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Kyriakidis I, Pelagiadis I, Stratigaki M, Katzilakis N, Stiakaki E. B-NHL Cases in a Tertiary Pediatric Hematology-Oncology Department: A 20-Year Retrospective Cohort Study. Life (Basel) 2024; 14:633. [PMID: 38792653 PMCID: PMC11122206 DOI: 10.3390/life14050633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Non-Hodgkin lymphoma (NHL) is among the five most common pediatric cancer diagnoses in children and adolescents and consists of a heterogeneous group of lymphoid tissue malignancies -with B-cell-derived NHL accounting for nearly 80% of cases. Novel and high-throughput diagnostic tools have significantly increased our understanding of B-NHL biology and molecular pathogenesis, leading to new NHL classifications and treatment options. This retrospective cohort study investigated 17 cases of both mature B-cell NHL (Burkitt lymphoma or BL; Diffuse large B-cell lymphoma or DLBCL; Primary mediastinal large B-cell lymphoma or PMBCL; Follicular lymphoma or FL) and immature B-cell progenitor NHL (B-lymphoblastic lymphoma or BLL) that were treated in a tertiary Pediatric Hematology-Oncology Department during the last 20 years. Modern NHL protocols for children, adolescents, and young adults, along with the addition of rituximab, are safe and efficient (100% overall survival; one relapse). Elevated ESR was more prevalent than elevated LDH. Analyses have focused on immune reconstitution (grade ≥3 infections, lymphocyte and immunoglobulin levels recovery) and body-mass-index changes post-treatment, late effects (in 53% of patients), and the presence of histology markers BCL2, BCL6, CD30, cMYC, and Ki-67%. One patient was diagnosed with a second malignant neoplasm (papillary thyroid cancer).
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Affiliation(s)
| | | | | | | | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology & Autologous Hematopoietic Stem Cell Transplantation Unit, University Hospital of Heraklion & Laboratory of Blood Diseases and Childhood Cancer Biology, School of Medicine, University of Crete, 71003 Heraklion, Greece; (I.K.); (I.P.); (M.S.); (N.K.)
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2
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Jamaluddine Z, Sharara E, Helou V, El Rashidi N, Safadi G, El-Helou N, Ghattas H, Sato M, Blencowe H, Campbell OMR. Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review. Arch Dis Child 2023; 108:956-969. [PMID: 37339859 DOI: 10.1136/archdischild-2022-324884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 05/04/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Size at birth, an indicator of intrauterine growth, has been studied extensively in relation to subsequent health, growth and developmental outcomes. Our umbrella review synthesises evidence from systematic reviews and meta-analyses on the effects of size at birth on subsequent health, growth and development in children and adolescents up to age 18, and identifies gaps. METHODS We searched five databases from inception to mid-July 2021 to identify eligible systematic reviews and meta-analyses. For each meta-analysis, we extracted data on the exposures and outcomes measured and the strength of the association. FINDINGS We screened 16 641 articles and identified 302 systematic reviews. The literature operationalised size at birth (birth weight and/or gestation) in 12 ways. There were 1041 meta-analyses of associations between size at birth and 67 outcomes. Thirteen outcomes had no meta-analysis.Small size at birth was examined for 50 outcomes and was associated with over half of these (32 of 50); continuous/post-term/large size at birth was examined for 35 outcomes and was consistently associated with 11 of the 35 outcomes. Seventy-three meta-analyses (in 11 reviews) compared risks by size for gestational age (GA), stratified by preterm and term. Prematurity mechanisms were the key aetiologies linked to mortality and cognitive development, while intrauterine growth restriction (IUGR), manifesting as small for GA, was primarily linked to underweight and stunting. INTERPRETATION Future reviews should use methodologically sound comparators to further understand aetiological mechanisms linking IUGR and prematurity to subsequent outcomes. Future research should focus on understudied exposures (large size at birth and size at birth stratified by gestation), gaps in outcomes (specifically those without reviews or meta-analysis and stratified by age group of children) and neglected populations. PROSPERO REGISTRATION NUMBER CRD42021268843.
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Affiliation(s)
- Zeina Jamaluddine
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Eman Sharara
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Vanessa Helou
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nadine El Rashidi
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Gloria Safadi
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nehmat El-Helou
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Hala Ghattas
- Center for Research On Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Miho Sato
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Hannah Blencowe
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Oona M R Campbell
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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3
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Gupta S, Craig JW. Classic Hodgkin lymphoma in young people. Semin Diagn Pathol 2023; 40:379-391. [PMID: 37451943 DOI: 10.1053/j.semdp.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
Classic Hodgkin lymphoma (CHL) is a unique form of lymphoid cancer featuring a heterogeneous tumor microenvironment and a relative paucity of malignant Hodgkin and Reed-Sternberg (HRS) cells with characteristic phenotype. Younger individuals (children, adolescents and young adults) are affected as often as the elderly, producing a peculiar bimodal age-incidence profile that has generated immense interest in this disease and its origins. Decades of epidemiological investigations have documented the populations most susceptible and identified multiple risk factors that can be broadly categorized as either biological or environmental in nature. Most risk factors result in overt immunodeficiency or confer more subtle alterations to baseline health, physiology or immune function. Epstein Barr virus, however, is both a risk factor and well-established driver of lymphomagenesis in a significant subset of cases. Epigenetic changes, along with the accumulation of somatic driver mutations and cytogenetic abnormalities are required for the malignant transformation of germinal center-experienced HRS cell precursors. Chromosomal instability and the influence of endogenous mutational processes are critical in this regard, by impacting genes involved in key signaling pathways that promote the survival and proliferation of HRS cells and their escape from immune destruction. Here we review the principal features, known risk factors and lymphomagenic mechanisms relevant to newly diagnosed CHL, with an emphasis on those most applicable to young people.
