RESPONSE: Re: Birth Order, Atopy, and Risk of Non-Hodgkin Lymphoma

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Abstract
We recently reported ( 1 ) that early birth order is associated with a reduced risk of non-Hodgkin lymphoma (NHL). Although birth order reflects the number of older siblings, Kemp et al. suggest that examination of younger sibling numbers and birth intervals may provide insights into the timing and mechanism of the risk reduction. In a case–control study ( 2 ) , these researchers found that increased exposure to younger siblings was associated with a reduced risk of multiple sclerosis (MS). In addition, because high Epstein-Barr Virus (EBV) antibody patterns were associated with exposure to younger siblings among the control subjects, they suggested that exposure to infection with EBV through younger siblings may decrease the risk of MS ( 2 ) .

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