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Lupo PJ, Chambers TM, Mueller BA, Clavel J, Dockerty JD, Doody DR, Erdmann F, Ezzat S, Filippini T, Hansen J, Heck JE, Infante-Rivard C, Kang AY, Magnani C, Malagoli C, Metayer C, Bailey HD, Mora AM, Ntzani E, Petridou ET, Pombo-de-Oliveira MS, Rashed WM, Roman E, Schüz J, Wesseling C, Spector LG, Scheurer ME. Nonchromosomal birth defects and risk of childhood acute leukemia: An assessment in 15 000 leukemia cases and 46 000 controls from the Childhood Cancer and Leukemia International Consortium. Int J Cancer 2024; 154:434-447. [PMID: 37694915 PMCID: PMC11034994 DOI: 10.1002/ijc.34720] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/01/2023] [Accepted: 08/16/2023] [Indexed: 09/12/2023]
Abstract
Although recent studies have demonstrated associations between nonchromosomal birth defects and several pediatric cancers, less is known about their role on childhood leukemia susceptibility. Using data from the Childhood Cancer and Leukemia International Consortium, we evaluated associations between nonchromosomal birth defects and childhood leukemia. Pooling consortium data from 18 questionnaire-based and three registry-based case-control studies across 13 countries, we used multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between a spectrum of birth defects and leukemia. Our analyses included acute lymphoblastic leukemia (ALL, n = 13 115) and acute myeloid leukemia (AML, n = 2120) cases, along with 46 172 controls. We used the false discovery rate to account for multiple comparisons. In the questionnaire-based studies, the prevalence of birth defects was 5% among cases vs 4% in controls, whereas, in the registry-based studies, the prevalence was 11% among cases vs 7% in controls. In pooled adjusted analyses, there were several notable associations, including (1) digestive system defects and ALL (OR = 2.70, 95% CI: 1.46-4.98); (2) congenital anomalies of the heart and circulatory system and AML (OR = 2.86, 95% CI: 1.81-4.52) and (3) nervous system defects and AML (OR = 4.23, 95% CI: 1.50-11.89). Effect sizes were generally larger in registry-based studies. Overall, our results could point to novel genetic and environmental factors associated with birth defects that could also increase leukemia susceptibility. Additionally, differences between questionnaire- and registry-based studies point to the importance of complementary sources of birth defect phenotype data when exploring these associations.
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Affiliation(s)
- Philip J. Lupo
- Department of Pediatrics, Division of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Tiffany M. Chambers
- Department of Pediatrics, Division of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
| | - Beth A. Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Jacqueline Clavel
- CRESS, UMR-S1153, INSERM, Paris-Descartes University, Villejuif, France
| | - John D. Dockerty
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - David R. Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Friederike Erdmann
- International Agency for Research on Cancer (IARC), Section of Environment and Lifestyle Epidemiology, Lyon, France
- Division of Childhood Cancer Epidemiology, Institute for Medical Biostatistics, Epidemiology and Clinical Research, Department of Pediatrics, Informatics (IMBEI), Johannes Gutenberg University of Minnesota, Mainz, Germany
| | - Sameera Ezzat
- Department of Epidemiology and Preventive Medicine, NLISSI Collaborative Research Center, National Liver Institute, Menoufia University, Cairo, Egypt
| | - Tommaso Filippini
- CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Julia E. Heck
- College of Health and Public Service, University of North Texas, Denton, Texas, USA
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Alice Y. Kang
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Corrado Magnani
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Piemonte, Novara, Italy
| | - Carlotta Malagoli
- CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Helen D. Bailey
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
| | - Ana M. Mora
- Center for Environmental Research and Community Health (CERCH), School of Public Health University of California, Berkeley, Berkeley, California, USA
| | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, Medical School, University of Ioannina, Ioannina, Greece
- Center for Evidence Synthesis in Health, Policy and Practice, Center for Research Synthesis in Health, School of Public Health, Brown University, Providence, RI, United States
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece
| | | | | | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, United Kingdom
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), Section of Environment and Lifestyle Epidemiology, Lyon, France
| | - Catharina Wesseling
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Logan G. Spector
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael E. Scheurer
- Department of Pediatrics, Division of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA
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Schraw JM, Petridou ET, Bonaventure A, Dockerty JD, Karalexi M, Ntzani E, Infante-Rivard C, Clavel J, Bracci PM, McKean-Cowdin R, Roman E, Kane E, Erdmann F, Schüz J, Mueller BA, Scheurer ME. Breastfeeding and risk of childhood brain tumors: a report from the Childhood Cancer and Leukemia International Consortium. Cancer Causes Control 2023; 34:1005-1015. [PMID: 37421504 DOI: 10.1007/s10552-023-01746-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE Studies report mixed findings regarding the association of breastfeeding with childhood brain tumors (CBT), the leading causes of cancer-related mortality in young people. Our objective was to determine whether breastfeeding is associated with CBT incidence. METHODS We pooled data on N = 2610 cases with CBT (including 697 cases with astrocytoma, 447 cases with medulloblastoma/primitive neuroectodermal tumor [PNET], 167 cases with ependymoma) and N = 8128 age- and sex-matched controls in the Childhood Cancer and Leukemia International Consortium. We computed unconditional logistic regression models to estimate the odds ratio (OR) and 95% confidence interval (CI) of CBT, astrocytoma, medulloblastoma/PNET, and ependymoma according to breastfeeding status, adjusting for study, sex, mode of delivery, birthweight, age at diagnosis/interview, maternal age at delivery, maternal educational attainment, and maternal race/ethnicity. We evaluated any breastfeeding versus none and breastfeeding ≥ 6 months versus none. We subsequently performed random effects meta-analysis to confirm our findings, identify potential sources of heterogeneity, and evaluate for outliers or influential studies. RESULTS Breastfeeding was reported by 64.8% of control mothers and 64.5% of case mothers and was not associated with CBT (OR 1.04, 95% CI 0.94-1.15), astrocytoma (OR 1.01, 95% CI 0.87-1.17), medulloblastoma/PNET (OR 1.11, 95% CI 0.93-1.32), or ependymoma (OR 1.06, 95% CI 0.81-1.40). Results were similar when we restricted to breastfeeding ≥ 6 months and in meta-analyses. CONCLUSION Our data suggest that breastfeeding does not protect against CBT.
