Estimation of the Exposure-Response Relation between Benzene and Acute Myeloid Leukemia by Combining Epidemiologic, Human Biomarker, and Animal Data.

Abstract

BACKGROUND:

Chemical risk assessment can benefit from integrating data across multiple evidence bases, especially in exposure-response curve (ERC) modeling when data across the exposure range are sparse.

METHODS:

We estimated the ERC for benzene and acute myeloid leukemia (AML), by fitting linear and spline-based Bayesian meta-regression models that included summary risk estimates from non-AML and nonhuman studies as prior information. Our complete dataset included six human AML studies, three human leukemia studies, 10 human biomarker studies, and four experimental animal studies.

RESULTS:

A linear meta-regression model with intercept best predicted AML risks after cross-validation, both for the full dataset and AML studies only. Risk estimates in the low exposure range [<40 parts per million (ppm)-years] from this model were comparable, but more precise when the ERC was derived using all available data than when using AML data only. Allowing for between-study heterogeneity, RRs and 95% prediction intervals (95% PI) at 5 ppm-years were 1.58 (95% PI, 1.01-3.22) and 1.44 (95% PI, 0.85-3.42), respectively.

CONCLUSIONS:

Integrating the available epidemiologic, biomarker, and animal data resulted in more precise risk estimates for benzene exposure and AML, although the large between-study heterogeneity hampers interpretation of these results. The harmonization steps required to fit the Bayesian meta-regression model involve a range of assumptions that need to be critically evaluated, as they seem crucial for successful implementation.

IMPACT:

By describing a framework for data integration and explicitly describing the necessary data harmonization steps, we hope to enable risk assessors to better understand the advantages and assumptions underlying a data integration approach.See related commentary by Keil, p. 695.

• Authors: Bernice Scholten, Lützen Portengen, Anjoeka Pronk, Rob Stierum, George S Downward, Jelle Vlaanderen, Roel Vermeulen
• Journal: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology (Cancer Epidemiol Biomarkers Prev) Vol. 31 Issue 4 Pg. 751-757 (04 01 2022) ISSN: 1538-7755 [Electronic] United States
• PMID: 34906966 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: ©2021 American Association for Cancer Research.

Chemical References

• Biomarkers
• Benzene

Topics

• Animals
• Bayes Theorem
• Benzene (toxicity)
• Biomarkers
• Humans
• Leukemia, Myeloid, Acute (chemically induced, epidemiology)
• Occupational Exposure