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Vacek M, Zárraga Vargas LC, González Domínguez E, Garcia Rodriguez L, Tello Teran OA, Mojica Cardoso C, Ocampo Roosens LV, Acevedo Fernandez JJ, Li W, Lee B, Olalla Tapia JS, Flatt T. Increased Incidence of TdT-negative Pre-B Acute Lymphoblastic Leukemia Associated With Poor Prognostic Features Among Mexican Children in Central Mexico. J Pediatr Hematol Oncol 2024; 46:e131-e136. [PMID: 38132672 DOI: 10.1097/mph.0000000000002802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023]
Abstract
Mexican and Hispanic children in Mexico and the United States, respectively, have the highest incidence and worst outcomes of pre-B acute lymphoblastic leukemia (ALL) compared with other racial/ethnic groups. Terminal deoxynucleotidyl transferase (TdT) is an intranuclear DNA polymerase normally present on immature lymphocytes (TdT-positive) and distinguishes ALL from mature lymphoid malignancies. We performed a multisite retrospective study to determine the incidence of TdT-negative precursor B-cell acute lymphoblastic leukemia (pre-B ALL) among Mexican, Caucasian, and US-born Hispanic children to correlate TdT expression with patient characteristics and known prognostic factors. Fisher exact test was performed for categorical variables and the Wilcoxon rank-sum test was used for continuous variables. TdT-negative pre-B ALL was most frequently identified in patients with National Cancer Institute high-risk disease ( P =0.014). TdT-negative expression was also most frequently associated with hypodiploid pre-B ALL ( P =0.001) and KMT2A gene rearrangement ( P =0.0012). Mexican children had the highest incidence of TdT-negative ALL compared with Caucasians and US Hispanics ( P <0.001), with an increased incidence of poor prognostic features as well. This study demonstrates significant differences in TdT-negative expression, genomic alterations, and leukemic ploidy based on race and ethnicity.
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Affiliation(s)
- Meagan Vacek
- Department of Pediatric Hematology-Oncology, Children's Mercy Hospital, Kansas City, MO
| | - Laura C Zárraga Vargas
- Stem Cell Biology Lab, Autonomous University of Morelos State, Cuernavaca
- The Dr. Ruy Perez Tamayo Diagnostic and Molecular Medicine Unit, Hospital del Niño Morelense, Emiliano Zapata
| | | | | | | | | | | | | | | | - Brian Lee
- Division of Health Services and Outcomes Research, Children's Mercy Hospital, Kansas City, MO
| | - Jesús S Olalla Tapia
- Stem Cell Biology Lab, Autonomous University of Morelos State, Cuernavaca
- The Dr. Ruy Perez Tamayo Diagnostic and Molecular Medicine Unit, Hospital del Niño Morelense, Emiliano Zapata
| | - Terrie Flatt
- Department of Pediatric Hematology-Oncology, Children's Mercy Hospital, Kansas City, MO
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2
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Nguyen A, Crespi CM, Vergara X, Kheifets L. Commercial outdoor plant nurseries as a confounder for electromagnetic fields and childhood leukemia risk. ENVIRONMENTAL RESEARCH 2022; 212:113446. [PMID: 35550811 DOI: 10.1016/j.envres.2022.113446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Close residential proximity to powerlines and high magnetic fields exposure may be associated with elevated childhood leukemia risks as reported by prior studies and pooled analyses. Magnetic fields exposure from high-voltage powerlines is associated with proximity to these powerlines and consequently with any factor varying with distance. Areas underneath powerlines in California may be sites for commercial plant nurseries that can use pesticides, a potential childhood leukemia risk factor. OBJECTIVES Assess if potential pesticide exposure from commercial plant nurseries is a confounder or interacts with proximity or magnetic fields exposure from high-voltage powerlines to increase childhood leukemia risk. METHODS A comprehensive childhood leukemia record-based case-control study with 5788 cases and 5788 controls (born and diagnosed in California, 1986-2008) was conducted. Pesticide, powerline, and magnetic field exposure assessment utilized models that incorporated geographical information systems, aerial satellite images, site visits and other historical information. RESULTS The relationship for calculated fields with childhood leukemia (odds ratio (OR) 1.51, 95% confidence interval (CI) 0.70-3.23) slightly attenuated when controlling for nursery proximity (OR 1.43, 95% CI 0.65-3.16) or restricting analysis to subjects living far (>300 m) from nurseries (OR 1.43, 95% CI 0.79-2.60). A similar association pattern was observed between distance to high-voltage powerlines and childhood leukemia. The association between nursery proximity and childhood leukemia was unchanged or only slightly attenuated when controlling for calculated fields or powerline distance; ORs remained above 2 when excluding subjects with high calculated fields or close powerline proximity (OR 2.16, 95% CI 0.82-5.67 and OR 2.15, 95% CI 0.82-5.64, respectively). The observed relationships were robust to different time periods, reference categories, and cut points. DISCUSSION Close residential proximity to nurseries is suggested as an independent childhood leukemia risk factor. Our results do not support plant nurseries as an explanation for observed childhood leukemia risks for powerline proximity and magnetic fields exposure, although small numbers of subjects concurrently exposed to high magnetic fields, close powerline proximity and plant nurseries limited our ability to fully assess potential confounding.
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Affiliation(s)
- A Nguyen
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA.
| | - C M Crespi
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA.
| | - X Vergara
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA.
| | - L Kheifets
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA.
