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Groves FD, Watkins BT, Roberts DJ, Tucker TC, Shen T, Flood TJ. Birth Weight and Risk of Childhood Acute Lymphoblastic Leukemia in Arizona, Illinois, and Kentucky. South Med J 2019; 111:579-584. [PMID: 30285262 DOI: 10.14423/smj.0000000000000873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To confirm the previously reported increased risk of leukemia among macrosomic children (those with birth weight >4 kg). METHODS Birth certificates of Arizona, Illinois, and Kentucky children diagnosed as having acute lymphoblastic leukemia (ALL) before age 5 years were matched with birth certificates from leukemia-free children of the same sex, race, and ethnicity who were born in the same county on or about the same day. Odds ratios (ORs) for ALL among children of low (<2.5 kg) or high (>4 kg) birth weight were calculated by conditional logistic regression. RESULTS Children with high birth weight had an elevated risk of ALL in the first 5 years of life (OR 1.28, 95% confidence interval [CI] 1.01-1.61). The excess risk was confined to non-Hispanic whites (OR 1.77, 95% CI 1.27-2.48), both boys (OR 1.57, 95% CI 1.01-2.45) and girls (OR 2.10, 95% CI 1.26-3.52). CONCLUSIONS This study confirms the association between high birth weight and ALL previously reported by other studies in children of European ancestry. The literature on maternal risk factors for both macrosomia and ALL is reviewed, with maternal overnutrition emerging as a plausible risk factor for both outcomes.
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Affiliation(s)
- Frank D Groves
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Brittany T Watkins
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Daniel J Roberts
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Thomas C Tucker
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Tiefu Shen
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
| | - Timothy J Flood
- From the Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, the Illinois State Cancer Registry, Springfield, and the Arizona Cancer Registry, Phoenix
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Pérez-Saldivar ML, Fajardo-Gutiérrez A, Sierra-Ramírez JA, Núñez-Villegas N, Pérez-Lorenzana H, Dorantes-Acosta EM, Román-Zepeda PF, Rodríguez-Zepeda MDC, González-Ulivarri JE, López-Santiago N, Martínez-Silva SI, Paredes-Aguilera R, Velázquez-Aviña MM, Flores-Lujano J, Jiménez-Hernández E, Núñez-Enríquez JC, Bekker-Méndez VC, Mejía-Aranguré JM. Parental Exposure to Workplace Carcinogens and the Risk of Development of Acute Leukemia in Infants. Case-Control Study. Arch Med Res 2017; 47:684-693. [PMID: 28476196 DOI: 10.1016/j.arcmed.2016.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/23/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Occupational exposure of parents to carcinogens is of great interest in the etiology of leukemias. Evidence of the impact of such exposure on infants or small children is scarce. Here we estimated whether occupational exposure of parents to carcinogens could be a risk factor for leukemias in their children. METHODS Cases of acute leukemia (AL) in infants ≤24 months old diagnosed in Mexico City (1998-2013) were included in a population-based, case-control study. Each of the 195 cases was matched with at least one healthy child (n = 369). For each of four exposure windows studied, the degree of exposure to carcinogens was determined for both parents by using a validated occupational exposure index. An unconditional logistic regression was carried out. RESULTS Odds ratios (OR) and the 95% confidence intervals (CI) of the overall occupational exposure for parents during the four exposure windows indicated no association with risk of AL in their children. Pre-conception, the OR by the father 0.77 (0.49-1.21), by the mother 1.03 (0.50-2.11); during pregnancy, father 0.66 (0.38-1.15), mother 1.79 (0.46-6.90); during breastfeeding, father 0.75 (0.43-1.30), mother 0.96 (0.21-4.30); and after birth, father 0.74 (0.45-1.22), mother 0.90 (0.24-3.32). The statistical power of the sample size to identify an OR ≥2 and an exposure of ≥10% among controls was 78%. CONCLUSIONS These data support the idea that parents' occupational exposure during any of the periods studied was not a risk factor contributing to the etiology of AL in infants ≤24 months of age.