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Affiliation(s)
- Jeremy M Schraw
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA.
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece
| | - Audrey Bonaventure
- UMR-1153, CRESS, Université de Paris, INSERM, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France
| | - John D Dockerty
- Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Maria Karalexi
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece
| | - Evangelia Ntzani
- Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110, Ioannina, Greece
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Jacqueline Clavel
- UMR-1153, CRESS, Université de Paris, INSERM, Epidemiology of Childhood and Adolescent Cancers Team, Villejuif, France
- National Registry of Childhood Cancers, APHP, Hôpital Paul-Brousse, Villejuif, and CHU de Nancy, Vandoeuvre-Lès-Nancy, France
| | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Hellen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | | | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Eleanor Kane
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Friederike Erdmann
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, World Health Organization (IARC/WHO), Lyon, France
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research On Cancer (IARC/WHO), Lyon, France
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA
- Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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3
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Dreyfuss A, Max D, Flynn J, Zhang Z, Gillespie EF, Xu AJ, Cuaron J, Mueller BA, Khan AJ, Cahlon O, Powell SN, McCormick B, Braunstein LZ. Locoregional Control Benefit of a Tumor Bed Boost for Ductal Carcinoma In Situ (DCIS). Int J Radiat Oncol Biol Phys 2023; 117:e174. [PMID: 37784787 DOI: 10.1016/j.ijrobp.2023.06.1018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiotherapy (RT) following breast conserving surgery (BCS) for ductal carcinoma in situ (DCIS) reduces invasive and in situ recurrences. Whereas landmark studies suggest that a tumor bed boost improves local control for invasive breast cancer, the benefit in DCIS remains less certain. We evaluated outcomes of DCIS patients treated with or without a boost and hypothesized that a tumor bed boost would improve locoregional control rates. MATERIALS/METHODS The study cohort comprised patients with DCIS who underwent BCS at our institution from 2004-2018. Clinicopathologic features, treatment parameters and outcomes were ascertained from medical records. Patient and tumor characteristics were evaluated relative to outcomes using univariable and multivariable Cox models. Recurrence-free survival (RFS) estimates were generated using the Kaplan Meier method. RESULTS We identified 1675 patients who underwent BCS for DCIS (median age 56 [interquartile range (IQR) 49, 64]). Boost RT was employed in 68% of cases (n = 1146) and endocrine therapy in 32% (n = 536). At a median follow-up of 4.2 years (IQR 1.4, 7.0), we observed 61 locoregional recurrence events (56 local, 5 regional) and 21 deaths. Univariable logistic regression demonstrated that boost RT was more common among younger patients (p<0.001) with positive/close margins (p<0.001), and with larger tumors (p<0.001) of higher grade (p = 0.025). The 10-year RFS rate was 88.8% among those receiving a boost and 84.3% among those without a boost (p = 0.3), and neither univariable nor multivariable analyses revealed an association between boost RT and locoregional recurrence. CONCLUSION Among patients with DCIS who underwent BCS, use of a tumor bed boost was not associated with locoregional recurrence or RFS. Despite a preponderance of adverse features among the boost cohort, outcomes were similar to those not receiving a boost, suggesting that a boost may mitigate risk of recurrence among patients with high-risk features. Ongoing studies will elucidate the extent to which a tumor bed boost influences disease control rates.
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Affiliation(s)
- A Dreyfuss
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - D Max
- University of California in Los Angeles, Los Angeles, CA
| | - J Flynn
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Z Zhang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - E F Gillespie
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - A J Xu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Cuaron
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - B A Mueller
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A J Khan
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - O Cahlon
- New York University Langone Health, New York, NY
| | - S N Powell
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - B McCormick
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - L Z Braunstein
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
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4
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Hall AG, Syrjala KL, Ketterl TG, Ganz PA, Jacobs LA, Palmer SC, Partridge A, Rajotte EJ, Mueller BA, Baker KS. Socioeconomic Factors and Adherence to Health Care Recommendations in Adolescent and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2023; 12:701-709. [PMID: 36779982 PMCID: PMC10611968 DOI: 10.1089/jayao.2022.0109] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Purpose: The majority of adolescent and young adult (AYA) cancer survivors do not receive recommended health care surveillance after therapy. We used cross-sectional survey data to evaluate the impact of income, education, marital status, and insurance on health care adherence among AYA survivors. Methods: Eligible survivors were 18-39 years at diagnosis with invasive malignancy, 1-5 years from therapy completion. Online surveys assessed sociodemographic factors and self-report of completion of recommended health care services. Diagnosis and treatment data were abstracted from medical records. Multivariable logistic regression calculated odds ratios (ORs) and 95% confidence intervals (CIs) for adherence in relation to socioeconomic status and support. Results: Of 344 participants, 36% were adherent to at least 80% of recommendations. Adherence varied by cancer type: 34% for breast cancer, 52% for leukemia/lymphoma, 23% for other tumors. Adherence rates were similar among White, Asian, and Hispanic/Latinx patients. Lower adherence was associated with lower education (OR: 0.43; 95% CI: 0.23-0.80 for <4-year college degree) and lower annual income (OR: 0.51; 95% CI: 0.28-0.95 for $41,000-$80,000; OR: 0.40; 95% CI: 0.19-0.86 for ≤$40,000). Adherence decreased with decreasing income levels among those who were 1 to less than 3 years after diagnosis (OR: 0.25; 95% CI: 0.07-0.93 for $81,000-$120,000; OR: 0.24; 95% CI: 0.07-0.84 for $41,000-$80,000; OR: 0.13; 95% CI: 0.03-0.60 for ≤$40,000). Conclusion: Risk of nonadherence to health care guidelines was associated with lower income and lower education among AYA cancer survivors. Identification of these risks and related barriers to adherence in AYA survivors will inform interventions designed to meet needs of these high-risk groups, particularly during the first years after diagnosis. Trial Registration: NCT02192333.