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Affiliation(s)
- Srishti Gupta
- Department of Pathology, University of Virginia Health System, 1215 Lee Street, 3rd Floor Hospital Expansion Room 3032, PO Box 800904, Charlottesville, VA 22908, USA
| | - Jeffrey W Craig
- Department of Pathology, University of Virginia Health System, 1215 Lee Street, 3rd Floor Hospital Expansion Room 3032, PO Box 800904, Charlottesville, VA 22908, USA.
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4
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Odutola MK, van Leeuwen MT, Turner J, Bruinsma F, Seymour JF, Prince HM, Milliken ST, Hertzberg M, Trotman J, Opat SS, Lindeman R, Roncolato F, Verner E, Harvey M, Tiley C, Underhill CR, Benke G, Giles GG, Vajdic CM. Associations between early-life growth pattern and body size and follicular lymphoma risk and survival: a family-based case-control study. Cancer Epidemiol 2022; 80:102241. [PMID: 36058036 DOI: 10.1016/j.canep.2022.102241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/04/2022] [Accepted: 08/21/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND The influence of early-life growth pattern and body size on follicular lymphoma (FL) risk and survival is unclear. In this study, we aimed to investigate the association between gestational age, growth during childhood, body size, changes in body shape over time, and FL risk and survival. METHODS We conducted a population-based family case-control study and included 706 cases and 490 controls. We ascertained gestational age, growth during childhood, body size and body shape using questionnaires and followed-up cases (median=83 months) using record linkage with national death records. We used a group-based trajectory modeling approach to identify body shape trajectories from ages 5-70. We examined associations with FL risk using unconditional logistic regression and used Cox regression to assess the association between body mass index (BMI) and all-cause and FL-specific mortality among cases. RESULTS We found no association between gestational age, childhood height and FL risk. We observed a modest increase in FL risk with being obese 5 years prior to enrolment (OR=1.43, 95 %CI=0.99-2.06; BMI ≥30 kg/m2) and per 5-kg/m2 increase in BMI 5 years prior to enrolment (OR=1.14, 95 %CI=0.99-1.31). The excess risk for obesity 5 years prior to enrolment was higher for ever-smokers (OR=2.00, 95 %CI=1.08-3.69) than never-smokers (OR=1.14, 95 %CI=0.71-1.84). We found no association between FL risk and BMI at enrolment, BMI for heaviest lifetime weight, the highest categories of adult weight or height, trouser size, body shape at different ages or body shape trajectory. We also observed no association between all-cause or FL-specific mortality and excess adiposity at or prior to enrolment. CONCLUSION We observed a weak association between elevated BMI and FL risk, and no association with all-cause or FL-specific mortality, consistent with previous studies. Future studies incorporating biomarkers are needed to elucidate possible mechanisms underlying the role of body composition in FL etiology.
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Affiliation(s)
- Michael K Odutola
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
| | - Marina T van Leeuwen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
| | - Jennifer Turner
- Douglass Hanly Moir Pathology, Macquarie Park and Department of Clinical Medicine, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, Australia.
| | - Fiona Bruinsma
- Cancer Epidemiology Division, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.
| | - John F Seymour
- Royal Melbourne Hospital, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia.
| | - H Miles Prince
- Epworth Healthcare and Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.
| | - Samuel T Milliken
- St. Vincent's Hospital, Sydney and University of New South Wales, Sydney, New South Wales, Australia.
| | - Mark Hertzberg
- Department of Haematology, Prince of Wales Hospital and University of New South Wales, Sydney, New South Wales, Australia.
| | - Judith Trotman
- Concord Repatriation General Hospital and University of Sydney, Concord, New South Wales, Australia.
| | - Stephen S Opat
- Clinical Haematology, Monash Health and Monash University, Clayton, Australia.
| | - Robert Lindeman
- New South Wales Health Pathology and University of New South Wales, Sydney, New South Wales, Australia.
| | - Fernando Roncolato
- St. George Hospital, Kogarah and University of New South Wales, Sydney, New South Wales, Australia.
| | - Emma Verner
- Concord Repatriation General Hospital and University of Sydney, Concord, New South Wales, Australia.
| | - Michael Harvey
- Liverpool Hospital, Liverpool and Western Sydney University, New South Wales, Australia.
| | - Campbell Tiley
- Gosford Hospital and The University of Newcastle, New South Wales, Australia.
| | - Craig R Underhill
- Rural Medical School and Border Medical Oncology Research Unit, Albury, New South Wales, Australia.
| | - Geza Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia.