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3
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Digitale JC, Kim MO, Kuzniewicz MW, Newman TB. Update on Phototherapy and Childhood Cancer in a Northern California Cohort. Pediatrics 2021; 148:peds.2021-051033. [PMID: 34716218 DOI: 10.1542/peds.2021-051033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We aimed to reassess the relationship between phototherapy and cancer in an extended version of a previous cohort and to replicate a report from Quebec of increased cancer risk after phototherapy beginning at age 4 years. METHODS This cohort study included 139 100 children born at ≥35 weeks' gestation from 1995 to 2017, followed through March 16, 2019, in Kaiser Permanente Northern California hospitals who had a qualifying bilirubin level from -3 mg/dL to +4.9 mg/dL from the American Academy of Pediatrics phototherapy threshold; an additional 40 780 children and 5 years of follow-up from our previous report. The exposure was inpatient phototherapy (yes or no), and the outcomes were various types of childhood cancer. We used Cox proportional hazard models, controlling for propensity-score quintiles, and allowed for time-dependent exposure effects to assess for the risk of cancer after a latent period. RESULTS Over a mean (SD) follow-up of 8.2 (5.7) years, the crude incidence of cancer per 100 000 person-years was 25.1 among those exposed to phototherapy and 19.2 among those not exposed (233 cases of cancer). After propensity adjustment, phototherapy was not associated with any cancer (hazard ratio [HR]: 1.13, 95% confidence interval [CI]: 0.83-1.54), hematopoietic cancer (HR: 1.17, 95% CI: 0.74-1.83), or solid tumors (HR: 1.01, 95% CI: 0.65-1.58). We also found no association with cancer diagnoses at age ≥4 years. CONCLUSIONS We did not confirm previous, concerning associations between phototherapy and adjusted risk of any cancer, nonlymphocytic leukemia, or brain and/or central nervous systems tumors in later childhood.
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Affiliation(s)
| | - Mi-Ok Kim
- Department of Epidemiology and Biostatistics.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
| | - Michael W Kuzniewicz
- Pediatrics.,Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Thomas B Newman
- Department of Epidemiology and Biostatistics.,Pediatrics.,Division of Research, Kaiser Permanente Northern California, Oakland, California
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Marcotte EL, Domingues AM, Sample JM, Richardson MR, Spector LG. Racial and ethnic disparities in pediatric cancer incidence among children and young adults in the United States by single year of age. Cancer 2021; 127:3651-3663. [PMID: 34151418 DOI: 10.1002/cncr.33678] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/05/2021] [Accepted: 04/26/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Incidence rates of pediatric cancers in the United States are typically reported in 5-year age groups, obscuring variation by single year of age. Additionally, racial and ethnic variation in incidence is typically presented in broad categories rather than by narrow age ranges. METHODS The Surveillance, Epidemiology, and End Results (SEER) 18 data (2000-2017) were examined to calculate frequencies and age-adjusted incidence rates among individuals aged birth to 39 years. Incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) were estimated as the measure of association for rate comparisons by race and Hispanic origin overall and by single year of age. RESULTS Several histologic types showed substantial variation in race/ethnicity-specific and overall rates by single year of age. Overall, Black children and young adults experienced substantially decreased incidence of acute lymphoid leukemia (IRR, 0.52; 95% CI, 0.49-0.55) compared to Whites, and this decreased incidence was strongest at ages 1 through 7 years and 16 through 20 years. Hispanic individuals experienced decreased overall incidence of Hodgkin lymphoma (IRR, 0.50; 95% CI, 0.48-0.52) and astrocytoma (IRR, 0.54; 95% CI, 0.52-0.56) and increased risk of acute lymphoblastic leukemia (IRR, 1.46; 95% CI, 1.42-1.51) compared to non-Hispanic Whites, and the increased risk was strongest at ages 10 through 23 years. Substantial decreased risk across many tumor types was also observed for Asian/Pacific Islanders and American Indian/Alaska Natives. CONCLUSIONS Examination of incidence rates for pediatric cancers by narrow age groups may provide insights regarding etiological differences in subgroups. Additionally, variation in age-specific incidence rates by race and ethnicity may enable hypothesis generation on drivers of disparities observed.
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Affiliation(s)
- Erin L Marcotte
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.,University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
| | - Allison M Domingues
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Jeannette M Sample
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Michaela R Richardson
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Logan G Spector
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.,University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota
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Deziel NC, Zhang Y, Wang R, Wiemels JL, Morimoto L, Clark CJ, Metayer C, Ma X. Birth Characteristics and Risk of Pediatric Thyroid Cancer: A Population-Based Record-Linkage Study in California. Thyroid 2021; 31:596-606. [PMID: 32912083 PMCID: PMC8195873 DOI: 10.1089/thy.2020.0217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Incidence rates of thyroid cancer in children and young adults (age 0-19 years) have nearly doubled over a recent 15-year period in the United States. Children with thyroid cancer may require long-term therapy and surveillance and are at greater risk for second primary malignancies. High-dose exposure to ionizing radiation is the only known nongenetic risk factor; the vast majority of cases have an unknown etiology. Methods: We conducted a population-based nested case-control study to evaluate the relationship between a range of birth characteristics and the risk of pediatric thyroid cancer. Using linked birth records and cancer registry data from California, we included 1012 cases who were diagnosed with first primary thyroid cancer at the age of 0-19 years from 1988 to 2015 and 50,600 birth-year matched controls (1:50 case to control ratio). We estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) by using multivariable logistic regression models applied to the full population and stratified by thyroid cancer subtypes (papillary and follicular), race/ethnicity (white and Hispanic), and age at diagnosis (0-14 and 15-19 years). Results: Hispanic ethnicity (OR: 1.20 [CI 1.01-1.42]), higher birth weight (OR: 1.11 [CI 1.04-1.18] per 500g), and higher maternal education (13-15 years OR: 1.35 [CI 1.09-1.68], 16+ years OR: 1.35 [CI 1.07-1.71]) were associated with an increased risk of pediatric thyroid cancer, while male sex (OR: 0.21 [CI 0.18-0.25]) and higher birth order (third or higher OR: 0.81 [CI 0.68-0.98]) were associated with a decreased risk. Some heterogeneity was observed across subtype, most notably an elevated OR with higher birth order for follicular thyroid cancer, in contrast to the reduced risk for this category among papillary thyroid cancer cases (p-value for interaction = 0.01). Hispanic ethnicity was a risk factor for papillary, but not follicular thyroid cancer (p-value for interaction = 0.07). Conclusions: In this population-based study of birth characteristics and pediatric thyroid cancer, we identified several important risk factors for pediatric thyroid cancer, including female sex, Hispanic ethnicity, higher birth weight, higher maternal educational attainment, and lower birth order. Our data provide new areas for replication and investigation of biological mechanisms for this poorly understood malignancy.