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Affiliation(s)
- María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS); Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional.
| | - Arturo Fajardo-Gutiérrez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS)
| | | | - Nancy Núñez-Villegas
- Servicio de Hematología Pediátrica, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS
| | - Héctor Pérez-Lorenzana
- Servicio de Cirugía Pediátrica, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS
| | | | - Pedro Francisco Román-Zepeda
- Servicio de Hematología Pediátrica, Hospital General Regional (HGR) No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS
| | | | | | | | | | | | | | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS)
| | - Elva Jiménez-Hernández
- Servicio de Hematología Pediátrica, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS)
| | - Vilma Carolina Bekker-Méndez
- Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología "Dr. Daniel Méndez Hernández", CMN "La Raza", IMSS
| | - Juan Manuel Mejía-Aranguré
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS); Laboratorio de Biología Molecular, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS; Coordinación de Investigación en Salud, CMN "Siglo XXI", IMSS.
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Josefina Venero‐Fernández S, Fundora‐Hernández H, Batista‐Gutierrez L, Suárez‐Medina R, de la C. Mora‐Faife E, García‐García G, del Valle‐Infante I, Gómez‐Marrero L, Britton J, Fogarty AW. The association of low birth weight with serum C reactive protein in 3-year-old children living in Cuba: A population-based prospective study. Am J Hum Biol 2017; 29:e22936. [PMID: 27859847 PMCID: PMC5484324 DOI: 10.1002/ajhb.22936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/18/2016] [Accepted: 10/08/2016] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Low birthweight is associated with a decreased risk of childhood leukemia and an increased risk of both cardiovascular disease and all-cause mortality in adult life. Possible biological mediators include systemic innate immunity and inflammation. We tested the hypothesis that birthweight was inversely associated with serum high sensitivity C reactive protein assay (hsCRP), a measure of both innate immunity and systemic inflammation. METHODS Data on birthweight and current anthropometric measures along with a range of exposures were collected at 1 and 3 years of age in a population-based cohort study of young children living in Havana, Cuba. A total of 986 children aged 3-years-old provided blood samples that were analyzed for serum hsCRP levels. RESULTS Nearly 49% of children had detectable hsCRP levels in their serum. Lower birthweight was linearly associated with the natural log of hsCRP levels (beta coefficient -0.70 mg L-1 per kg increase in birthweight, 95% CI: -1.34 to -0.06). This was attenuated but still present after adjustment for the child's sex and municipality (-0.65 mg L-1 per kg birthweight; 95% CI: -1.38 to +0.08). There were no associations between growth from birth or anthropometric measures at 3 years and systemic inflammation. CONCLUSIONS Birthweight was inversely associated with serum hsCRP levels in children aged 3 years living in Cuba. These observations provide a potential mechanism that is present at the age of 3 years to explain the association between low birthweight and both decreased childhood leukemia and increased cardiovascular disease in adults.
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Affiliation(s)
| | - Hermes Fundora‐Hernández
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Lourdes Batista‐Gutierrez
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Ramón Suárez‐Medina
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Esperanza de la C. Mora‐Faife
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Gladys García‐García
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Ileana del Valle‐Infante
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Liem Gómez‐Marrero
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - John Britton
- Nottingham Biomedical Research Unit, Division of Epidemiology and Public HealthUniversity of Nottingham, Clinical Sciences Building, City HospitalNottinghamNG5 1PBUnited Kingdom
| | - Andrew W. Fogarty
- Nottingham Biomedical Research Unit, Division of Epidemiology and Public HealthUniversity of Nottingham, Clinical Sciences Building, City HospitalNottinghamNG5 1PBUnited Kingdom
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Law GR. Host, family and community proxies for infections potentially associated with leukaemia. RADIATION PROTECTION DOSIMETRY 2008; 132:267-272. [PMID: 18945723 DOI: 10.1093/rpd/ncn263] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Three hypotheses have proposed the involvement of infections in the aetiology of childhood leukaemia, suggesting either a specific leukaemogenic infection or a series of common infections that lead to a dysregulation of the immune system. Much of the evidence for the link with infections has been based on epidemiological observations, often using proxy measures of infection. Proxy measures include population mixing, parental occupation, age distribution of incidence, spatial and space-time clustering of cases, birth order and day care during infancy. This paper discusses the proxies used and examines to what extent a commonly used proxy measure, birth order, is a fair representation of either specific infections or general infectious load. It is clear that although leukaemia, and other diseases, may be linked with infections, one needs to (1) measure specific and general infections with more accuracy and (2) understand how proxy measures relate to real infections in the population.