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia; The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
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Graham C, Metayer C, Morimoto LM, Wiemels JL, Siddique A, Di M, Rodwin RL, Kadan-Lottick NS, Ma X, Wang R. Hispanic Ethnicity Differences in Birth Characteristics, Maternal Birthplace, and Risk of Early-Onset Hodgkin Lymphoma: A Population-Based Case-Control Study. Cancer Epidemiol Biomarkers Prev 2022; 31:1788-1795. [PMID: 35709749 PMCID: PMC9444874 DOI: 10.1158/1055-9965.epi-22-0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/15/2022] [Accepted: 06/13/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Hispanic ethnicity differences in the risk of early-onset Hodgkin lymphoma diagnosed at <40 years are understudied. We conducted a population-based case-control study to evaluate associations between birth characteristics and early-onset Hodgkin lymphoma with a focus on potential ethnic differences. METHODS This study included 1,651 non-Hispanic White and 1,168 Hispanic cases with Hodgkin lymphoma endorsing a range of races diagnosed at the age of 0 to 37 years during 1988-2015 and 140,950 controls without cancer matched on race/ethnicity and year of birth from the California Linkage Study of Early-Onset Cancers. OR and 95% confidence intervals (CI) were estimated from multivariable logistic regression models. RESULTS Having a foreign-born mother versus a United States-born mother (i.e., the reference group) was associated with an increased risk of early-onset Hodgkin lymphoma among non-Hispanic Whites (OR = 1.52; 95% CI, 1.31-1.76; P < 0.01) and a decreased risk among Hispanics (OR = 0.78; 95% CI, 0.69-0.88; P < 0.01). Among both race groups, risk of early-onset Hodgkin lymphoma increased with birthweight and maternal age (all Ptrends < 0.01). Among non-Hispanic Whites, each 5-year increase in maternal age (OR = 1.11; 95% CI, 1.04-1.18; Ptrend < 0.01) and paternal age (OR = 1.07; 95% CI, 1.02-1.13; Ptrend < 0.01) was associated with increased risk of early-onset Hodgkin lymphoma. Compared with female Hispanics, male Hispanics had an increased risk of early-onset Hodgkin lymphoma (OR = 1.26; 95% CI, 1.12-1.42; P < 0.01). CONCLUSIONS Maternal birthplace may play a role in risk of early-onset Hodgkin lymphoma that differs by ethnicity. IMPACT The ethnic differences observed between certain birth characteristics, maternal birthplace, and early-onset Hodgkin lymphoma raise questions about the underlying biological, generational, lifestyle, residential, and genetic contributions to the disease.
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Affiliation(s)
- Connor Graham
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States
| | - Catherine Metayer
- Department of Epidemiology, School of Public Health, University of California, Berkeley, California, United States
| | - Libby M. Morimoto
- Department of Epidemiology, School of Public Health, University of California, Berkeley, California, United States
| | - Joseph L. Wiemels
- Center for Genetic Epidemiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, United States
| | - Arfan Siddique
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States
| | - Mengyang Di
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States
| | - Rozalyn L. Rodwin
- Section of Pediatric Hematology/Oncology, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States
| | | | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States
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6
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Kessous R, Sheiner E, Rosen GB, Kapelushnik J, Wainstock T. Increased incidence of childhood lymphoma in children with a history of small for gestational age at birth. Arch Gynecol Obstet 2022; 306:1485-1494. [PMID: 35133455 DOI: 10.1007/s00404-022-06410-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/10/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate whether children that were born small for gestational age (SGA) have an increased risk for childhood neoplasm. STUDY DESIGN A population-based cohort analysis comparing the risk for long-term childhood neoplasms (benign and malignant) in children that were born SGA vs. those that were appropriate for gestational age (AGA), between the years1991-2014. Childhood neoplasms were predefined based on ICD-9 codes, as recorded in the hospital medical files. Kaplan-Meier survival curves were constructed to compare cumulative oncological morbidity in both groups over time. Cox proportional hazards model was used to control for confounders. RESULTS During the study period 231,973 infants met the inclusion criteria; out of those 10,998 were born with a diagnosis of SGA. Children that were SGA at birth had higher incidence of lymphoma (OR 2.50, 95% CI 1.06-5.82; p value = 0.036). In addition, cumulative incidence over time of total childhood lymphoma was significantly higher in SGA children (Log Rank = 0.030). In a Cox regression model controlling for other perinatal confounders; SGA at birth remained independently associated with an increased risk for childhood lymphoma (adjusted HR 2.41, 95% CI 1.03-5.56, p value = 0.043). CONCLUSION Being delivered SGA is associated with an increased long-term risk for childhood malignancy and specifically lymphoma.
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Affiliation(s)
- Roy Kessous
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, 84101, Beer-Sheva, Israel.