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Affiliation(s)
- Nicole C. Deziel
- Department of Environmental Health Sciences and Yale School of Public Health, New Haven, Connecticut, USA
- Address correspondence to: Nicole C. Deziel, PhD, Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
| | - Yawei Zhang
- Department of Environmental Health Sciences and Yale School of Public Health, New Haven, Connecticut, USA
- Section of Surgical Outcomes and Epidemiology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Joseph L. Wiemels
- Center for Genetic Epidemiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Libby Morimoto
- Department of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Cassandra J. Clark
- Department of Environmental Health Sciences and Yale School of Public Health, New Haven, Connecticut, USA
| | - Catherine Metayer
- Department of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
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6
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Jiménez-Hernández E, Duarte-Rodríguez DA, Núñez-Enriquez JC, Flores-Lujano J, Martín-Trejo JA, Espinoza-Hernández LE, Arellano-Galindo J, Medina-Sanson A, García-Jiménez X, Paredes-Aguilera R, Flores-Villegas LV, Peñaloza-González JG, Torres-Nava JR, Espinosa-Elizondo RM, Amador-Sánchez R, Dosta-Herrera JJ, Mondragón-García JA, Valdés-Guzmán H, Mejía-Pérez L, Espinoza-Anrubio G, Paz-Bribiesca MM, Salcedo-Lozada P, Landa-García RÁ, Ramírez-Colorado R, Hernández-Mora L, Pérez-Saldivar ML, 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, Cárdenas-Cardos R, Altamirano-García MB, 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, Rosas-Vargas H, Mejía-Aranguré JM. Maternal and paternal ages at conception of index child and risk of childhood acute leukaemia: A multicentre case-control study in Greater Mexico City. Cancer Epidemiol 2020; 67:101731. [PMID: 32447241 DOI: 10.1016/j.canep.2020.101731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The parental age at conception has been reported to be a risk factor for childhood acute leukaemia (AL); however, the relationship is controversial. The aim of the present study was to investigate the association between parental age at conception and the risk of AL in Mexican children, a population with a high incidence of the disease and a high prevalence of pregnancies in adolescents and young adults. METHODS A multicentre case-control study was conducted. Incident AL cases younger than 17 years of age diagnosed between 2010 and 2015 were included. Controls were matched with cases according to age, sex, and health institution. Using logistic regression analysis, adjusted odds ratios (aOR) and 95 % confidence intervals (95 % CI) were calculated for each maternal stratum after adjusting for paternal age at conception of index child. The maternal age between 25 and 29.99 years was selected as the reference category. RESULTS In most strata where maternal and paternal ages were assessed, no association was found with the risk of developing acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in their offspring. An increased risk for AML was observed when the mother was between 20 and 24.99 years of age and the father aged 25-29.99 years (aOR, 1.94; 95 % CI, 1.03-3.67). In addition, there was a positive association for ALL when the mother´s age was between 20 and 24.99 years and the father was <20 years of age, however, a very wide confidence interval was noted (aOR, 12.26; 95 % CI, 1.41-106.83). CONCLUSION In the present study, maternal and paternal ages assessed in different strata showed little association with risk of developing ALL and AML in children. Positive associations between risk of both types of childhood AL were observed with younger paternal and maternal ages.
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Affiliation(s)
- Elva Jiménez-Hernández
- Coordinación de Investigación en Salud, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico; Servicio de Hematología Pediátrica, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS. Calzada Vallejo y Jacarandas S/N Col. La Raza, Delegación Azcapotzalco, Mexico City, 02990, Mexico.
| | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Juan Carlos Núñez-Enriquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematología, UMAE Hospital de Pediatría, CMN "Siglo XXI", IMSS.Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Laura Eugenia Espinoza-Hernández
- Servicio de Hematología Pediátrica, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS. Calzada Vallejo y Jacarandas S/N Col. La Raza, Delegación Azcapotzalco, Mexico City, 02990, Mexico.
| | - José Arellano-Galindo
- Hospital Infantil de México Federico Gómez, Secretaria de Salud (SS). Calle Doctor Márquez 162, Col. Doctores, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Aurora Medina-Sanson
- Hospital Infantil de México Federico Gómez, Secretaria de Salud (SS). Calle Doctor Márquez 162, Col. Doctores, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Xochiketzalli García-Jiménez
- Servicio de Hematología, UMAE Hospital de Pediatría, CMN "Siglo XXI", IMSS.Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Rogelio Paredes-Aguilera
- Servicio de Hematología, Instituto Nacional de Pediatría (INP), SS. Insurgentes Sur 3700, Letra C, Col. Insurgentes Cuicuilco, Delegación Coyoacán, Mexico City, 04530, Mexico.
| | - Luz Victoria Flores-Villegas
- Servicio de Hematología Pediátrica, CMN "20 de Noviembre", Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE). Félix Cuevas 540, Col. Del Valle, Delegación Benito Juárez, Mexico City, 03229, Mexico.
| | - José Gabriel Peñaloza-González
- Servicio de Onco-Pediatría, Hospital Juárez de México, SS. Av. Instituto Politécnico Nacional 5160, Col. Magdalena de las Salinas, Delegación Gustavo A. Madero, Mexico City, 07760, Mexico.
| | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediátrico "Moctezuma", Secretaría de Salud de la Ciudad de México (SSCDMX). Oriente 158-189, Col. Moctezuma 2a Sección, Delegación Venustiano Carranza, Mexico City, 15530, Mexico.
| | - Rosa Martha Espinosa-Elizondo
- Servicio de Hematología Pediátrica, Hospital General de México, SSa. Eje 2A Sur (Dr. Balmis) 148, Col. Doctores, Delegación Cuauhtémoc, Mexico City, 06726, Mexico.
| | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, Hospital General Regional (HGR), No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS. Av. Gabriel Mancera No. 222, Col. Del Valle, Mexico City, 03100, Mexico.
