Evidence map›Paper›PMID 21690473›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2011

Chronic immune stimulation might act as a trigger for the development of acute myeloid leukemia or myelodysplastic syndromes.

Sigurdur Y Kristinsson, Magnus Björkholm, Malin Hultcrantz, Åsa R Derolf, Ola Landgren, Lynn R Goldin

Open access · bronzeAbstract read
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 159 papers.

0numbers the graph read from it
0cells of the map it votes in
159citing papers in PubMed
5.3field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

159 citing papers in PubMed, 289 citations in OpenAlex.

  1. Article
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  9. Ageing, immune fitness and cancer.Nature reviews. Cancer · 2025
    Review
  10. Review
  11. Review
  12. Expert Perspective: Hematologic Malignancies and Vasculitis.Arthritis & rheumatology (Hoboken, N.J.) · 2025
    Review
  13. Science advances · 2025
    Article
  14. Article
  15. Article
  16. The Prognostic Value of C-Reactive Protein and Albumin in Newly Diagnosed Patients with AML.International journal of hematology-oncology and stem cell research · 2025
    Article
  17. Review
  18. Review
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  20. Article

99 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Sigurdur Y KristinssonDept of Medicine, Division of Hematology, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden. sigurdur.kristinsson@karolinska.se
Magnus Björkholm
Malin Hultcrantz
Åsa R Derolf
Ola Landgren
Lynn R Goldin
Karolinska University Hospital · SE

Funding

Family Studies ZIACP004410 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI SAVAGE, SHARON A. · 2009 to 2025
$56.1M
Genetic EpidemiologyZIACP005803 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI GOLDSTEIN, ALISA · 2009 to 2025
$24.8M
STUDIES OF PERSONS AT HIGH RISK OF CANCER--GENETIC EPIDEMIOLOGYZ01CP004410 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI TUCKER, MARGARET · 1985 to 2008
$15.0M
CLINICAL/IMMUNOLOGIC/GENETIC ANALYSES OF AUTOIMMUNE LYMPHOPROLIFERATIVE SYNDROMEZ01AI000732 · NIAID · NIAID EXTRAMURAL ACTIVITIES · PI RAO, VEMULKONDA · 1995 to 2008
$1.1M
Population based studiesZIABC011205 · NCI · DIVISION OF BASIC SCIENCES - NCI · PI LANDGREN, OLA · 2009 to 2014
$858k
Intramural NIH HHS Z01 CP004410
6 · The paper itself

Abstract

purposePatients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) often present with infections, but there are little data to assess whether a personal history of selected infections may act as pathogenic triggers. To additionally expand our knowledge on the role of immune stimulation in the causation of AML and MDS, we have conducted a large, population-based study to evaluate the risk of AML and MDS associated with a prior history of a broad range of infections or autoimmune diseases. PATIENTS AND

methodsBy using population-based central registries in Sweden, we included 9,219 patients with AML, 1,662 patients with MDS, and 42,878 matched controls. We used logistic regression to calculate odds ratios (ORs) and 95% CIs for the association of AML or MDS with infectious and/or autoimmune diseases.

resultsOverall, a history of any infectious disease was associated with a significantly increased risk of both AML (OR, 1.3; 95% CI, 1.2 to 1.4) and MDS (OR, 1.3; 95% CI, 1.1 to 1.5). These associations were significant even when we limited infections to those occurring 3 or more years before AML/MDS. A previous history of any autoimmune disease was associated with a 1.7-fold (95% CI, 1.5 to 1.9) increased risk for AML and 2.1-fold (95% CI, 1.7 to 2.6) increased risk for MDS. A large range of conditions were each significantly associated with AML and MDS.

conclusionOur novel findings indicate that chronic immune stimulation acts as a trigger for AML/MDS development. The underlying mechanisms may also be due to a common genetic predisposition or an effect of treatment for infections/autoimmune conditions.

Indexed as

AdultAgedAged, 80 and overAutoimmune DiseasesCase-Control StudiesCommunicable DiseasesFemaleHumansLeukemia, Myeloid, AcuteLogistic ModelsMaleMiddle AgedMyelodysplastic SyndromesOdds RatioRegistriesRisk Assessment

Identifiers

PMID21690473
PMCPMC3138717
OpenAlexW2129049052

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.