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Milne E, Greenop KR, Scott RJ, Haber M, Norris MD, Attia J, Jamieson SE, Miller M, Bower C, Bailey HD, Dawson S, McCowage GB, de Klerk NH, van Bockxmeer FM, Armstrong BK. Folate pathway gene polymorphisms, maternal folic acid use, and risk of childhood acute lymphoblastic leukemia. Cancer Epidemiol Biomarkers Prev 2015; 24:48-56. [PMID: 25395472 DOI: 10.1158/1055-9965.epi-14-0680] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Several studies suggest that maternal folic acid supplementation before or during pregnancy protects against childhood acute lymphoblastic leukemia (ALL). We investigated associations between ALL risk and folate pathway gene polymorphisms, and their modification by maternal folic acid supplements, in a population-based case-control study (2003-2007). METHODS All Australian pediatric oncology centers provided cases; controls were recruited by national random digit dialing. Data from 392 cases and 535 controls were included. Seven folate pathway gene polymorphisms (MTHFR 677C>T, MTHFR 1298A>C, MTRR 66A>G, MTR 2756 A>G, MTR 5049 C>A, CBS 844 Ins68, and CBS 2199 T>C) were genotyped in children and their parents. Information on prepregnancy maternal folic acid supplement use was collected. ORs were estimated with unconditional logistic regression adjusted for frequency-matched variables and potential confounders. Case-parent trios were also analyzed. RESULTS There was some evidence of a reduced risk of ALL among children who had, or whose father had, the MTRR 66GG genotype: ORs 0.60 [95% confidence interval (CI) 0.39-0.91] and 0.64 (95% CI, 0.40-1.03), respectively. The ORs for paternal MTHFR 677CT and TT genotypes were 1.41 (95% CI, 1.02-1.93) and 1.81 (95% CI, 1.06-3.07). ORs varied little by maternal folic acid supplementation. CONCLUSIONS Some folate pathway gene polymorphisms in the child or a parent may influence ALL risk. While biologically plausible, underlying mechanisms for these associations need further elucidation. IMPACT Folate pathway polymorphisms may be related to risk of childhood ALL, but larger studies are needed for conclusive results.
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Affiliation(s)
- Elizabeth Milne
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
| | - Kathryn R Greenop
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Rodney J Scott
- Hunter Medical Research Institute, John Hunter Hospital, New Lambton, New South Wales, Australia. School of Biomedical Sciences and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia. Hunter Area Pathology Service, HNEHealth, Newcastle, New South Wales, Australia
| | - Michelle Haber
- Children's Cancer Institute Australia for Medical Research, Lowy Cancer Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Murray D Norris
- Children's Cancer Institute Australia for Medical Research, Lowy Cancer Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - John Attia
- Hunter Medical Research Institute, John Hunter Hospital, New Lambton, New South Wales, Australia. School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Sarra E Jamieson
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Margaret Miller
- School of Exercise and Health Sciences, Edith Cowan University, Mount Lawley, Western Australia, Australia
| | - Carol Bower
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Helen D Bailey
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia. Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Somer Dawson
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | | | - Nicholas H de Klerk
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Frank M van Bockxmeer
- Department of Clinical Biochemistry, Royal Perth Hospital and the School of Surgery, University of Western Australia, Perth, Western Australia, Australia
| | - Bruce K Armstrong
- Sax Institute, Haymarket, New South Wales, Australia. Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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