| | - Juan José Dosta-Herrera
- Servicio de Cirugía Pediátrica, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS. Calzada Vallejo y Jacarandas S/N Col. La Raza, Delegación Azcapotzalco, Mexico City, 02990, Mexico.
| | - Javier Anastacio Mondragón-García
- Servicio de Cirugía Pediátrica, HGR No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS. Av. Gabriel Mancera No. 222, Col. Del Valle, Mexico City, 03100, Mexico.
| | - Heriberto Valdés-Guzmán
- Hospital Pediátrico de Iztacalco, SSCDMX. Av. Coyuya y Terraplén de Rio Frio S/N, Col. La Cruz. Iztacalco, Mexico City, 08310 Mexico.
| | - Laura Mejía-Pérez
- Hospital Pediátrico de Iztapalapa, SSCDMX. Av. Ermita Iztapalapa 780, Col. Granjas San Antonio. Delegación Iztapalapa, Mexico City, 09070. Mexico.
| | - Gilberto Espinoza-Anrubio
- Servicio de Pediatría, Hospital General Zona (HGZ) No. 8 "Dr. Gilberto Flores Izquierdo"IMSS. Av. Rio Magdalena 289 Ciudad De México, Col.Tizapan San Angel, Delegación Álvaro Obregón, Mexico City, 1090, Mexico.
| | - María Minerva Paz-Bribiesca
- Servicio de Pediatría, Hospital Juárez del Centro, SS. Jesus María 13, Col Centro, Delegación Cuahtemoc, Mexico City, 06000, Mexico.
| | - Perla Salcedo-Lozada
- Hospital General de Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM). Av. Simón Bolivar 1, Fraccionamiento Las Américas, Municipio Ecatepec de Morelos. State of Mexico, 55076. Mexico.
| | - Rodolfo Ángel Landa-García
- Hospital General "Dr. Manuel Gea González" SS. Calz. de Tlalpan 4800, Tlalpan Centro I, Belisario Domínguez Secc 16, Delegación Tlalpan, Mexico City,14080, Mexico.
| | - Rosario Ramírez-Colorado
- Hospital Pediátrico "La Villa", SSCDMX. Av. Cantera, Esq. Av. Hidalgo S/n, Col. Estanzuela. Delegación Gustavo A. Madero, Mexico City, 07050, Mexico.
| | - Luis Hernández-Mora
- Hospital Pediátrico "San Juan de Aragón", SSCDMX. Av. 506, S/N San Juan de Aragón 1A. Delegación Gustavo A. Madero, 07969, Mexico.
| | - María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Marlene Santamaría-Ascencio
- Servicio de Pediatría, HGR No. 72 "Lic. Vicente Santos Guajardo", IMSS. Calle Filiberto Gómez; S/N, Tlalnepantla, Edo. de Mexico, CP54030. México.
| | - Anselmo López-Loyola
- Servicio de Cirugía Pediátrica, HGZ No. 32, IMSS. Clzd. del Hueso S/N, Col. EX-Ex Hacienda Coapa, Delegación Coyoacán, Mexico City, 14310, Mexico.
| | - Arturo Hermilo Godoy-Esquivel
- Servicio de Cirugía Pediátrica, Hospital Pediátrico de Moctezuma, SSCDMX. Oriente 158-189, Col. Moctezuma 2a Sección, Delegación Venustiano Carranza, Mexico City, 15530, Mexico.
| | - Luis Ramiro García-López
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, SSCDMX. Carlos Lazo 25, Col. Tacubaya, Delegación Miguel Hidalgo, México City, 11870, Mexico.
| | - Alison Ireri Anguiano-Ávalos
- Urgencias Pediátricas, HGZ No. 47, IMSS. Av. Campaña de Ébano S/N Col. Unidad Vicente Guerrero, Dlegación Iztapalapa, México City, 09200. Mexico.
| | - Karina Mora-Rico
- Servicio de Cirugía Pediátrica, Hospital Regional "1° Octubre", ISSSTE. Av Instituto Politécnico Nacional 1669, Revolución IMSS, Delegación Gustavo A Madero, 07300 Mexico.
| | - Alejandro Castañeda-Echevarría
- Servicio de Pediatría, HGR No. 25 IMSS.Clzd. Ignacio Zaragoza 1840, Col. Juan Escutia, Delegación Iztapalapa, Mexico City, 09100 Mexico.
| | - Roberto Rodríguez-Jiménez
- Servicio de Pediatría, Hospital General de Zona con Medicina Familiar (HGZMF) No. 29, IMSS. AV. 510, S/N, Col. Unidad San Juan de Aragón. Delegación Gustavo A. Madero, Mexico City, 07950, Mexico.
| | - José Alberto Cibrian-Cruz
- Servicio de Cirugía Pediátrica, HGZ No. 27, IMSS. AV. Lázaro Cárdenas, S/N Tlaltelolco, Delegación Cuauhtémoc, México City, 06900 Mexico.
| | - Rocío Cárdenas-Cardos
- Servicio de Oncología, INP, SSa. Insurgentes Sur 3700, Letra C, Col. Insurgentes Cuicuilco, Delegación Coyoacán, Mexico City, 04530, Mexico.
| | - Martha Beatriz Altamirano-García
- Servicio de Pediatría, Hospital General Zona (HGZ) No. 8 "Dr. Gilberto Flores Izquierdo"IMSS. Av. Rio Magdalena 289 Ciudad De México, Col.Tizapan San Angel, Delegación Álvaro Obregón, Mexico City, 1090, Mexico.
| | - Martin Sánchez-Ruiz
- Hospital General de Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM). Av. Simón Bolivar 1, Fraccionamiento Las Américas, Municipio Ecatepec de Morelos. State of Mexico, 55076. Mexico.
| | - Roberto Rivera-Luna
- Servicio de Oncología, INP, SSa. Insurgentes Sur 3700, Letra C, Col. Insurgentes Cuicuilco, Delegación Coyoacán, Mexico City, 04530, Mexico.
