Identification of Occupational Exposures in Acute Hematologic Malignancy
Condition: Non Hodgkin Lymphoma; Chronic Lymphocytic Leukemia; Multiple Myeloma
MeSH terms: Multiple Myeloma; Leukemia, Lymphocytic, Chronic, B-Cell; Hematologic Neoplasms
Study type: Observational

Summary: 
      Lymphoid hemopathies are a group of malignant haematological disorders characterized by
      clonal proliferation of cells of the lymphoid line. Non-Hodgkin's lymphoma (NHL), chronic
      lymphocytic leukemia (CLL), and multiple myeloma (MM) are the most frequently encountered
      features of lymphoid hemopathies. Duriong the last 35 years the prevalence of these
      pathologies has increased in France but also in most industrialized countries. This increased
      can't be solely explained by demographic changes and improvements in diagnostic techniques.
      As a result, the involvement of environmental and professional factors is strongly suspected.
      Studies have shown that these diseases are associated with some professions or type of
      activity, including agricultural occupations, and other sectors such as agriculture,
      printing, woodworking. Some organic solvents and pesticides have been suspected of being risk
      factors of hematologic malignancies. Based on cohort studies and case-control studies, some
      of them have been identified by the International Cancer Research Center as associated with
      the occurrence of NHL with a sufficient or limited level of evidence. One of the difficulties
      encountered in the analysis of the literature has been the permanent evolution of the
      international classification of lymphoid hemopathies over the past 30 years. The old
      epidemiological studies are therefore difficult to interpret. Lymphoid hemopathies cover a
      range of different conditions, thus it is likely that carcinogens involved vary according to
      the type of hemopathy. Finally, environmental and occupational exposures to various chemicals
      and biological agents have evolved over time. The aim of this study is firstly to develop and
      validate a questionnaire to identify and quantify exposures to nuisances (substances and
      agents) suspected of being associated with the occurrence of NHL, MM and LLC. In a second
      time, this questionnaire will be used as a support for the realization of a subsequent
      case-control study to improve epidemiological knowledge on these diseases.
    

Detailed description: 
      This study is a prospective, multicenter study on patients with a diagnosis of NHL, MM or
      CLL. All the patients with a diagnosis of NHL, MM or CLL in the participant centers will be
      purposed to participate. Each patient included will have an interview with a clinical study
      technician or doctor of occupational medicine. A specific detailed questionnaire has been
      created for the study. It focuses on specialized professional careers to spread occupational
      exposures to nuisances (substances and agents) suspected of being associated with NHL, MM or
      LLC risk. Each questionnaire will be evaluated by a physician expert in occupational disease,
      to conclude on the parameters exposure to the various suspected carcinogens. The study will
      cover 300 patients.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The study will be proposed to all the patients diagnosed with NHL, MM and CLL aged between
        20 and 80 years old, without HIV infection and history of bone marrow transplant. If the
        patients agree to participate, a clinical research technician or a physician will give them
        a 2-hour questionnaire on their past occupational and exposures to toxic products. This
        filled questionnaire will then be interpreted by a specialized doctor to evaluate the
        exposition to each toxic products.