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Affiliation(s)
- Anurekha G Hall
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Karen L Syrjala
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Tyler G Ketterl
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Patricia A Ganz
- UCLA Jonsson Comprehensive Cancer Center and UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Linda A Jacobs
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven C Palmer
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ann Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Emily Jo Rajotte
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Beth A Mueller
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - K Scott Baker
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
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5
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Cederquist G, Boe L, Walsh MF, Stadler Z, Xu AJ, Mueller BA, Roth O'Brien DA, Bernstein MB, Cuaron J, Bakhoum SF, Powell SN, Khan AJ, Robson ME, Maxwell K, Taunk NK, Braunstein LZ. Risk of Radiation-Associated Secondary Malignancies among Patients with Breast Cancer Harboring TP53 Germline Variants. Int J Radiat Oncol Biol Phys 2023; 117:S45-S46. [PMID: 37784503 DOI: 10.1016/j.ijrobp.2023.06.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation-associated malignancies are rare and poorly understood. TP53 encodes a multifunctional protein that maintains genome integrity and is the most common somatically mutated gene in cancer. Germline pathogenic variants of TP53 predispose carriers to several cancers comprising the Li-Fraumeni syndrome. It is hypothesized that carriers are also at increased risk of radiotherapy (RT)-associated secondary malignancies; however, reports are mixed. We evaluated the risk of secondary malignancies after breast RT among patients with Li-Fraumeni syndrome. MATERIALS/METHODS This multi-institutional cohort study included carriers of TP53 germline variants who underwent surgical treatment for breast cancer between 1980 and 2020. Patients were stratified based on germline TP53 classification (pathogenic variants [PV] vs variants of uncertain significance [VUS]). The primary outcome of interest was the cumulative incidence risk of developing an in-field secondary cancer after radiotherapy for primary breast carcinoma. RESULTS Ninety-one patients (57 PV and 34 VUS) were evaluated with a median age of 36 years (interquartile range [IQR] 31, 42) and a median follow up of 7.9 years (IQR 4.7, 14.4). Among those with PV who received RT (n = 22), 4 secondary non-breast cancers developed in the radiation field (15-year cumulative incidence 19% [95% CI: 4-43%]), whereas, among those with PV who did not receive RT (n = 35), 0 secondary non-breast cancers were observed in the treated breast (15-year cumulative incidence 0%; p = 0.043). We observed 3 radiation-associated sarcomas among patients with PV who received RT (15-year risk 12% [95% CI 2-33%]) compared with 0 among those who did not receive RT (p = 0.08). No RT-associated sarcomas were observed among 18 patients with TP53 VUS who received RT. RT was not associated with overall survival, despite higher T and N breast cancer stage among those receiving RT (p = 0.33). As expected, patients with PV were more likely than those with VUS to develop any secondary cancer following breast cancer treatment (15-year risk: 54% [95% CI: 33-72%] vs. 14% [95% CI: 3-36%]). CONCLUSION Carriers of pathogenic variants of TP53 are at elevated risk of developing secondary malignancies after breast cancer treatment. This population is at particular risk of developing in-field secondary cancers following RT. This iatrogenic risk must be weighed against the anticipated therapeutic benefit of tumor control. Shared decision making is crucial in the radiotherapeutic management of breast cancer patients harboring the Li-Fraumeni syndrome.