| | - Luis Rodolfo Rodríguez-Villalobos
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, SSCDMX. Carlos Lazo 25, Col. Tacubaya, Delegación Miguel Hidalgo, México City, 11870, Mexico.
| | - Francisco Hernández-Pérez
- Urgencias Pediátricas, HGZ No. 47, IMSS. Av. Campaña de Ébano S/N Col. Unidad Vicente Guerrero, Dlegación Iztapalapa, México City, 09200. Mexico.
| | - Jaime Ángel Olvera-Durán
- Servicio de Cirugía Pediátrica, Hospital Regional "1° Octubre", ISSSTE. Av Instituto Politécnico Nacional 1669, Revolución IMSS, Delegación Gustavo A Madero, 07300 Mexico.
| | - Luis Rey García-Cortés
- Delegación Regional Estado de México Oriente, IMSS. Calle 4 25, Fracc. Industrial Alce Blanco, Municipio de Naucalpan de Juárez, State of Mexico, 53370, Mexico.
| | - Minerva Mata-Rocha
- Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Omar Alejandro Sepúlveda-Robles
- Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Vilma Carolina Bekker-Méndez
- Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología "Dr.Daniel Méndez Hernández", CMN "La Raza", IMSS. Address. Av. Río Consulado, Col La Raza S/N. Delegación Azcapotzalco, Mexico City, 02990 Mexico.
| | - Silvia Jiménez-Morales
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Mexico City,14610 Mexico.
| | - Haydee Rosas-Vargas
- Unidad de Investigación Médica en Genética Humana, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Juan Manuel Mejía-Aranguré
- Coordinación de Investigación en Salud, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico; Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico; Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
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Park AS, Ritz B, Yu F, Cockburn M, Heck JE. Prenatal pesticide exposure and childhood leukemia - A California statewide case-control study. Int J Hyg Environ Health 2020; 226:113486. [PMID: 32087503 DOI: 10.1016/j.ijheh.2020.113486] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/17/2020] [Accepted: 02/10/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND A number of epidemiologic studies with a variety of exposure assessment approaches have implicated pesticides as risk factors for childhood cancers. Here we explore the association of pesticide exposure in pregnancy and early childhood with childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) utilizing land use and pesticide use data in a sophisticated GIS tool. METHODS We identified cancer cases less than 6 years of age from the California Cancer Registry and cancer-free controls from birth certificates. Analyses were restricted to those living in rural areas and born 1998-2011, resulting in 162 cases of childhood leukemia and 9,805 controls. Possible carcinogens were selected from the Environmental Protection Agency's classifications and pesticide use was collected from the California Department of Pesticide Regulation's (CDPR) Pesticide Use Reporting (PUR) system and linked to land-use surveys. Exposures for subjects were assessed using a 4000m buffer around the geocoded residential addresses at birth. Unconditional logistic and hierarchical regression models were used to assess individual pesticide and pesticide class associations. RESULTS We observed elevated risks for ALL with exposure to any carcinogenic pesticide (adjusted Odds Ratio (aOR): 2.83, 95% CI: 1.67-4.82), diuron (Single-pesticide model, adjusted (OR): 2.38, 95% CI: 1.57-3.60), phosmet (OR: 2.10, 95% CI: 1.46-3.02), kresoxim-methyl (OR: 1.77, 95% CI: 1.14-2.75), and propanil (OR: 2.58, 95% CI: 1.44-4.63). Analyses based on chemical classes showed elevated risks for the group of 2,6-dinitroanilines (OR: 2.50, 95% CI: 1.56-3.99), anilides (OR: 2.16, 95% CI: 1.38-3.36), and ureas (OR: 2.18, 95% CI: 1.42-3.34). CONCLUSION Our findings suggest that in rural areas of California exposure to certain pesticides or pesticide classes during pregnancy due to residential proximity to agricultural applications may increase the risk of childhood ALL and AML. Future studies into the mechanisms of carcinogenicity of these pesticides may be beneficial.
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Affiliation(s)
- Andrew S Park
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Fei Yu
- Department of Biostatistics, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001, N. Soto Street, Suite 318-A, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Dr. S, Box 951772, Los Angeles, CA, 90095-1772, USA; Jonsson Comprehensive Cancer Center, University of California, Box 951781, Los Angeles, CA, 90095-1781, USA.
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Maternal Residential Proximity to Major Roadways and the Risk of Childhood Acute Leukemia: A Population-Based Case-Control Study in Texas, 1995-2011. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16112029. [PMID: 31181608 PMCID: PMC6603856 DOI: 10.3390/ijerph16112029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/29/2019] [Accepted: 06/04/2019] [Indexed: 01/23/2023]
Abstract
Acute leukemia is the most common pediatric malignancy. Some studies suggest early-life exposures to air pollution increase risk of childhood leukemia. Therefore, we explored the association between maternal residential proximity to major roadways and risk of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Information on cases with acute leukemia (n = 2030) was obtained for the period 1995–2011 from the Texas Cancer Registry. Birth certificate controls were frequency matched (10:1) on birth year (n = 20,300). Three residential proximity measures were assessed: (1) distance to nearest major roadway, (2) residence within 500 meters of a major roadway, and (3) roadway density. Multivariate logistic regression was used to generate adjusted odds ratios (aOR) and 95% confidence intervals (CI). Mothers who lived ≤500 meters to a major roadway were not more likely to have a child who developed ALL (OR = 1.03; 95% CI: 0.91–1.16) or AML (OR = 0.84; 95% CI: 0.64–1.11). Mothers who lived in areas characterized by high roadway density were not more likely to have children who developed ALL (OR = 1.06, 95% CI: 0.93–1.20) or AML (OR = 0.83, 95% CI: 0.61–1.13). Our results do not support the hypothesis that maternal proximity to major roadways is strongly associated with childhood acute leukemia. Future assessments evaluating the role of early-life exposure to environmental factors on acute leukemia risk should explore novel methods for directly measuring exposures during relevant periods of development.
