- Smedby, Karin E;
- Foo, Jia Nee;
- Skibola, Christine F;
- Darabi, Hatef;
- Conde, Lucia;
- Hjalgrim, Henrik;
- Kumar, Vikrant;
- Chang, Ellen T;
- Rothman, Nathaniel;
- Cerhan, James R;
- Brooks-Wilson, Angela R;
- Rehnberg, Emil;
- Irwan, Ishak D;
- Ryder, Lars P;
- Brown, Peter N;
- Bracci, Paige M;
- Agana, Luz;
- Riby, Jacques;
- Cozen, Wendy;
- Davis, Scott;
- Hartge, Patricia;
- Morton, Lindsay M;
- Severson, Richard K;
- Wang, Sophia S;
- Slager, Susan L;
- Fredericksen, Zachary S;
- Novak, Anne J;
- Kay, Neil E;
- Habermann, Thomas M;
- Armstrong, Bruce;
- Kricker, Anne;
- Milliken, Sam;
- Purdue, Mark P;
- Vajdic, Claire M;
- Boyle, Peter;
- Lan, Qing;
- Zahm, Shelia H;
- Zhang, Yawei;
- Zheng, Tongzhang;
- Leach, Stephen;
- Spinelli, John J;
- Smith, Martyn T;
- Chanock, Stephen J;
- Padyukov, Leonid;
- Alfredsson, Lars;
- Klareskog, Lars;
- Glimelius, Bengt;
- Melbye, Mads;
- Liu, Edison T;
- Adami, Hans-Olov;
- Humphreys, Keith;
- Liu, Jianjun
- Editor(s): Gibson, Greg
Non-Hodgkin lymphoma (NHL) represents a diverse group of hematological malignancies, of which follicular lymphoma (FL) is a prevalent subtype. A previous genome-wide association study has established a marker, rs10484561 in the human leukocyte antigen (HLA) class II region on 6p21.32 associated with increased FL risk. Here, in a three-stage genome-wide association study, starting with a genome-wide scan of 379 FL cases and 791 controls followed by validation in 1,049 cases and 5,790 controls, we identified a second independent FL-associated locus on 6p21.32, rs2647012 (OR(combined) = 0.64, P(combined) = 2 × 10(-21)) located 962 bp away from rs10484561 (r(2)<0.1 in controls). After mutual adjustment, the associations at the two SNPs remained genome-wide significant (rs2647012:OR(adjusted) = 0.70, P(adjusted) = 4 × 10(-12); rs10484561:OR(adjusted) = 1.64, P(adjusted) = 5 × 10(-15)). Haplotype and coalescence analyses indicated that rs2647012 arose on an evolutionarily distinct haplotype from that of rs10484561 and tags a novel allele with an opposite (protective) effect on FL risk. Moreover, in a follow-up analysis of the top 6 FL-associated SNPs in 4,449 cases of other NHL subtypes, rs10484561 was associated with risk of diffuse large B-cell lymphoma (OR(combined) = 1.36, P(combined) = 1.4 × 10(-7)). Our results reveal the presence of allelic heterogeneity within the HLA class II region influencing FL susceptibility and indicate a possible shared genetic etiology with diffuse large B-cell lymphoma. These findings suggest that the HLA class II region plays a complex yet important role in NHL.