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Affiliation(s)
- G Cederquist
- Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - L Boe
- Memorial Sloan Kettering, New York, NY
| | - M F Walsh
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Z Stadler
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A J Xu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - B A Mueller
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - D A Roth O'Brien
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - M B Bernstein
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Cuaron
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - S F Bakhoum
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - S N Powell
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A J Khan
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - M E Robson
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - K Maxwell
- University of Pennsylvania, Philadelphia, PA
| | - N K Taunk
- Hospital of the University of Pennsylvania, Philadelphia, PA
| | - L Z Braunstein
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
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O'Brien DAR, Boe LA, Mueller BA, Cuaron J, Xu AJ, Bernstein MB, McCormick B, Powell SN, Khan AJ, Braunstein LZ. Accelerated Partial Breast Irradiation (APBI) For HER2+ Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e204. [PMID: 37784860 DOI: 10.1016/j.ijrobp.2023.06.1085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Historically, HER2+ breast cancer exhibited poor outcomes and, hence, has not been well-studied among trials of accelerated partial breast irradiation (APBI). We hypothesized that in contemporary practice with effective HER2-targeted agents, patients with HER2+ breast cancer now have excellent disease control and survival outcomes when treated with adjuvant APBI. MATERIALS/METHODS Using a prospectively-maintained institutional database, we identified all HER2+ breast cancer patients treated with breast conserving surgery (BCS) and adjuvant APBI from 2000 - 2022. Salient clinicopathologic parameters were collected, as were receipt of systemic and endocrine therapies. All patients received external beam APBI to a total dose of 40Gy in 10 daily fractions over 2 weeks. We analyzed outcomes including local recurrence (LR), regional recurrence, distant recurrence, and death. Cumulative incidence functions were calculated to estimate the incidence of LR with the competing risk of death. All statistical analyses were performed in R version 4.2.2. RESULTS The study cohort comprised 52 patients with HER2+ breast cancer (median age 64 years; range 44-87). Nearly all had T1 tumors (98%; median size 15 mm; range 1 - 21 mm). Approximately 10% had multifocal disease, with one exhibiting suspicion for lymphovascular invasion. Most patients had ER+ disease (88%). All patients had negative final surgical margins. Nearly all underwent sentinel node biopsy (94%), with the remainder undergoing no surgical axillary evaluation. 42 (81%) received chemotherapy, 40 (77%) endocrine therapy, and 42 (81%) HER2-directed therapy, most commonly trastuzumab. At 143.8 person-years of follow-up (range 7 - 226 months for each patient), we observed two LR events, at 14 and 26 months, yielding a 2-year LR rate of 3.8%. No regional or distant recurrences were observed, nor were any contralateral invasive breast cancer events or breast-specific mortality events. Two deaths were noted in the cohort, both without evidence of disease. CONCLUSION Among a cohort of HER2+ early-stage breast cancer patients managed with BCS and APBI, we observed a 2-year LR rate of 3.8% with no regional or distant recurrences, and excellent overall survival. These findings merit longer term follow-up among larger cohorts, although are thus far consistent with the results of contemporary randomized trials of APBI unselected for HER2-status.
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Affiliation(s)
- D A Roth O'Brien
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - L A Boe
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - B A Mueller
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Cuaron
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York City, NY
| | - A J Xu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - M B Bernstein
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - B McCormick
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - S N Powell
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A J Khan
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - L Z Braunstein
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
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7
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Singh N, Sabo J, Crane DA, Doody DR, Schiff MA, Mueller BA. Birth Outcomes and Rehospitalizations Among Pregnant Women With Rheumatoid Arthritis and Systemic Lupus Erythematosus and Their Offspring. Arthritis Care Res (Hoboken) 2023; 75:2022-2031. [PMID: 36625100 DOI: 10.1002/acr.25087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To compare obstetric/birth outcomes and rehospitalization among women with and without rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) and their infants. METHODS This population-based retrospective cohort study identified women with RA (n = 1,223) and SLE (n = 1,354) and unexposed women with singleton births 1987-2014 in Washington State in linked vital hospital discharge records. Outcomes, including cause-specific hospitalizations <2 years postpartum, were compared by estimating adjusted relative risks (RRs) and cause-specific rehospitalization hazard ratios (HRs) with 95% confidence intervals (95% CIs). RESULTS We observed increased risks of several adverse outcomes; RRs were often greatest for SLE. Women with RA/SLE more often required rehospitalization, most notably at <6 months postpartum (RA: 4% versus 2%; RR 2.22 [95% CI 1.62-3.04]; SLE: 6% versus 2%; RR 2.78 [95% CI 2.15-3.59]). Maternal postpartum rehospitalization was greatest for musculoskeletal conditions (RA: HR 19.1 [95% CI 13.6-26.8]; SLE: HR 29.8 [95% CI 22.1-40.1]). Infants of women with SLE more often had malformations (9% versus 6%; RR 1.46 [95% CI 1.21-1.75]), and increased mortality at <2 years (RR 2.11 [95% CI 1.21-3.67]). Infants of women with SLE also experienced more frequent rehospitalizations in their first year of life. CONCLUSION Women with RA or SLE and their infants experienced adverse outcomes, particularly infants of women with SLE. Maternal/infant rehospitalization was more common; most marked in the early months postpartum. Close follow-up during these time periods is crucial to minimize adverse outcomes.
