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Duarte-Rodríguez DA, Flores-Lujano J, McNally RJQ, Pérez-Saldivar ML, Jiménez-Hernández E, Martín-Trejo JA, Espinoza-Hernández LE, Medina-Sanson A, Paredes-Aguilera R, Merino-Pasaye LE, Velázquez-Aviña MM, Torres-Nava JR, Espinosa-Elizondo RM, Amador-Sánchez R, Dosta-Herrera JJ, Mondragón-García JA, González-Ulibarri JE, Martínez-Silva SI, Espinoza-Anrubio G, Paz-Bribiesca MM, Salcedo-Lozada P, Landa-García RÁ, Ramírez-Colorado R, Hernández-Mora L, Santamaría-Ascencio M, López-Loyola A, Godoy-Esquivel AH, García-López LR, Anguiano-Ávalos AI, Mora-Rico K, Castañeda-Echevarría A, Rodríguez-Jiménez R, Cibrian-Cruz JA, Solís-Labastida KA, Cárdenas-Cardos R, López-Santiago N, Flores-Villegas LV, Peñaloza-González JG, González-Ávila AI, Sánchez-Ruiz M, Rivera-Luna R, Rodríguez-Villalobos LR, Hernández-Pérez F, Olvera-Durán JÁ, García-Cortés LR, Mata-Rocha M, Sepúlveda-Robles OA, Bekker-Méndez VC, Jiménez-Morales S, Meléndez-Zajgla J, Rosas-Vargas H, Vega E, Núñez-Enríquez JC, Mejía-Aranguré JM. Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia. Front Oncol 2024; 14:1304633. [PMID: 38420017 PMCID: PMC10899509 DOI: 10.3389/fonc.2024.1304633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
Background A heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC). Methods A population-based case-control study was conducted. Children <18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff's spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained. Results A total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p<0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed. Conclusions The identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL.
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Affiliation(s)
- David Aldebarán Duarte-Rodríguez
- División de Desarrollo de la Investigación en Salud, Coordinación de Investigación en Salud, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - 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), Ciudad de Mexico, Mexico
| | - Richard J. Q. McNally
- Population Health Sciences Institute, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - 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), Ciudad de Mexico, Mexico
| | - Elva Jiménez-Hernández
- Servicio de Oncología, Hospital Pediátrico “Moctezuma”, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematología, Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Laura Eugenia Espinoza-Hernández
- Servicio de Hematología, Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Aurora Medina-Sanson
- Departamento de Hemato-Oncología, Hospital Infantil de Mexico “Federico Gómez”, Secretaría de Salud (SS), Ciudad de Mexico, Mexico
| | | | - Laura Elizabeth Merino-Pasaye
- Servicio de Hematología Pediátrica, Centro Médico Nacional (CMN) “20 de Noviembre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Ciudad de Mexico, Mexico
| | | | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediátrico “Moctezuma”, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | | | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, Hospital General Regional (HGR) No 1 “Dr Carlos MacGregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Juan José Dosta-Herrera
- Servicio de Cirugía Pediátrica, Hospital General “Gaudencio González Garza”, Centro Médico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Javier Anastacio Mondragón-García
- Servicio de Cirugía Pediátrica, Hospital General Regional (HGR) No 1 “Dr Carlos MacGregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | | | - Sofía Irene Martínez-Silva
- Hospital Pediátrico de Iztapalapa, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Gilberto Espinoza-Anrubio
- Servicio de Pediatría, Hospital General Zona (HGZ) No 8 “Dr Gilberto Flores Izquierdo”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | | | - Perla Salcedo-Lozada
- Hospital General de Ecatepec “Las Américas”, Instituto de Salud del Estado de Mexico (ISEM), Ecatepec de Morelos, Mexico
| | | | - Rosario Ramírez-Colorado
- Hospital Pediátrico “La Villa”, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Luis Hernández-Mora
- Hospital Pediátrico “San Juan de Aragón”, Secretar´ıa de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Marlene Santamaría-Ascencio
- Servicio de Pediatría, Hospital General Regional (HGR) No 72 “Lic. Vicente Santos Guajardo”, Instituto Mexicano del Seguro Social (IMSS), Tlalnepantla de Baz, Mexico
| | - Anselmo López-Loyola
- Servicio de Cirugía Pediátrica, Hospital General Zona (HGZ) No. 32, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Arturo Hermilo Godoy-Esquivel
- Servicio de Cirugía Pediátrica, Hospital Pediátrico de Moctezuma, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Luis Ramiro García-López
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Alison Ireri Anguiano-Ávalos