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, 84101, Beer-Sheva, Israel
| | - Guy Beck Rosen
- Pediatric Hemato-Oncology Department, Saban Pediatric Medical Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Joseph Kapelushnik
- Pediatric Hemato-Oncology Department, Saban Pediatric Medical Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Tamar Wainstock
- The Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Heck JE, Lee PC, Wu CK, Tsai HY, Ritz B, Arah OA, Li CY. Gestational risk factors and childhood cancers: A cohort study in Taiwan. Int J Cancer 2020; 147:1343-1353. [PMID: 32020595 DOI: 10.1002/ijc.32905] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/05/2019] [Accepted: 01/13/2020] [Indexed: 12/18/2022]
Abstract
Gestational risk factors such as birth weight, gestational age and parity have been repeatedly found to be related to pediatric cancers, but few reports have emerged from Asian countries. Here we report on demographic and gestational factors in a Taiwanese cohort. Our study included all children born in Taiwan 2004-2014 for whom there was a birth record (n = 2,079,037), of which 1900 children had been diagnosed with cancer prior to age 12. We conducted multivariable hazard regression to examine associations between demographic and gestational factors with cancer. Greater parity (family with 2+ older children) was related to acute myeloid leukemia [Hazard ratio (HR) = 2.15, 95% confidence interval (CI): 1.31, 3.55), central nervous system tumors (HR = 1.67, CI: 1.13, 2.48) and neuroblastoma (HR = 1.67, CI: 1.07, 2.63). Hepatoblastoma cases had a higher risk of low birth weight (<2,500 g; HR = 3.01, CI: 1.85, 4.91), very preterm birth (<33 weeks gestation; HR = 13.71, CI: 7.45, 25.23), plural pregnancies (HR = 2.37, CI: 1.10, 5.14) and both small (HR = 2.13, CI: 1.23, 3.67) and large (HR = 1.83, CI: 1.01, 3.32) for gestational age. Germ cell tumors were more common among children born in rural areas (HR = 1.63, CI: 1.02, 2.60). Despite that Taiwan has lower rates of both high and low birthweight compared to other developed nations, we observed several similar associations to those reported in Western Countries. Further research should examine unique exposures in Taiwan that may be contributing to higher incidence of certain cancer types.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA.,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chia-Kai Wu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hsin-Yun Tsai
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA
| | - Onyebuchi A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California-Los Angeles (UCLA), Los Angeles, CA.,Department of Statistics, UCLA College of Letters and Science, Los Angeles, CA.,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Chung-Yi Li
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
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8
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Peckham-Gregory EC, Danysh HE, Brown AL, Eckstein O, Grimes A, Chakraborty R, Lubega J, McClain KL, Allen CE, Scheurer ME, Lupo PJ. Evaluation of maternal and perinatal characteristics on childhood lymphoma risk: A population-based case-control study. Pediatr Blood Cancer 2017; 64. [PMID: 27896915 DOI: 10.1002/pbc.26321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/23/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND Lymphoma is one of the most common pediatric malignancies; however, there are few well-established risk factors. Therefore, we investigated if maternal and perinatal characteristics influenced the risk of childhood lymphoma. PROCEDURE Information on cases (n = 374) diagnosed with lymphoma and born in Texas for the period 1995-2011 was obtained from the Texas Cancer Registry. Birth certificate controls were randomly selected at a ratio of 10 controls per 1 case for the same period of 1995-2011. Unconditional logistic regression was used to generate unadjusted (OR) and adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the following histologic subtypes: Hodgkin (HL), Burkitt (BL), and non-BL non-HLs (non-BL NHLs). RESULTS Overall, our findings indicate specific maternal and perinatal characteristics influence childhood lymphoma risk. Mexico-born mothers were more likely to have offspring who developed BL compared to mothers born in the United States (U.S.; aOR: 2.15; 95% CI: 1.06-4.36). Further, mothers who resided at time of delivery in a county on the U.S.-Mexico border were more likely to give birth to offspring who developed non-BL NHL (aOR: 1.72; 95% CI: 1.11-2.67) compared to mothers not living on the U.S.-Mexico border at time of infant birth. Last, infants born large-for-gestational-age experienced a twofold increase in BL risk (aOR: 2.00; 95% CI: 1.10-3.65). CONCLUSIONS In this population-based assessment, we confirmed previously reported risk predictors of childhood lymphoma, including sex of infant, while highlighting novel risk factors that warrant assessment in future studies.