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Affiliation(s)
| | | | | | - David R Doody
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Melissa A Schiff
- University of New Mexico, Albuquerque, and University of Washington School of Public Health, Seattle
| | - Beth A Mueller
- Fred Hutchinson Cancer Research Center and University of Washington School of Public Health, Seattle
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Li CI, Weiss NS, Madeleine MM, Mueller BA, Malone KE. In Memoriam: Janet R. Daling, 1934-2022. Am J Epidemiol 2023:7087286. [PMID: 36973965 DOI: 10.1093/aje/kwad066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Indexed: 03/29/2023] Open
Affiliation(s)
| | - Noel S Weiss
- Department of Epidemiology, University of Washington, Seattle
| | | | - Beth A Mueller
- Epidemiology Program, Fred Hutchinson Cancer Research Center
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9
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Motlaghian SM, Vahidi V, Belger A, Bustillo JR, Faghiri A, Ford JM, Iraji A, Lim K, Mathalon DH, Miller R, Mueller BA, O'Leary D, Potkin SG, Preda A, van Erp TG, Calhoun VD. A method for estimating and characterizing explicitly nonlinear dynamic functional network connectivity in resting-state fMRI data. J Neurosci Methods 2023; 389:109794. [PMID: 36652974 DOI: 10.1016/j.jneumeth.2023.109794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 01/13/2023] [Indexed: 01/16/2023]
Abstract
The past 10 years have seen an explosion of approaches that focus on the study of time-resolved change in functional connectivity (FC). FC characterization among networks at a whole-brain level is frequently termed functional network connectivity (FNC). Time-resolved or dynamic functional network connectivity (dFNC) focuses on the estimation of transient, recurring, whole-brain patterns of FNC. While most approaches in this area have attempted to capture dynamic linear correlation, we are particularly interested in whether explicitly nonlinear relationships, above and beyond linear, are present and contain unique information. This study thus proposes an approach to assess explicitly nonlinear dynamic functional network connectivity (EN dFNC) derived from the relationship among independent component analysis time courses. Linear relationships were removed at each time point to evaluate, typically ignored, explicitly nonlinear dFNC using normalized mutual information (NMI). Simulations showed the proposed method estimated explicitly nonlinearity over time, even within relatively short windows of data. We then, applied our approach on 151 schizophrenia patients, and 163 healthy controls fMRI data and found three unique, highly structured, mostly long-range, functional states that also showed significant group differences. In particular, explicitly nonlinear relationships tend to be more widespread than linear ones. Results also highlighted a state with long range connections to the visual domain, which were significantly reduced in schizophrenia. Overall, this work suggests that quantifying EN dFNC may provide a complementary and potentially valuable tool for studying brain function by exposing relevant variation that is typically ignored.
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Affiliation(s)
- S M Motlaghian
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (Trends), Georgia State, Georgia Tech, and Emory, Atlanta, GA, USA.
| | - V Vahidi
- Department of Computer and Information Science, Spelman College, GA, USA
| | - A Belger
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - J R Bustillo
- Department of Psychiatry, University of New Mexico Albuquerque, NM, USA
| | - A Faghiri
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (Trends), Georgia State, Georgia Tech, and Emory, Atlanta, GA, USA
| | - J M Ford
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA, USA
| | - A Iraji
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (Trends), Georgia State, Georgia Tech, and Emory, Atlanta, GA, USA
| | - K Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - D H Mathalon
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA, USA
| | - R Miller
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (Trends), Georgia State, Georgia Tech, and Emory, Atlanta, GA, USA
| | - B A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - D O'Leary
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - S G Potkin
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - A Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - T G van Erp
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - V D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (Trends), Georgia State, Georgia Tech, and Emory, Atlanta, GA, USA
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10
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Chehab L, Doody DR, Esbenshade AJ, Guilcher GM, Dvorak CC, Fisher BT, Mueller BA, Chow EJ, Rossoff J. A Population-Based Study of the Long-Term Risk of Infections Associated With Hospitalization in Childhood Cancer Survivors. J Clin Oncol 2023; 41:364-372. [PMID: 35878085 PMCID: PMC9839247 DOI: 10.1200/jco.22.00230] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/28/2022] [Accepted: 06/24/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE Infections pose a significant risk during therapy for childhood cancer. However, little is known about the risk of infection in long-term survivors of childhood cancer. METHODS We performed a retrospective observational study of children and adolescents born in Washington State diagnosed with cancer before age 20 years and who survived at least 5 years after diagnosis. Survivors were categorized as having a hematologic or nonhematologic malignancy and were matched to individuals without cancer in the state birth records by birth year and sex with a comparator:survivor ratio of 10:1. The primary outcome was incidence of any infection associated with a hospitalization using diagnostic codes from state hospital discharge records. Incidence was reported as a rate (IR) per 1,000 person-years. Multivariate Poisson regression was used to calculate incidence rate ratios (IRR) for cancer survivors versus comparators. RESULTS On the basis of 382 infection events among 3,152 survivors and 771 events among 31,519 comparators, the IR of all hospitalized infections starting 5 years after cancer diagnosis was 12.6 (95% CI, 11.4 to 13.9) and 2.4 (95% CI, 2.3 to 2.6), respectively, with an IRR 5.1 (95% CI, 4.5 to 5.8). The survivor IR during the 5- to 10-year (18.1, 95% CI, 15.9 to 20.5) and > 10-year postcancer diagnosis (8.3, 95% CI, 7.0 to 9.7) periods remained greater than comparison group IRs for the same time periods (2.3, 95% CI, 2.1 to 2.6 and 2.5, 95% CI, 2.3 to 2.8, respectively). When potentially vaccine-preventable infections were evaluated, survivors had a greater risk of infection relative to comparators (IRR, 13.1; 95% CI, 7.2 to 23.9). CONCLUSION Infectious complications continue to affect survivors of childhood cancer many years after initial diagnosis. Future studies are needed to better understand immune reconstitution to determine specific factors that may mitigate this risk.