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de Haas V, Ismaila N, Advani A, Arber DA, Dabney RS, Patel-Donelly D, Kitlas E, Pieters R, Pui CH, Sweet K, Zhang L. Initial Diagnostic Work-Up of Acute Leukemia: ASCO Clinical Practice Guideline Endorsement of the College of American Pathologists and American Society of Hematology Guideline. J Clin Oncol 2019; 37:239-253. [PMID: 30523709 PMCID: PMC6338392 DOI: 10.1200/jco.18.01468] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The College of American Pathologists (CAP) and the American Society of Hematology (ASH) developed an evidence-based guideline on the initial diagnostic work-up of acute leukemia (AL). Because of the relevance of this topic to the ASCO membership, ASCO reviewed the guideline and applied a set of procedures and policies for endorsing clinical practice guidelines that have been developed by other professional organizations. METHODS The CAP-ASH guideline on initial diagnostic work-up of AL was reviewed for developmental rigor by methodologists. Then, an ASCO Endorsement Expert Panel updated the literature search and reviewed the content and recommendations. RESULTS The ASCO Expert Panel determined that the recommendations from the guideline, published in 2016, are clear, thorough, and based on the most relevant scientific evidence. ASCO fully endorsed the CAP-ASH guideline on initial diagnostic work-up of AL and included some discussion points according to clinical practice and updated literature. CONCLUSION Twenty-seven guideline statements were reviewed. Some discussion points were included to better assess CNS involvement in leukemia and to provide novel insights into molecular diagnosis and potential markers for risk stratification and target therapy. These discussions are categorized into four sections: (1) initial diagnosis focusing on basic diagnostics and determination of risk parameters, (2) molecular markers and minimal residual disease detection, (3) context of referral to another institution with expertise in the management of AL, and (4) reporting and record keeping for better outlining and follow-up discussion. Additional information is available at: www.asco.org/hematologic-malignancies-guidelines .
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Affiliation(s)
- Valérie de Haas
- 1 Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | | | | | | | | | | | - Rob Pieters
- 1 Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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Amoon AT, Oksuzyan S, Crespi CM, Arah OA, Cockburn M, Vergara X, Kheifets L. Residential mobility and childhood leukemia. ENVIRONMENTAL RESEARCH 2018; 164:459-466. [PMID: 29574256 PMCID: PMC7491916 DOI: 10.1016/j.envres.2018.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 03/08/2018] [Accepted: 03/10/2018] [Indexed: 05/29/2023]
Abstract
AIMS Studies of environmental exposures and childhood leukemia studies do not usually account for residential mobility. Yet, in addition to being a potential risk factor, mobility can induce selection bias, confounding, or measurement error in such studies. Using data collected for California Powerline Study (CAPS), we attempt to disentangle the effect of mobility. METHODS We analyzed data from a population-based case-control study of childhood leukemia using cases who were born in California and diagnosed between 1988 and 2008 and birth certificate controls. We used stratified logistic regression, case-only analysis, and propensity-score adjustments to assess predictors of residential mobility between birth and diagnosis, and account for potential confounding due to residential mobility. RESULTS Children who moved tended to be older, lived in housing other than single-family homes, had younger mothers and fewer siblings, and were of lower socioeconomic status. Odds ratios for leukemia among non-movers living <50 meters (m) from a 200+ kilovolt line (OR: 1.62; 95% CI: 0.72-3.65) and for calculated fields ≥ 0.4 microTesla (OR: 1.71; 95% CI: 0.65-4.52) were slightly higher than previously reported overall results. Adjustments for propensity scores based on all variables predictive of mobility, including dwelling type, increased odds ratios for leukemia to 2.61 (95% CI: 1.76-3.86) for living < 50 m from a 200 + kilovolt line and to 1.98 (1.11-3.52) for calculated fields. Individual or propensity-score adjustments for all variables, except dwelling type, did not materially change the estimates of power line exposures on childhood leukemia. CONCLUSION The residential mobility of childhood leukemia cases varied by several sociodemographic characteristics, but not by the distance to the nearest power line or calculated magnetic fields. Mobility appears to be an unlikely explanation for the associations observed between power lines exposure and childhood leukemia.
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Affiliation(s)
- A T Amoon
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA.
| | - S Oksuzyan
- Division of HIV and STD Programs, Los Angeles County Department of Public Health, 600 S Commonwealth Ave, Los Angeles, CA 90005, USA
| | - C M Crespi
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA
| | - O A Arah
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA
| | - M Cockburn
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - X Vergara
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA; Energy & Environment Sector, Electric Power Research Institute, 3420 Hillview Avenue, Palo Alto, CA 94304, USA
| | - L Kheifets
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA
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Peckham-Gregory EC, McClain KL, Allen CE, Scheurer ME, Lupo PJ. The role of parental and perinatal characteristics on Langerhans cell histiocytosis: characterizing increased risk among Hispanics. Ann Epidemiol 2018; 28:521-528. [PMID: 29724524 PMCID: PMC6054892 DOI: 10.1016/j.annepidem.2018.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/23/2018] [Accepted: 04/10/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE Potential roles of inherited and environmental risk factors in pathogenesis of Langerhans cell histiocytosis (LCH), a myeloid neoplastic disorder, are undefined. We therefore evaluated the role of parental and perinatal factors on the risk of this childhood cancer. METHODS Information on LCH cases (n = 162) for the period 1995-2011 was obtained from the Texas Cancer Registry. Birth certificate controls were frequency-matched on year of birth at a ratio of 10:1 for the same period. Variables evaluated included parental age, race/ethnicity, size for gestational age, and birth order. Logistic regression was used to generate an adjusted odds ratio (aOR) and 95% confidence interval (CI) testing the association between each factor and LCH. RESULTS Few perinatal or parental factors were associated with LCH risk, with the exception of race/ethnicity. Mothers of Hispanic ethnicity were more likely to have children who developed LCH compared to non-Hispanic whites (aOR: 1.51; 95% CI: 1.02-2.25). This risk increased when both parents were Hispanic (aOR: 1.80; 95% CI: 1.13-2.87). Non-Hispanic black mothers were suggested as less likely to give birth to offspring who developed LCH compared to non-Hispanic whites (aOR: 0.50; 95% CI: 0.24-1.02). CONCLUSIONS LCH is characterized by somatic mutations in MAPK pathway genes in myeloid precursors. Increased risk for LCH in children of Hispanic parents suggests potential impact of inherited factors on LCH pathogenesis.