- Urgencias Pediátricas, Hospital General Zona (HGZ) No 47, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Karina Mora-Rico
- Servicio de Cirugía Pediátrica, Hospital Regional “1° Octubre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Instituto Politécnico Nacional 1669, Revolución Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Alejandro Castañeda-Echevarría
- Servicio de Pediatría, Hospital General Regional (HGR) No. 25 Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Roberto Rodríguez-Jiménez
- Servicio de Pediatría, Hospital General de Zona con Medicina Familiar (HGZMF) No. 29, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - José Alberto Cibrian-Cruz
- Servicio de Cirugía Pediátrica, Hospital General Zona (HGZ) No. 27, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Karina Anastacia Solís-Labastida
- Servicio de Hematología, Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Rocío Cárdenas-Cardos
- Servicio de Oncología, Instituto Nacional de Pediatr´ıa (INP), SS, Ciudad de Mexico, Mexico
| | - Norma López-Santiago
- Servicio de Hematología, Instituto Nacional de Pediatría (INP), SS, Ciudad de Mexico, Mexico
| | - Luz Victoria Flores-Villegas
- Servicio de Hematología Pediátrica, Centro Médico Nacional (CMN) “20 de Noviembre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Ciudad de Mexico, Mexico
| | - José Gabriel Peñaloza-González
- Servicio de Onco-Pediatría, Hospital Juárez de Mexico, SS, Instituto Politécnico Nacional 5160, Ciudad de Mexico, Mexico
| | - Ana Itamar González-Ávila
- Servicio de Hematología Pediátrica, Hospital General Regional (HGR) No 1 “Dr Carlos MacGregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Martin Sánchez-Ruiz
- Hospital General de Ecatepec “Las Américas”, Instituto de Salud del Estado de Mexico (ISEM), Ecatepec de Morelos, Mexico
| | - Roberto Rivera-Luna
- Servicio de Oncología, Instituto Nacional de Pediatr´ıa (INP), SS, Ciudad de Mexico, Mexico
| | - Luis Rodolfo Rodríguez-Villalobos
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Francisco Hernández-Pérez
- Urgencias Pediátricas, Hospital General Zona (HGZ) No 47, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Jaime Ángel Olvera-Durán
- Servicio de Cirugía Pediátrica, Hospital Regional “1° Octubre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Instituto Politécnico Nacional 1669, Revolución Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Luis Rey García-Cortés
- Delegación Regional Estado de Mexico Oriente, Instituto Mexicano del Seguro Social (IMSS), Naucalpan de Juárez, Mexico
| | - Minerva Mata-Rocha
- Laboratorio de Biología Molecular, Unidad Me´dica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Me´dico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Omar Alejandro Sepúlveda-Robles
- Laboratorio de Biología Molecular, Unidad Me´dica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Me´dico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Vilma Carolina Bekker-Méndez
- Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología “Dr Daniel Méndez Hernández”, Centro Me´dico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Silvia Jiménez-Morales
- Laboratory of Innovation and Precision Medicine, Nucleus A. Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de Mexico, Mexico
| | - Jorge Meléndez-Zajgla
- Laboratorio de Genómica Funcional del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de Mexico, Mexico
| | - Haydée Rosas-Vargas
- Unidad de Investigación Médica en Genética Humana, Unidad Me´dica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Me´dico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Elizabeth Vega
- Instituto de Ciencias de la Atmósfera y Cambio Climático, Universidad Nacional Autónoma de Mexico (UNAM), Ciudad de Mexico, Mexico
| | - 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), Ciudad de Mexico, Mexico
- División de Investigación en Salud, Unidad Me´dica de Alta Especialidad (UMAE) Hospital de Pediatría “Dr. Silvestre Frenk Freund”, Centro Me´dico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Juan Manuel Mejía-Aranguré
- Laboratorio de Genómica Funcional del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de Mexico, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de Mexico (UNAM), Ciudad de Mexico, Mexico
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Škorvaga M, Nikitina E, Kubeš M, Košík P, Gajdošechová B, Leitnerová M, Copáková L, Belyaev I. Incidence of common preleukemic gene fusions in umbilical cord blood in Slovak population. PLoS One 2014; 9:e91116. [PMID: 24621554 PMCID: PMC3951330 DOI: 10.1371/journal.pone.0091116] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 02/06/2014] [Indexed: 12/11/2022] Open
Abstract