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Affiliation(s)
- Leena Chehab
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - David R. Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Adam J. Esbenshade
- Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center, Nashville, TN
| | - Gregory M.T. Guilcher
- Section of Pediatric Oncology/Cellular Therapy, Departments of Oncology and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Christopher C. Dvorak
- Division of Pediatric Allergy, Immunology & Bone Marrow Transplantation, University of California San Francisco, San Francisco, CA
| | - Brian T. Fisher
- Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA
| | - Beth A. Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Epidemiology, University of Washington (UW), Seattle, WA
| | - Eric J. Chow
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jenna Rossoff
- Division of Hematology/Oncology/Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
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11
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Ohlsen TJD, Doody DR, Mueller BA, Desai AD, Chow EJ. Population-Based Impact of Rurality and Neighborhood-Level Socioeconomic Disadvantage on Pediatric Cancer Mortality in Washington State. Cancer Epidemiol Biomarkers Prev 2023; 32:141-148. [PMID: 36343539 PMCID: PMC9839485 DOI: 10.1158/1055-9965.epi-22-0897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/19/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Childhood cancer-related mortality differs by socioeconomic factors, but the impact of residential location, including rurality and neighborhood-level socioeconomic disadvantage, is not well-characterized. METHODS This retrospective cohort study linked Washington State cancer registry data (1992-2013) to state birth (1974-2013) and death records (1992-2013) to identify residents <20 years diagnosed with cancer (n = 4,306). Census-based rural-urban commuting area codes and Area Deprivation Index (ADI) defined rural residence and neighborhood socioeconomic disadvantage at time of cancer diagnosis, respectively. Neighborhoods in the highest state ADI quintile were classified as the most disadvantaged. Kaplan-Meier estimates and Cox hazards models, adjusted for key characteristics, were used to compare mortality by rural and ADI classification. RESULTS Five-year overall survival for children from non-rural low ADI neighborhoods (referent) was 80.9%±0.8%, versus 66.4%±2.9% from non-rural high ADI neighborhoods, 69.4%±3.8% from rural low ADI neighborhoods, and 66.9%±3.8% from rural high ADI neighborhoods (P < 0.01 for each comparison versus referent). Compared with the referent group, children from comparator neighborhoods had a greater mortality risk: Rural low ADI [hazard ratio (HR), 1.50; 95% confidence interval (CI), 1.12-2.02], rural high ADI (HR, 1.53; 95% CI, 1.16-2.01), and non-rural high ADI (HR, 1.64; 95% CI, 1.32-2.04). Associations of ADI and rurality with mortality varied in sub-analyses by cancer type. CONCLUSIONS Children with cancer living in rural and/or socioeconomically disadvantaged neighborhoods at diagnosis experienced greater mortality relative to those without either factor. IMPACT Future investigation is needed to examine how rurality and poverty potentially impact healthcare utilization and health-related outcomes in pediatric oncology.
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Affiliation(s)
- Timothy J. D. Ohlsen
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute,Department of Pediatrics, Seattle Children’s Hospital, University of Washington,Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute
| | - David R. Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Center
| | - Beth A. Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Center,Department of Epidemiology, University of Washington
| | - Arti D. Desai
- Department of Pediatrics, Seattle Children’s Hospital, University of Washington,Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute
| | - Eric J. Chow
- Department of Pediatrics, Seattle Children’s Hospital, University of Washington,Public Health Sciences Division, Fred Hutchinson Cancer Center
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12
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Yang SW, Kernic MA, Mueller BA, Simon GE, Chan KCG, Vander Stoep A. Mother's and Father's Serious Mental Illness and Risk of Child Injury in a Taiwanese Birth Cohort. J Clin Psychiatry 2022; 83. [PMID: 36112598 DOI: 10.4088/jcp.21m14214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Objective: Parental serious mental illness (SMI) is associated with childhood injury. This study investigated whether child injury risk differs according to which parent is affected, SMI diagnosis, or timing of SMI onset. Methods: This cohort study included 1,999,322 singletons born in 2004-2014 identified from the national Taiwanese registries. General estimating equation Poisson models were used to estimate incidence rate ratios (IRRs) of injury events and hospitalizations before the age of 5 years among children according to which parent was affected, SMI diagnosis (schizophrenia [ICD-9-CM codes: 295, 297, 298.3, 298.4, 298.9], bipolar disorder [296.00-296.16, 296.40-296.81, 296.89-296.99, 298.1, 648.4], or major depressive disorder [MDD; 296.20-296.36, 296.82, 298.0]), and timing of diagnosis (before or after childbirth, as a proxy of timing of onset). Data analysis was performed on data obtained from April 20, 2017, to May 6, 2020. Results: Relative to unexposed children, the IRRs of injury hospitalizations for children with two SMI-affected parents, maternal SMI only, and paternal SMI only were 1.85 (95% CI, 1.38-2.48), 1.58 (95% CI, 1.48-1.68), and 1.34 (95% CI, 1.23-1.46), respectively. The IRRs of injury hospitalizations for maternal schizophrenia, bipolar disorder, and MDD were 2.09 (95% CI, 1.82-2.40), 1.77 (95% CI, 1.56-2.00), and 1.38 (95% CI, 1.26-1.50), respectively. The IRRs for paternal schizophrenia, bipolar disorder, and MDD were 1.39 (95% CI, 1.20-1.60), 1.61 (95% CI, 1.39-1.87), and 1.19 (95% CI, 1.05-1.36), respectively. The magnitude of excess risk was similar for children whose parent(s) experienced SMI diagnosed before and after childbirth. Conclusions: We found children with two SMI-affected parents or at least one parent with schizophrenia or bipolar disorder to be at greatest risk of severe injury requiring hospitalization. These parents may benefit from extra parenting support and injury prevention coaching.