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Affiliation(s)
- Erin C Peckham-Gregory
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX
| | - Kenneth L McClain
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX
| | - Carl E Allen
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX; Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX; Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX.
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12
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A genome-wide association study of LCH identifies a variant in SMAD6 associated with susceptibility. Blood 2017; 130:2229-2232. [PMID: 28935696 DOI: 10.1182/blood-2017-08-800565] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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13
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Kheifets L, Crespi CM, Hooper C, Cockburn M, Amoon AT, Vergara XP. Residential magnetic fields exposure and childhood leukemia: a population-based case-control study in California. Cancer Causes Control 2017; 28:1117-1123. [PMID: 28900736 DOI: 10.1007/s10552-017-0951-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 08/28/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE Studies have reported an increased risk of childhood leukemia associated with exposure to magnetic fields. We conducted a large records-based case-control study of childhood leukemia risk and exposure to magnetic fields from power lines in California. METHODS The study included 5,788 childhood leukemia cases (born in and diagnosed in California 1986-2008) matched to population-based controls on age and sex. We calculated magnetic fields at birth addresses using geographic information systems, aerial imagery, historical information on load and phasing, and site visits. RESULTS Based on unconditional logistic regression controlling for age, sex, race/ethnicity, and socioeconomic status using subjects geocoded to a basic standard of accuracy, we report a slight risk deficit in two intermediate exposure groups and a small excess risk in the highest exposure group (odds ratio of 1.50 (95% confidence interval [0.70, 3.23])). Subgroup and sensitivity analyses as well as matched analyses gave similar results. All estimates had wide confidence intervals. CONCLUSION Our large, statewide, record-based case-control study of childhood leukemia in California does not in itself provide clear evidence of risk associated with greater exposure to magnetic fields from power lines, but could be viewed as consistent with previous findings of increased risk.
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Affiliation(s)
- Leeka Kheifets
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E Young Drive South, Los Angeles, CA, 90024, USA.
| | - Catherine M Crespi
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, 90024, USA
| | | | - Myles Cockburn
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Aryana T Amoon
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E Young Drive South, Los Angeles, CA, 90024, USA
| | - Ximena P Vergara
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E Young Drive South, Los Angeles, CA, 90024, USA.,Energy and Environment, Electric Power Research Institute, Palo Alto, CA, 94304, USA
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Kheifets L, Swanson J, Yuan Y, Kusters C, Vergara X. Comparative analyses of studies of childhood leukemia and magnetic fields, radon and gamma radiation. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2017; 37:459-491. [PMID: 28586320 DOI: 10.1088/1361-6498/aa5fc7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this paper we compare the findings of epidemiologic studies of childhood leukemia that examined at least two of ELF magnetic fields and/or distance to power lines, and exposure to radon and gamma radiation or distance to nuclear plants. Many of the methodologic aspects are common to studies of non-ionising (i.e. ELF-MF) and ionising radiation. A systematic search and review of studies with more than one exposure under study identified 33 key and 35 supplementary papers from ten countries that have been included in this review. Examining studies that have looked at several radiation exposures, and comparing similarities and differences for the different types of radiation, through the use of directed acyclic graphs, we evaluate to what extent bias, confounding and other methodological issues might be operating in these studies. We found some indication of bias, although results are not clear cut. There is little evidence that confounding has had a substantial influence on results. Influence of the residential mobility on the study conduct and interpretation is complex and can manifest as a selection bias, confounding, increased measurement error or could also be a potential risk factor. Other factors associated with distance to power lines and to nuclear power plants should be investigated. A more complete and consistent reporting of results in the future studies will allow for a more informative comparison across studies and integration of results.
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Affiliation(s)
- Leeka Kheifets
- University of California Los Angeles, United States of America
| | - John Swanson
- National Grid, 1-3 Strand, London, United Kingdom
| | - Yingzhe Yuan
- University of California Los Angeles, United States of America
| | - Cynthia Kusters
- University of California Los Angeles, United States of America
| | - Ximena Vergara
- University of California Los Angeles, United States of America
- Electric Power Research Institute, Palo Alto, CA, United States of America
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Contreras ZA, Ritz B, Virk J, Cockburn M, Heck JE. Maternal pre-pregnancy and gestational diabetes, obesity, gestational weight gain, and risk of cancer in young children: a population-based study in California. Cancer Causes Control 2016; 27:1273-85. [PMID: 27613707 PMCID: PMC5066566 DOI: 10.1007/s10552-016-0807-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/30/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE We aimed to examine the influence of pre-pregnancy diabetes, pre-pregnancy body mass index (BMI), gestational diabetes, and gestational weight gain on childhood cancer risk in offspring. METHODS We identified cancer cases (n = 11,149) younger than age 6 years at diagnosis from the California Cancer Registry registered between 1988 and 2013. Controls (n = 270,147) were randomly sampled from California birth records, and frequency matched by year of birth to all childhood cancers during the study period. Exposure and covariate information were extracted from birth records. Unconditional logistic regression models were generated to assess the importance of pre-pregnancy diabetes, pre-pregnancy BMI, gestational diabetes, and gestational weight gain on childhood cancer risk. RESULTS We observed increased risks of acute lymphoblastic leukemia and Wilms' tumor in children of mothers with pre-pregnancy diabetes [odds ratio (OR) 95 % confidence interval (CI) 1.37 (1.11, 1.69); OR (95 % CI) 1.45 (0.97, 2.18), respectively]. When born to mothers who were overweight prior to pregnancy (BMI 25-<30), children were at increased risk of leukemia [OR (95 % CI) 1.27 (1.01, 1.59)]. Insufficient gestational weight gain increased the risk of acute myeloid leukemia [OR (95 % CI) 1.50 (0.92, 2.42)] while excessive gestational weight gain increased the risk of astrocytomas [OR (95 % CI) 1.56 (0.97, 2.50)]. No associations were found between gestational diabetes and childhood cancer risk in offspring. CONCLUSIONS We estimated elevated risks of several childhood cancers in the offspring of mothers who had diabetes and were overweight prior to pregnancy, as well as mothers who gained insufficient or excessive weight. Since few studies have focused on these factors in relation to childhood cancer, replication of our findings in future studies is warranted.