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Affiliation(s)
- Erin C Peckham-Gregory
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Heather E Danysh
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Austin L Brown
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Olive Eckstein
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Amanda Grimes
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Rikhia Chakraborty
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Joseph Lubega
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Kenneth L McClain
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Carl E Allen
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas.,Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston, Texas
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9
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Triebwasser C, Wang R, DeWan AT, Metayer C, Morimoto L, Wiemels JL, Kadan-Lottick N, Ma X. Birth weight and risk of paediatric Hodgkin lymphoma: Findings from a population-based record linkage study in California. Eur J Cancer 2016; 69:19-27. [PMID: 27814470 PMCID: PMC5125877 DOI: 10.1016/j.ejca.2016.09.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/08/2016] [Accepted: 09/13/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the relationship between birth weight (along with a variety of pre and perinatal characteristics) and the risk of paediatric Hodgkin lymphoma (HL) diagnosed at age <20 years. METHOD We linked California statewide birth records from 1978-2009 and cancer diagnosis data from 1988-2011 to conduct a population-based case-control study with 1216 cases and 4485 controls (matched on birth month and year, sex, and race/ethnicity). Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) of paediatric HL overall and by age of diagnosis, controlling for other perinatal factors. RESULTS Compared to children with a normal birth weight (2500-3999 g), those who had a high birth weight (≥4000 g) had an increased risk of paediatric HL overall (OR = 1.23, 95% CI: 1.02-1.48) after adjusting for birth order, maternal age at the time of delivery, and paternal age at the time of delivery. The magnitude of association appeared larger for subgroups of children whose age of diagnosis was 0-10 years (OR = 1.56, 95% CI: 1.04-2.24) or 15-19 years (OR = 1.43, 95% CI: 1.11-1.83), while no association was observed in 11-14 year olds. Compared with firstborn children, those who were third or higher in birth order had a reduced risk of paediatric HL overall (OR = 0.80, 95% CI: 0.67-0.95), and this association also varied by age of diagnosis. CONCLUSIONS In this study with the largest number of paediatric HL cases, high birth weight was associated with an increased disease risk for most but not all ages of diagnosis. The different findings by age of diagnosis regarding both birth weight and birth order underscore the importance to stratify paediatric HL by age at diagnosis in future etiological investigations.
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Affiliation(s)
- Corey Triebwasser
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | - Andrew T DeWan
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | - Catherine Metayer
- Division of Epidemiology, School of Public Health, University of California, Berkeley, USA
| | - Libby Morimoto
- Division of Epidemiology, School of Public Health, University of California, Berkeley, USA
| | - Joseph L Wiemels
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Nina Kadan-Lottick
- Section of Pediatric Hematology/Oncology, Yale School of Medicine, USA; Yale Comprehensive Cancer Center, Yale School of Medicine, USA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA; Yale Comprehensive Cancer Center, Yale School of Medicine, USA.
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10
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Belbasis L, Savvidou MD, Kanu C, Evangelou E, Tzoulaki I. Birth weight in relation to health and disease in later life: an umbrella review of systematic reviews and meta-analyses. BMC Med 2016; 14:147. [PMID: 27677312 PMCID: PMC5039803 DOI: 10.1186/s12916-016-0692-5] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/09/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Birth weight, a marker of the intrauterine environment, has been extensively studied in epidemiological research in relation to subsequent health and disease. Although numerous meta-analyses have been published examining the association between birth weight and subsequent health-related outcomes, the epidemiological credibility of these associations has not been thoroughly assessed. The objective of this study is to map the diverse health outcomes associated with birth weight and evaluate the credibility and presence of biases in the reported associations. METHODS An umbrella review was performed to identify systematic reviews and meta-analyses of observational studies investigating the association between birth weight and subsequent health outcomes and traits. For each association, we estimated the summary effect size by random-effects and fixed-effects models, the 95 % confidence interval, and the 95 % prediction interval. We also assessed the between-study heterogeneity, evidence for small-study effects and excess significance bias. We further applied standardized methodological criteria to evaluate the epidemiological credibility of the statistically significant associations. RESULTS Thirty-nine articles including 78 associations between birth weight and diverse outcomes met the eligibility criteria. A wide range of health outcomes has been studied, ranging from anthropometry and metabolic diseases, cardiovascular diseases and cardiovascular risk factors, various cancers, respiratory diseases and allergies, musculoskeletal traits and perinatal outcomes. Forty-seven of 78 associations presented a nominally significant summary effect and 21 associations remained statistically significant at P < 1 × 10-6. Thirty associations presented large or very large between-study heterogeneity. Evidence for small-study effects and excess significance bias was present in 13 and 16 associations, respectively. One association with low birth weight (increased risk for all-cause mortality), two dose-response associations with birth weight (higher bone mineral concentration in hip and lower risk for mortality from cardiovascular diseases per 1 kg increase in birth weight) and one association with small-for-gestational age infants with normal birth weight (increased risk for childhood stunting) presented convincing evidence. Eleven additional associations had highly suggestive evidence. CONCLUSIONS The range of outcomes convincingly associated with birth weight might be narrower than originally described under the "fetal origin hypothesis" of disease. There is weak evidence that birth weight constitutes an effective public health intervention marker.