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Affiliation(s)
- Shiow-Wen Yang
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan.,School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.,School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Mary A Kernic
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Department of Epidemiology, University of Washington, Seattle, Washington
| | - Gregory E Simon
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | | | - Ann Vander Stoep
- Department of Epidemiology, University of Washington, Seattle, Washington.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.,Corresponding author: Ann Vander Stoep, PhD, University of Washington Child Health Institute, Box 354920, Seattle, WA 98195
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13
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Li S, Sok P, Xu K, Muskens IS, Elliott N, Myint SS, Pandey P, Hansen HM, Morimoto LM, Kang AY, Metayer C, Ma X, Mueller BA, Roy A, Roberts I, Rabin KR, Brown AL, Lupo PJ, Wiemels JL, de Smith AJ. Epigenome-wide association study of acute lymphoblastic leukemia in children with Down syndrome. Blood Adv 2022; 6:4132-4136. [PMID: 35588500 PMCID: PMC9327551 DOI: 10.1182/bloodadvances.2022007098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/10/2022] [Indexed: 01/07/2023] Open
Affiliation(s)
- Shaobo Li
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Pagna Sok
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - Keren Xu
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Ivo S. Muskens
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Natalina Elliott
- Department of Paediatrics and MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, Oxford University and BRC Blood Theme, NIHR Oxford Biomedical Centre, Oxford, UK
| | - Swe Swe Myint
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Priyatama Pandey
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Helen M. Hansen
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA
| | - Libby M. Morimoto
- School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Alice Y. Kang
- School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
| | - Beth A. Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA; and
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Anindita Roy
- Department of Paediatrics and MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, Oxford University and BRC Blood Theme, NIHR Oxford Biomedical Centre, Oxford, UK
| | - Irene Roberts
- Department of Paediatrics and MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, Oxford University and BRC Blood Theme, NIHR Oxford Biomedical Centre, Oxford, UK
| | - Karen R. Rabin
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - Austin L. Brown
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - Philip J. Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - Joseph L. Wiemels
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Adam J. de Smith
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
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14
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Xu K, Li S, Muskens IS, Elliott N, Myint SS, Pandey P, Hansen HM, Morimoto LM, Kang AY, Ma X, Metayer C, Mueller BA, Roberts I, Walsh K, Horvath S, Wiemels JL, de Smith AJ. Accelerated epigenetic aging in newborns with Down syndrome. Aging Cell 2022; 21:e13652. [PMID: 35661546 PMCID: PMC9282838 DOI: 10.1111/acel.13652] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/11/2022] [Accepted: 05/18/2022] [Indexed: 01/07/2023] Open
Abstract
Accelerated aging is a hallmark of Down syndrome (DS), with adults experiencing early-onset Alzheimer's disease and premature aging of the skin, hair, and immune and endocrine systems. Accelerated epigenetic aging has been found in the blood and brain tissue of adults with DS but when premature aging in DS begins remains unknown. We investigated whether accelerated aging in DS is already detectable in blood at birth. We assessed the association between age acceleration and DS using five epigenetic clocks in 346 newborns with DS and 567 newborns without DS using Illumina MethylationEPIC DNA methylation array data. We compared two epigenetic aging clocks (DNAmSkinBloodClock and pan-tissue DNAmAge) and three epigenetic gestational age clocks (Haftorn, Knight, and Bohlin) between DS and non-DS newborns using linear regression adjusting for observed age, sex, batch, deconvoluted blood cell proportions, and genetic ancestry. Targeted sequencing of GATA1 was performed in a subset of 184 newborns with DS to identify somatic mutations associated with transient abnormal myelopoiesis. DS was significantly associated with increased DNAmSkinBloodClock (effect estimate = 0.2442, p < 0.0001), with an epigenetic age acceleration of 244 days in newborns with DS after adjusting for potential confounding factors (95% confidence interval: 196-292 days). We also found evidence of epigenetic age acceleration associated with somatic GATA1 mutations among newborns with DS (p = 0.015). DS was not associated with epigenetic gestational age acceleration. We demonstrate that accelerated epigenetic aging in the blood of DS patients begins prenatally, with implications for the pathophysiology of immunosenescence and other aging-related traits in DS.
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Affiliation(s)
- Keren Xu
- Center for Genetic Epidemiology, Department of Population and Public Health SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Shaobo Li
- Center for Genetic Epidemiology, Department of Population and Public Health SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Ivo S. Muskens
- Center for Genetic Epidemiology, Department of Population and Public Health SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Natalina Elliott
- Department of Paediatrics and MRC Molecular Haematology Unit, Weatherall Institute of Molecular MedicineOxford University and BRC Blood Theme, NIHR Oxford Biomedical CentreOxfordUK
| | - Swe Swe Myint
- Center for Genetic Epidemiology, Department of Population and Public Health SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Priyatama Pandey
- Center for Genetic Epidemiology, Department of Population and Public Health SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Helen M. Hansen
- Department of Neurological SurgeryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Libby M. Morimoto
- School of Public HealthUniversity of California, BerkeleyBerkeleyCaliforniaUSA
| | - Alice Y. Kang
- School of Public HealthUniversity of California, BerkeleyBerkeleyCaliforniaUSA
| | - Xiaomei Ma
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
| | - Catherine Metayer
- School of Public HealthUniversity of California, BerkeleyBerkeleyCaliforniaUSA
| | - Beth A. Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, and Department of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - Irene Roberts
- Department of Paediatrics and MRC Molecular Haematology Unit, Weatherall Institute of Molecular MedicineOxford University and BRC Blood Theme, NIHR Oxford Biomedical CentreOxfordUK
| | - Kyle M. Walsh
- Department of NeurosurgeryDuke UniversityDurhamNorth CarolinaUSA
| | - Steve Horvath
- Department of Human GeneticsDavid Geffen School of Medicine, University of CaliforniaLos AngelesCaliforniaUSA
| | - Joseph L. Wiemels
- Center for Genetic Epidemiology, Department of Population and Public Health SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Adam J. de Smith
- Center for Genetic Epidemiology, Department of Population and Public Health SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
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15
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Camchong J, Haynos AF, Hendrickson T, Fiecas MB, Gilmore CS, Mueller BA, Kushner MG, Lim KO. Resting Hypoconnectivity of Theoretically Defined Addiction Networks during Early Abstinence Predicts Subsequent Relapse in Alcohol Use Disorder. Cereb Cortex 2022; 32:2688-2702. [PMID: 34671808 PMCID: PMC9393062 DOI: 10.1093/cercor/bhab374] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022] Open
Abstract
Theoretical models of addiction suggest that alterations in addiction domains including incentive salience, negative emotionality, and executive control lead to relapse in alcohol use disorder (AUD). To determine whether the functional organization of neural networks underlying these domains predict subsequent relapse, we generated theoretically defined addiction networks. We collected resting functional magnetic resonance imaging data from 45 individuals with AUD during early abstinence (number of days abstinent M = 25.40, SD = 16.51) and calculated the degree of resting-state functional connectivity (RSFC) within these networks. Regression analyses determined whether the RSFC strength in domain-defined addiction networks measured during early abstinence predicted subsequent relapse (dichotomous or continuous relapse metrics). RSFC within each addiction network measured during early abstinence was significantly lower in those that relapsed (vs. abstained) and predicted subsequent time to relapse. Lower incentive salience RSFC during early abstinence increased the odds of relapsing. Neither RSFC in a control network nor clinical self-report measures predicted relapse. The association between low incentive salience RSFC and faster relapse highlights the need to design timely interventions that enhance RSFC in AUD individuals at risk of relapsing faster.