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Affiliation(s)
- Graham Richard Law
- Biostatistics Unit, Centre for Epidemiology and Biostatistics, Room 8.01, Worsley Building, University of Leeds, Leeds LS2 9LN, UK.
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Spector LG, Davies SM, Robison LL, Hilden JM, Roesler M, Ross JA. Birth characteristics, maternal reproductive history, and the risk of infant leukemia: a report from the Children's Oncology Group. Cancer Epidemiol Biomarkers Prev 2007; 16:128-34. [PMID: 17220341 DOI: 10.1158/1055-9965.epi-06-0322] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Leukemias with MLL gene rearrangements predominate in infants (<1 year of age), but not in older children, and may have a distinct etiology. High birth weight, higher birth order, and prior fetal loss have, with varying consistency, been associated with infant leukemia, but no studies have reported results with respect to MLL status. Here, we report for the first time such an analysis. During 1999 to 2003, mothers of 240 incident cases (113 MLL(+), 80 MLL(-), and 47 indeterminate) and 255 random digit dialed controls completed a telephone interview. Odds ratios and 95% confidence intervals for quartile of birth weight, birth order, gestational age, maternal age at delivery, prior fetal loss, pre-pregnancy body mass index, and weight gain during pregnancy were obtained using unconditional logistic regression; P for linear trend was obtained by modeling continuous variables. There was a borderline significant linear trend of increasing birth weight with MLL(+) (P = 0.06), but not MLL(-) (P = 0.93), infant leukemia. Increasing birth order showed a significant inverse linear trend, independent of birth weight, with MLL(+) (P = 0.01), but not MLL(-) (P = 0.18), infant leukemia. Other variables of interest were not notably associated with infant leukemia regardless of MLL status. This investigation further supports the contention that molecularly defined subtypes of infant leukemia have separate etiologies.
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Affiliation(s)
- Logan G Spector
- Division of Epidemiology/Clinical Research, Department of Pediatrics, University of Minnesota, 420 Delaware Street Southeast, MMC 715, Minneapolis, MN 55455, USA.
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Altieri A, Castro F, Bermejo JL, Hemminki K. Number of siblings and the risk of lymphoma, leukemia, and myeloma by histopathology. Cancer Epidemiol Biomarkers Prev 2006; 15:1281-6. [PMID: 16835324 DOI: 10.1158/1055-9965.epi-06-0087] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Epidemiologic evidence indicates that several markers of exposure to childhood infections are inversely associated with the risk of childhood leukemia and lymphomas. We used the Swedish Family-Cancer Database to assess the effects of number of siblings on the risk of non-Hodgkin's (n = 7,007) and Hodgkin's lymphomas (n = 3,115), leukemias (n = 7,650), and multiple myeloma (n = 1,492) by histopathology. Poisson regression models included terms for age, sex, family history, period, and socioeconomic index. Having four or more siblings compared with none was associated with an excess risk of childhood acute lymphoblastic leukemia [ALL; rate ratio (RR), 2.11; P(trend) = 0.001], acute monocytic leukemia (RR, 2.51; P(trend) = 0.002), and multiple myeloma (RR, 1.34; P(trend) = 0.006). Having three or more older siblings compared with none decreased the risk of acute monocytic leukemia (RR, 0.35; P(trend) = 0.001) and childhood ALL (RR, 0.69; P(trend) = 0.01). The risk of Hodgkin's lymphoma for five or more older siblings compared with none was 0.41 (P(trend) = 0.003). Acute myeloid leukemia, chronic lymphocytic leukemia, and other lymphoproliferative malignancies were not associated with number of siblings. In conclusion, we found an excess risk of childhood ALL and acute monocytic leukemia in large families. However, for ALL, acute monocytic leukemia, and Hodgkin's lymphoma, younger siblings were strongly protected compared with older siblings. The remarkable protective effect of number of older siblings on acute monocytic leukemia is a novel finding of potential interest. Possible interpretations of our findings in the context of a putative infectious etiology are discussed.
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Affiliation(s)
- Andrea Altieri
- Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg
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