NON-HODGKIN'S LYMPHOMA SECONDARY TO AMPHETAMINE USE
1) Nelson RA, Levine AM, Marks G, Bernstein L. Alcohol, tobacco and recreational drug use and the risk of non-Hodgkin's lymphoma. British Journal of Cancer 1997;76(11):1532-7
From Department of Preventive Medicine, School of Medicine, University of Southern California
A population based case-control study was conducted to determine whether risk of non-Hodgkin's lymphoma is related to previous tobacco, alcohol or recreational drugs. Amphetamines were associated with a significantly increased risk of non-Hodgkin's lymphoma (Odds ratio OR = 2.44, 95% CI = 1.13-5.31). In regards to dose-response relationships, there was a statistically significant trend observed with increasing use of amphetamines (P = 0.03) (i.e. the risk was greater among those with more frequent amphetamine use.)
2) Doody MM, Linet MS, Glass AG, Curtis RE, Pottern LM, Rush BB, Boice JD Jr, Fraumeni JF Jr, and Friedman GD. Risk of non-Hodgkin's lymphoma, multiple myeloma, and leukemia associated with common medications. Epidemiology 1996;7:131-139
From Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD
Data from two Kaiser Permanente medical care programs were used to
evaluate risks of hematopoietic and lymphoproliferative malignancies after use of 14 common medications. Included in the study were 510 patients with hematological and lymphoproliferative malignancies and 695 controls. In contrast to data from interview studies, medical record data are not subject to possible bias in the form of differential recall between case and control subjects. Using a minimum 5-year exposure lag between first notation and malignancy diagnosis the risk of non-Hodgkin's lymphoma was greater among plan members who were prescribed amphetamines (Odds ratio OR = 2.2; 95% CI = 1.1-4.8). The risk of non-Hodgkin's lymphoma rose with increasing number of medical record notations for amphetamines (P = 0.01). The OR for greater than or equal to 3 notations for amphetamines was: OR = 9.5; 95% CI 2.0-44.0).
Note: The OR for greater than or equal to 3 notations for amphetamines was: OR = 9.5; 95% CI 2.0-44.0).
The study by Nelson RA et al above (Department of Preventive Medicine, School of Medicine, University of Southern California) and the study by Doody MM et al above (Epidemiology Branch, National Cancer Institute) – both show:
1) A significant relationship between amphetamine use and the development of non-Hodgkin's lymphoma.
2) A dose response relationship. In the National Cancer Institute study, if there was three notations or more in the chart for amphetamine use the OR = 9.5; 95% CI 2.0-44.0).
A prospective case-control study of the aetiologic factors involved in the production of lymphoid malignancies was conducted within a defined geographic area covering six health districts in Yorkshire Region. Included in the study were 285 patients with lymphoid malignancies and an equal number of controls. Amphetamine use was associated with an increased risk ratio but this did not reach statistical significance in this study (Risk ratio = 3.04; 95% Confidence limits 0.66-14.09)
A case-control study of patients with Hodgkins disease from the Los Angeles County was performed. Included in the study were 218 patients with Hodgkin's disease and 218 controls. An assessment and determination of risk ratios for various risk factors was performed. The authors state quite clearly that one of the prestudy objectives was to assess the association between amphetamines and Hodgkin's disease. This study was performed to confirm a previous study by these authors that showed a significant relationship between amphetamine use and Hodgkin's disease. The authors again found a strong statistically significant association between Hodgkin's disease and amphetamine use (Risk ratio = 3.0, P = 0.01). A dose-effect relationship was suggested as the risk ratio for using amphetamines for at least 1 year was markedly increased (Risk ratio = 11.0, P = 0.003)
A case-control study of patients with Hodgkin's disease was undertaken
seeking clues to disease etiology. The above two manuscripts reported Hodgkin's disease patients had a sixfold increase in prior history of Dexedrine use when compared to matched nonrelated controls (relative risk = 6.3, P = < 0.01).
CASE REPORT (ACUTE MYELOBLASTIC LEUKEMIA) and AMPHETAMINES
Berry JN. Acute Myeloblastic leukemia in a benzedrine addict. Southern Medical Journal (1966) 59(10):1169-70
This paper reports that a 24 year old benzedrine addict develops acute myeloblastic leukemia after taking massive dosages of the drug benzedrine for more than 2 years. The author reviews briefly some of the hematological effects of amphetamines. The author also raises the question of whether the amphetamines could potentially cause leukemia because it is a synthetic benzene-ring derivative. The author points out that other agents/drugs that are benzene ring derivatives have known toxic hematological effects (e.g. author sites report of acute leukemia associated with phenybutazone therapy).
ACUTE LYMPHOBLASTIC LEUKEMIA AND AMPHETAMINE USE
1) Parental medication use and risk of childhood acute lymphoblastic leukemia. Wen W, Shu XO, Potter JD, Severson RK, Buckley JD, Reaman GH, Robison LL. Cancer 2002 Oct 15;95(8):1786-94
Few studies have examined the risk of childhood acute lymphoblastic leukemia (ALL) associated with parental medication use. As part of a large case-control study conducted by the Children's Cancer Group, we evaluated the association between maternal and paternal medication use and the risk of ALL in offspring. Participants included 1842 children of 14 years or younger with newly diagnosed and immunophenotypically defined ALL and 1986 individually matched controls. Paternal use of amphetamines or diet pills were associated with an increased risk of childhood ALL in the offspring (OR = 2.2, 99% CI: 1.2-3.9). Paternal use of amphetamines or diet pills (during the 1 year before pregnancy) more than doubled the offspring's risk of ALL. When both parents reported using these drugs the risk of childhood ALL rose even further (OR = 2.8). CONCLUSIONS: The findings of this study suggest that amphetamines use immediately before and during the index pregnancy may influence risk of ALL in offspring.