Low seroprevalence of Helicobacter pylori in patients with leukemia

Associations between three types of maternal bacterial infection and risk of leukemia in the offspring

A case-control study was nested within two maternity cohorts with a total of 7 million years of follow-up for assessment of the role of bacterial infections in childhood leukemia. Offspring of 550,000 mothers in Finland and Iceland were combined to form a joint cohort that was followed for cancer up to age 15 years during 1975-1997 through national cancer registries. For each index mother-case pair, three or four matched control mother-control pairs were identified from population registers. First-trimester serum samples were retrieved from mothers of 341 acute lymphoblastic leukemia cases and 61 other leukemia cases and from 1,212 control mothers. Sera were tested for antibodies to the genus Chlamydia, Helicobacter pylori, and Mycoplasma pneumoniae. Odds ratios and 95% confidence intervals, adjusted for sibship size, were calculated as estimates of relative risk. M. pneumoniae immunoglobulin M appeared to be associated with increased risk (odds ratio (OR) = 1.6), but the association lost statistical significance when the specificity of the immunoglobulin M was considered (OR = 1.5, 95% confidence interval: 0.9, 2.4). In Iceland, H. pylori immunoglobulin G was associated with increased risk of childhood leukemia in offspring (OR = 2.8, 95% confidence interval: 1.1, 6.9). Since H. pylori immunoglobulin G indicates chronic carriage of the microorganism, early colonization of the offspring probably differs between Iceland and Finland, two affluent countries.

Helicobacter pylori-associated large gastric ulcer during treatment for childhood leukemia

During treatment of acute lymphoblastic leukemia, serious gastrointestinal complications rarely occur in children. Helicobacter pylori is not known as a pathogen causing peptic ulcer in children with leukemia who are receiving chemotherapy. We describe a 14-year-old girl with acute lymphoblastic leukemia in whom, during the most aggressive part of treatment, a large, life-threatening H. pylori-associated gastric ulcer developed. H. pylori infection played a role in the origin of the ulcer, as confirmed by the clinical resolution after its specific treatment. This case points to a possible role for H. pylori as a pathogen in children with leukemia who have either evident or occult gastrointestinal bleeding.