2 vs <1 Child(ren)/room: OR 3.29, 95% CI 1.31-8.30], history of heart disease (OR 3.31, 95% CI 1.23-8.87), CT scans (≥3 vs. none: OR 4.92, 95% CI 1.55-15.67), having an implant (OR 10.77, 95% CI 1.01-3.10), and pig ownership (OR 5.92, 95% CI 1.17-29.92). Alcohol was associated with a reduced risk of MPNs (OR 0.49, 95% CI 0.28-0.88) as was home working on car exhausts (OR 0.33, 95% CI 0.12-0.88), painting at home (OR 0.49, 95% CI 0.28-0.86) and short haul air travel (p for trend 0.012). Participants working in occupations with high exposure to environmental tobacco smoke had an excess risk of MPN (OR 2.45, 95% CI 1.12-5.37). Work-based radiation and solvent exposure also appeared to increase risk of MPNs (p<0.05).

Conclusions

This exploratory study has confirmed a reported association between cigarette smoking and MPNs.  It has identified some potential novel risk factors including work-based radiation and solvent exposure.  The findings of this study need to be replicated in a larger, adequately powered, study in order to identify important risk factors for the classic MPNs.

Conflict of Interest

The authors declare no conflict of interest.

Acknowledgements: The MOSAICC Study team acknowledges the support of the National Institute for Health Research, through the Northern Ireland Cancer Research Network  (NICRN) and for Southampton the Central South Coast Cancer Network (CSCCN).  The team thank those who have participated in the MOSAICC study and the personnel who assisted in the recruitment of patients.

Disclosures: Mesa: Genentech: Research Funding ; NS Pharma: Research Funding ; CTI Biopharma: Research Funding ; Incyte Corporation: Research Funding ; Pfizer: Research Funding ; Promedior: Research Funding ; Novartis Pharmaceuticals Corporation: Consultancy ; Gilead: Research Funding .

*signifies non-member of ASH