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Affiliation(s)
- Lazaros Belbasis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Makrina D Savvidou
- Academic Department of Obstetrics and Gynecology, Chelsea and Westminster Hospital, Imperial College London, London, UK
| | - Chidimma Kanu
- Academic Department of Obstetrics and Gynecology, Chelsea and Westminster Hospital, Imperial College London, London, UK
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece. .,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. .,MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
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Ortega-García J, López-Hernández F, Cárceles-Álvarez A, Santiago-Rodríguez E, Sánchez A, Bermúdez-Cortés M, Fuster-Soler J. Analysis of small areas of paediatric cancer in the municipality of Murcia (Spain). ANALES DE PEDIATRÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.anpede.2015.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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12
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Ortega-García JA, López-Hernández FA, Cárceles-Álvarez A, Santiago-Rodríguez EJ, Sánchez AC, Bermúdez-Cortes M, Fuster-Soler JL. [Analysis of small areas of pediatric cancer in the municipality of Murcia (Spain)]. An Pediatr (Barc) 2015; 84:154-62. [PMID: 26164678 DOI: 10.1016/j.anpedi.2015.04.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/23/2015] [Accepted: 04/02/2015] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Occasionally, primary care pediatricians notice the presence of small clusters of pediatric cancer (PC), but are often frustrated by the findings after statistical analysis. The study of small areas in spatial epidemiology has led to advances in identifying clusters and the environmental risk factors involved. The purpose of this study was to describe the PC incidence and the spatial distribution at the minimum level of disaggregation possible in Murcia, presenting the first urban municipality map of PC in Spain. MATERIALS AND METHODS A population-based descriptive study was conducted on the PC cases diagnosed in children younger than 15 years, between 1998 and 2013 in the municipality of Murcia. Cases were classified by sex, age group, and tumor type. Coordinates of home addresses at the time of diagnosis were assigned to each case, and spatial and spatio-temporal analyses were carried out at the level of census tracts, using FleXScan and SatScan. RESULTS A total of 155 cases of PC were diagnosed during this period. The overall incidence of PC (138/10(6) of children under the age of 15) and the incidence for individual tumor types were within the expected ranges for Europe. A spatio-temporal cluster of Hodgkin lymphoma was identified. CONCLUSIONS Small area analysis of PC cases may be a useful tool for the identification of PC clusters, which would allow for the generation of hypotheses regarding disease etiology, as well as developing urban models for environmental surveillance of PC.
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Affiliation(s)
- J A Ortega-García
- Unidad de Salud Medioambiental Pediátrica, Servicio de Pediatría, Laboratorio de Entorno y Salud Humana, Instituto de Investigación Biosanitaria de la Región de Murcia (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
| | - F A López-Hernández
- Departamento de Métodos Cuantitativos e Informáticos, Universidad Politécnica de Cartagena, Murcia, España
| | - A Cárceles-Álvarez
- Unidad de Salud Medioambiental Pediátrica, Servicio de Pediatría, Laboratorio de Entorno y Salud Humana, Instituto de Investigación Biosanitaria de la Región de Murcia (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - E J Santiago-Rodríguez
- Unidad de Salud Medioambiental Pediátrica, Servicio de Pediatría, Laboratorio de Entorno y Salud Humana, Instituto de Investigación Biosanitaria de la Región de Murcia (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - A C Sánchez
- Unidad de Salud Medioambiental Pediátrica, Servicio de Pediatría, Laboratorio de Entorno y Salud Humana, Instituto de Investigación Biosanitaria de la Región de Murcia (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - M Bermúdez-Cortes
- Sección de Oncología y Hematología Pediátricas, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - J L Fuster-Soler
- Sección de Oncología y Hematología Pediátricas, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
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13
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O'Neill KA, Murphy MF, Bunch KJ, Puumala SE, Carozza SE, Chow EJ, Mueller BA, McLaughlin CC, Reynolds P, Vincent TJ, Von Behren J, Spector LG. Infant birthweight and risk of childhood cancer: international population-based case control studies of 40 000 cases. Int J Epidemiol 2015; 44:153-68. [PMID: 25626438 DOI: 10.1093/ije/dyu265] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND High birthweight is an established risk factor for childhood leukaemia. Its association with other childhood cancers is less clear, with studies hampered by low case numbers. METHODS We used two large independent datasets to explore risk associations between birthweight and all subtypes of childhood cancer. Data for 16 554 cases and 53 716 controls were obtained by linkage of birth to cancer registration records across five US states, and 23 772 cases and 33 206 controls were obtained from the UK National Registry of Childhood Tumours. US, but not UK, data were adjusted for gestational age, birth order, plurality, and maternal age and race/ethnicity. RESULTS Risk associations were found between birthweight and several childhood cancers, with strikingly similar results between datasets. Total cancer risk increased linearly with each 0.5 kg increase in birthweight in both the US [odds ratio 1.06 (95% confidence interval 1.04, 1.08)] and UK [1.06 (1.05, 1.08)] datasets. Risk was strongest for leukaemia [USA: 1.10 (1.06, 1.13), UK: 1.07 (1.04, 1.10)], tumours of the central nervous system [USA: 1.05 (1.01, 1.08), UK: 1.07 (1.04, 1.10)], renal tumours [USA: 1.17 (1.10, 1.24), UK: 1.12 (1.06, 1.19)] and soft tissue sarcomas [USA: 1.12 (1.05, 1.20), UK: 1.07 (1.00, 1.13)]. In contrast, increasing birthweight decreased the risk of hepatic tumours [USA: 0.77 (0.69, 0.85), UK: 0.79 (0.71, 0.89) per 0.5 kg increase]. Associations were also observed between high birthweight and risk of neuroblastoma, lymphomas, germ cell tumours and malignant melanomas. For some cancer subtypes, risk associations with birthweight were non-linear. We observed no association between birthweight and risk of retinoblastoma or bone tumours. CONCLUSIONS Approximately half of all childhood cancers exhibit associations with birthweight. The apparent independence from other factors indicates the importance of intrauterine growth regulation in the aetiology of these diseases.