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Affiliation(s)
- Zuelma A Contreras
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jasveer Virk
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Myles Cockburn
- Department of Preventive Medicine, USC/Keck School of Medicine, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
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Giddings BM, Whitehead TP, Metayer C, Miller MD. Childhood leukemia incidence in California: High and rising in the Hispanic population. Cancer 2016; 122:2867-75. [PMID: 27351365 DOI: 10.1002/cncr.30129] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/12/2016] [Accepted: 05/16/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND High rates of childhood leukemia incidence have been reported in Latin America and among Hispanic children in the United States. California's large Hispanic population affords an important opportunity to perform a detailed analysis of the leukemia burden among Hispanic children. METHODS Leukemias diagnosed among non-Hispanic white (NHW), Hispanic, African American (AA), and Asian/Pacific Islander (API) children aged birth to 19 years between January 1, 1990 and December 31, 2012 were obtained from the California Cancer Registry (11,084 cases). Age-adjusted incidence rates, standardized rate ratios (SRRs), and secular trends in incidence (annual percent change [APC]) were analyzed by subtype, race/ethnicity, sex, and age. RESULTS Compared with NHW children, the incidence of acute lymphoblastic leukemia (ALL) was higher among Hispanic (SRR, 1.32) and lower among AA (SRR, 0.55) and API (SRR, 0.91) children. From 1990 to 2012, the incidence of ALL increased overall (APC, 1.1%) and among males (APC, 1.0%), females (APC, 1.3%), Hispanics (APC, 1.1%), AAs (APC, 1.9%), AA males (APC, 2.8%), API males (APC, 1.9%), and Hispanic females (APC, 1.5%). The incidence of ALL increased among Hispanic males aged 15 to 19 years (APC, 2.5%) and Hispanic females aged birth to 4 years and 15 to 19 years (APCs of 2.2% and 1.9%, respectively). The incidence of acute myeloid leukemia did not appear to differ among racial/ethnic groups. From 1990 to 2012, the overall incidence of acute myeloid leukemia remained stable but increased among Hispanics (APC, 1.2%), females (APC, 1.0%), Hispanic females (APC, 2.3%), and Hispanic females aged 15 to 19 years (APC, 3.4%). CONCLUSIONS Notable differences in the incidence of childhood leukemia were observed among 4 racial/ethnic groups in California. Factors that may contribute to these differences include differential exposure to carcinogens and/or genetic susceptibility. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2867-2875. © 2016 American Cancer Society.
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Affiliation(s)
- Brenda M Giddings
- California Cancer Reporting and Epidemiologic Surveillance Program, Institute for Population Health Improvement, UC Davis Health System, Sacramento, California
| | - Todd P Whitehead
- Department of Epidemiology, University of California at Berkeley School of Public Health, Berkeley, California.,Center for Integrative Research on Childhood Leukemia and the Environment, University of California at Berkeley, Berkeley, California
| | - Catherine Metayer
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California at Berkeley, Berkeley, California.,Department of Epidemiology and Biostatistics, University of California at Berkeley School of Public Health, Berkeley, California
| | - Mark D Miller
- Center for Integrative Research on Childhood Leukemia and the Environment, University of California at Berkeley, Berkeley, California.,Western States Pediatric Environmental Health Specialty Unit, University of California at San Francisco, San Francisco, California
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17
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Crespi CM, Vergara XP, Hooper C, Oksuzyan S, Wu S, Cockburn M, Kheifets L. Childhood leukaemia and distance from power lines in California: a population-based case-control study. Br J Cancer 2016; 115:122-8. [PMID: 27219016 PMCID: PMC4931365 DOI: 10.1038/bjc.2016.142] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/06/2016] [Accepted: 04/26/2016] [Indexed: 01/21/2023] Open
Abstract
Background: Studies have reported an increased risk of childhood leukaemia associated with living near high-voltage electric power transmission lines that extend to distances at which magnetic fields from lines are negligible. We conducted a large records-based case-control study of childhood leukaemia risk in the population living near power lines in California. Methods: The study included 5788 childhood leukaemia and 3308 central nervous system (CNS) cancer cases (for comparison) born in and diagnosed in California (1986–2008), and matched to population-based controls by age and sex. We geocoded birth address and estimated the distance from residence to transmission lines using geographic information systems, aerial imagery, and, for some residences, site visits. Results: For leukaemia, there was a slight excess of cases within 50 m of a transmission line over 200 kV (odds ratio 1.4, 95% confidence interval 0.7–2.7). There was no evidence of increased risk for distances beyond 50 m, for lower-voltage lines, or for CNS cancers. Conclusions: Our findings did not clearly support an increased childhood leukaemia risk associated with close proximity (<50 m) to higher voltage lines, but could be consistent with a small increased risk. Reports of increased risk for distances beyond 50 m were not replicated.
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Affiliation(s)
- Catherine M Crespi
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA
| | - Ximena P Vergara
- Environment Sector, Electric Power Research Institute, Palo Alto, CA 94304, USA
| | | | - Sona Oksuzyan
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095-1772, USA
| | - Sheng Wu
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, USA
| | - Myles Cockburn
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Leeka Kheifets
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095-1772, USA
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18
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Lin JN, Lin CL, Lin MC, Lai CH, Lin HH, Yang CH, Sung FC, Kao CH. Risk of leukaemia in children infected with enterovirus: a nationwide, retrospective, population-based, Taiwanese-registry, cohort study. Lancet Oncol 2015; 16:1335-43. [DOI: 10.1016/s1470-2045(15)00060-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/09/2015] [Accepted: 06/09/2015] [Indexed: 10/23/2022]
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