The first event in origination of many childhood leukemias is likely the presence of preleukemic clone (transformed hematopoietic stem/progenitor cells with preleukemic gene fusions (PGF)) in newborn. Thus, the screening of umbilical cord blood (UCB) for PGF may be of high importance for developing strategies for childhood leukemia prevention and treatment. However, the data on incidence of PGF in UCB are contradictive. We have compared multiplex polymerase chain reaction (PCR) and real-time quantitative PCR (RT qPCR) in neonates from Slovak National Birth Cohort. According to multiplex PCR, all 135 screened samples were negative for the most frequent PGF of B-lineage acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). To explore the prevalence of prognostically important TEL-AML1, MLL-AF4 and BCR-ABL (p190), 200 UCB were screened using RT qPCR. The initial screening showed an unexpectedly high incidence of studied PGF. The validation of selected samples in two laboratories confirmed approximately ¼ of UCB positive, resulting in ∼4% incidence of TEL-AML1, ∼6.25% incidence of BCR-ABL1 p190, and ∼0.75% frequency of MLL-AF4. In most cases, the PGF presented at very low level, about 1–5 copies per 105 cells. We hypothesize that low PGF numbers reflect their relatively late origin and are likely to be eliminated in further development while higher number of PGF reflects earlier origination and may represent higher risk for leukemia.
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Affiliation(s)
- Milan Škorvaga
- Department of Molecular Genetics, Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Ekaterina Nikitina
- Department of Molecular Genetics, Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic
- Laboratory of Oncovirology, Cancer Research Institute, Siberian Branch of the Russian Academy of Medical Sciences, Tomsk, Russian Federation
| | - Miroslav Kubeš
- Laboratory of R&D, Eurocord-Slovakia, Bratislava, Slovak Republic
| | - Pavol Košík
- Department of Molecular Genetics, Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Beata Gajdošechová
- Department of Molecular Genetics, Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Michaela Leitnerová
- Department of Clinical Oncology, National Cancer Institute, Bratislava, Slovak Republic
| | - Lucia Copáková
- Department of Clinical Oncology, National Cancer Institute, Bratislava, Slovak Republic
| | - Igor Belyaev
- Department of Molecular Genetics, Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic
- * E-mail:
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Kulkarni K, Stobart K, Witol A, Rosychuk RJ. Leukemia and lymphoma incidence in children in Alberta, Canada: a population-based 22-year retrospective study. Pediatr Hematol Oncol 2011; 28:649-60. [PMID: 21981741 DOI: 10.3109/08880018.2011.613091] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
There is a paucity of published literature on the epidemiology of childhood acute leukemias and lymphomas in Canada. This study was designed to describe children and youth (age <20 years) diagnosed with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL) in Alberta, Canada, during 22 fiscal years. The Alberta Cancer Registry was used to extract data all ALL, AML, HL, and NHL cases diagnosed between April 1, 1982, and March 31, 2004. Population data for Alberta were also obtained. Descriptive statistics and cluster detection tests were used. During 22 years, 525, 117, 257, and 111 children (total = 1010) were diagnosed with ALL, AML, HL, and NHL, respectively. The median ages at diagnosis were 4, 11, 16, and 12 years for ALL, AML, HL, and NHL, respectively. The majority were male for ALL (287/525, 55%), AML (64/117, 55%), and NHL (81/111, 73%), and female for HL (133/257, 52%). The crude rates per 100,000 children were variable, without significant trends, over time and for each diagnosis; the median annual rates, per 100,000 children, were 3.00 (ranging from 1.87 to 3.75) for ALL, 0.62 (ranging from 0.26 to 1.27) for AML, 1.42 (ranging from 0.76 to 2.67) for HL, and 0.54 (ranging from 0.24 to 1.40) for NHL. A few potential spatiotemporal clusters were identified. They are likely due to small number of cases and plausibly clinically insignificant. Overall, childhood leukemia and lymphoma rates in Alberta have remained relatively stable, with no clear epidemiological trends and no significant spatiotemporal clustering. Further investigations are warranted to see if such stability continues and if spatiotemporal patterns arise from longer studies and studies in larger geographic regions with a larger sample size, whilst analyzing for other causal/associated factors, individual susceptibilities, and disease outcomes.
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Affiliation(s)
- Ketan Kulkarni
- Department of Pediatrics , Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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