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Affiliation(s)
- Kate A O'Neill
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Michael Fg Murphy
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Kathryn J Bunch
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Susan E Puumala
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Susan E Carozza
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Eric J Chow
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Beth A Mueller
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Colleen C McLaughlin
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Peggy Reynolds
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Tim J Vincent
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Julie Von Behren
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Logan G Spector
- Department of Paediatrics, Nuffield Department of Obstetrics and Gynaecology, National Perinatal Epidemiology Unit, Formerly of the Childhood Cancer Research Group, University of Oxford, Oxford, UK, Sanford Research Center, Sioux Falls, SD, USA, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA, Fred Hutchinson Cancer Research Center, Seattle, WA, USA, New York State Department of Health, Albany, NY, USA, Cancer Prevention Institute of California, Berkeley, CA, USA and Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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O’Neill KA, Bunch KJ, Murphy MFG. Intrauterine growth and childhood leukemia and lymphoma risk. Expert Rev Hematol 2014; 5:559-76. [DOI: 10.1586/ehm.12.39] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Bjørge T, Sørensen HT, Grotmol T, Engeland A, Stephansson O, Gissler M, Tretli S, Troisi R. Fetal growth and childhood cancer: a population-based study. Pediatrics 2013; 132:e1265-75. [PMID: 24167169 PMCID: PMC3813399 DOI: 10.1542/peds.2013-1317] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The etiology of childhood cancers is largely unknown. Studies have suggested that birth characteristics may be associated with risk. Our goal was to evaluate the risk of childhood cancers in relation to fetal growth. METHODS We conducted a case-control study nested within Nordic birth registries. The study included cancer cases diagnosed in Denmark, Finland, Norway, and Sweden among children born from 1967 to 2010 and up to 10 matched controls per case, totaling 17,698 cases and 172,422 controls. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were derived from conditional logistic regression. RESULTS Risks of all childhood cancers increased with increasing birth weight (P trend ≤ .001). Risks of acute lymphoid leukemia and Wilms tumor were elevated when birth weight was >4000 g and of central nervous system tumors when birth weight was >4500 g. Newborns large for gestational age were at increased risk of Wilms tumor (OR: 2.1 [95% CI: 1.2-3.6]) and connective/soft tissue tumors (OR: 2.1 [95% CI: 1.1-4.4]). In contrast, the risk of acute myeloid leukemia was increased among children born small for gestational age (OR: 1.8 [95% CI: 1.1-3.1]). Children diagnosed with central nervous system tumors at <1 year of age had elevated risk with increasing head circumference (P trend < .001). Those with head circumference >39 cm had the highest risk (OR: 4.7 [95% CI: 2.5-8.7]). CONCLUSIONS In this large, Nordic population-based study, increased risks for several childhood tumors were associated with measures of fetal growth, supporting the hypothesis that tumorigenesis manifesting in childhood is initiated in utero.
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Affiliation(s)
- Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, N-5020 Bergen, Norway.
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Anders Engeland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;,Norwegian Institute of Public Health, Bergen/Oslo, Norway
| | - Olof Stephansson
- Clinical Epidemiology Unit, Department of Medicine and,Department of Women and Children's Health, Division of Obstetrics and Gynecology Karolinska University Hospital and Institute, Stockholm, Sweden
| | - Mika Gissler
- National Institute for Health and Welfare (THL), Helsinki, Finland;,Nordic School of Public Health (NHV), Gothenburg, Sweden; and
| | | | - Rebecca Troisi
- Divisions of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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Crump C, Sundquist K, Sieh W, Winkleby MA, Sundquist J. Perinatal and family risk factors for Hodgkin lymphoma in childhood through young adulthood. Am J Epidemiol 2012; 176:1147-58. [PMID: 23171883 PMCID: PMC3571233 DOI: 10.1093/aje/kws212] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 04/11/2012] [Indexed: 11/12/2022] Open
Abstract
The incidence of Hodgkin lymphoma has increased among adolescents and young adults in recent decades, but the relevant risk factors in early life are still unknown. A national cohort study was conducted of 3,571,574 individuals born in Sweden in 1973-2008 and followed up for Hodgkin lymphoma incidence through 2009, to examine perinatal and family risk factors for Hodgkin lymphoma in childhood through young adulthood (ages 0-37 years). There were 943 Hodgkin lymphoma cases identified in 66.3 million person-years of follow-up. High fetal growth was associated with an increased risk of Hodgkin lymphoma after adjustment for gestational age at birth and other potential confounders (P(trend) = 0.005). Family history of Hodgkin lymphoma in a sibling or parent also was strongly associated with an increased risk, with adjusted hazard ratios = 8.83 (95% confidence interval: 3.67, 21.30) and 7.19 (95% confidence interval: 3.58, 14.44), respectively. No association was found between gestational age at birth, birth order, twinning, parental age, or parental education and Hodgkin lymphoma. These findings did not vary by age at Hodgkin lymphoma diagnosis. Similar associations were found for nodular sclerosis and mixed cellularity subtypes. These findings suggest that perinatal factors including possible growth factor pathways may contribute to the risk of Hodgkin lymphoma in childhood through young adulthood.
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Affiliation(s)
- Casey Crump
- Department of Medicine, Stanford University, Stanford, CA, USA.
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Crump C, Sundquist K, Sieh W, Winkleby MA, Sundquist J. Perinatal and family risk factors for non-Hodgkin lymphoma in early life: a Swedish national cohort study. J Natl Cancer Inst 2012; 104:923-30. [PMID: 22623506 PMCID: PMC3732249 DOI: 10.1093/jnci/djs225] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 03/28/2012] [Accepted: 03/29/2012] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The incidence of non-Hodgkin lymphoma (NHL) in early life has increased in recent decades, but the relevant risk factors remain largely unknown. We examined perinatal and family risk factors for NHL in childhood through young adulthood. METHODS We conducted a national cohort study of 3 571 574 individuals born in Sweden in 1973-2008 who were followed for incidence of NHL through 2009 (ages 0-37 years). Detailed information on perinatal and family characteristics and NHL diagnoses were obtained from national birth and cancer registries. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between perinatal and family variables and NHL; P values are from two-sided tests. RESULTS There were 936 NHL case patients identified in 66.3 million person-years of follow-up. Independent risk factors for NHL included family history of NHL in either a sibling (adjusted HR = 9.84; 95% CI = 2.46 to 39.41; P = .001) or parent (adjusted HR = 2.36; 95% CI = 1.27 to 4.38; P = .007); high fetal growth (for ≥ 2 SDs relative to 0 to <1 SD from the mean: adjusted HR = 1.64; 95% CI = 1.19 to 2.25; P = .002); older maternal age (adjusted HR for each 5-year increment = 1.11; 95% CI = 1.04 to 1.19; P (trend) = .004); low birth order (adjusted HR for each increment of one birth = 0.91; 95% CI = 0.84 to 0.99; P (trend) = .02); and male sex (adjusted HR = 1.58; 95% CI = 1.38 to 1.80; P < .001). Male sex was associated with onset of NHL before 15 years of age but not with later-onset NHL, whereas the other risk factors did not vary by age at diagnosis. No association was found between gestational age at birth, twinning, paternal age, or parental education and NHL. CONCLUSION In this large national cohort study, family history of NHL, high fetal growth, older maternal age, low birth order, and male sex were independent risk factors for NHL in early life.
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Affiliation(s)
- Casey Crump
- Department of Medicine, Stanford University, 900 Blake Wilbur Dr, Stanford, CA 94304-2205,USA.
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Allergy-associated symptoms in relation to childhood non-Hodgkin's as contrasted to Hodgkin's lymphomas: a case-control study in Greece and meta-analysis. Eur J Cancer 2012; 48:1860-6. [PMID: 22230747 DOI: 10.1016/j.ejca.2011.12.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 07/15/2011] [Accepted: 12/11/2011] [Indexed: 11/23/2022]
Abstract
An increase of the prevalence of childhood allergic diseases and the incidence of childhood Hodgkin's (HL) and non-Hodgkin's lymphoma (NHL) were reported in the late 20th century. Among adults, several studies point to an inverse association with lymphoma; it remains to be confirmed whether allergy is also related to childhood lymphomas and whether the association, if any, is of an aetiologic nature. Between 1996 and 2008, 277 children (aged 0-14 years) with HL (N = 111) or NHL (N = 166) were enrolled in Nationwide Registry for Childhood Hematological Malignancies (NARECHEM), a Greek hospital-based-registry of childhood hematological malignancies. Hospital controls were individually matched to cases on age and sex. Multivariate conditional logistic regression was used to estimate odds ratios (ORs) with 95%confidence intervals (CIs) for associations of allergic diseases and other covariates with childhood HL or NHL risk. Subsequently, we combined our results with those of a French case-control study in a meta-analysis amounting to a total of 330 NHL cases/1478 controls and 239 HL cases/959 controls. After controlling for sociodemographic, perinatal and environmental factors, childhood NHL was less prevalent among children with allergy-associated symptoms overall (OR:0.50, 95%CI:0.27-0.92) or a history of asthma (OR:0.43, 95%CI:0.21-0.88). By contrast, allergy did not seem to be associated with childhood HL risk, although statistical power was limited. Fewer seaside holidays and higher birth weight were also associated with increased childhood NHL risk. The combined OR of the two studies for the association of asthma with NHL risk was: 0.52, 95%CI:0.32-0.84, whereas for HL: 0.86, 95%CI:0.51-1.45. Allergy seems to be strongly and inversely associated with childhood NHL. It remains to be elucidated in future investigations comprising larger populations, focusing on specific disease subtypes and employing more pertinent study-designs, whether this association is genuinely protective.
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