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Affiliation(s)
- J Camchong
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
| | - A F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
| | - T Hendrickson
- University of Minnesota Informatics Institute, University of Minnesota, Minneapolis, MN 55455, USA
| | - M B Fiecas
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - C S Gilmore
- Geriatric Research, Education, and Clinical Center (GRECC), Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - B A Mueller
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
| | - M G Kushner
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
| | - K O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN 55454, USA
- Geriatric Research, Education, and Clinical Center (GRECC), Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
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Emerson MA, Olshan AF, Chow EJ, Doody DR, Mueller BA. Hospitalization and Mortality Outcomes Among Childhood Cancer Survivors by Race, Ethnicity, and Time Since Diagnosis. JAMA Netw Open 2022; 5:e2219122. [PMID: 35763295 PMCID: PMC9240906 DOI: 10.1001/jamanetworkopen.2022.19122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IMPORTANCE Cancer outcomes are relatively poor in adults who belong to minoritized racial and ethnic groups. Survival and long-term outcomes by race and ethnicity in individuals with childhood cancers are less studied. OBJECTIVE To evaluate survival and hospitalization among American Indian and Alaska Native, Asian, Black, and Hispanic children compared with non-Hispanic White children with cancer. DESIGN, SETTING, AND PARTICIPANTS This cohort study evaluated all individuals born in Washington State who were younger than 20 years (hereafter referred to as children) and had been diagnosed with cancer during 1987 to 2012, with follow-up ranging from 1 to 27 years. The data subset was built in 2019, and statistical analyses were completed in January 2022. EXPOSURES Race and ethnicity. MAIN OUTCOMES AND MEASURES Mortality and hospitalization events for all other racial and ethnic groups relative to non-Hispanic White children estimated by Cox proportional hazards regressions for the first 5 years after diagnosis and among cancer survivors 5 or more years after diagnosis. RESULTS A total of 4222 children (mean [SD] age, 8.4 [6.4] years; 2199 [52.1%] male; 113 American Indian and Alaska Native [2.7%], 311 Asian [7.4%], 196 Black [4.6%], 387 Hispanic [9.2%], and 3215 non-Hispanic White [76.1%]) with cancer diagnosed at younger than 20 years during 1987 to 2012 were included. Mortality was similar across all groups. Compared with non-Hispanic White survivors at less than 5 years after diagnosis, there were no greatly increased hazard ratios (HRs) for hospitalization. Among survivors at 5 or more years after diagnosis, hospitalization HRs were 1.7 (95% CI, 1.0-3.0) for American Indian and Alaska Native survivors and 1.5 (95% CI, 0.9-2.4) for Black survivors. Significantly increased HRs among Hispanic children were observed for infection-related (HR, 1.4; 95% CI, 1.2-1.6), endocrine-related (HR, 1.3; 95% CI, 1.1-1.6), hematologic-related (HR, 1.3; 95% CI, 1.1-1.5), respiratory-related (HR, 1.3; 95% CI, 1.0-1.5), and digestive-related (HR, 1.2; 95% CI, 1.0-1.5) conditions. American Indian and Alaskan Native children had increased HRs for infection-related (HR, 2.3; 95% CI, 1.2-4.5), hematologic-related (HR, 3.0; 95% CI, 1.4-6.5), and digestive-related (HR, 2.6; 95% CI, 1.3-5.4) conditions. Both American Indian and Alaska Native (HR, 3.6; 95% CI, 1.4-9.0) and Black (HR, 2.5; 95% CI, 1.2-5.5) children had increased mental health-related hospitalizations and death. CONCLUSIONS AND RELEVANCE In this cohort study, disproportionately increased long-term risks of hospitalization for physical and mental conditions may have contributed to worse outcomes by race. A key component to bridging the morbidity gap by race is improved understanding of reasons for greater cause-specific hospitalizations in some groups, with development of culturally appropriate intervention strategies.
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Affiliation(s)
- Marc A. Emerson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Andrew F. Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Eric J. Chow
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington
- Department of Pediatrics, University of Washington School of Medicine, Seattle
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - David R. Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Beth A. Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle
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17
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Ohlsen TJD, Doody DR, Desai AD, Mueller BA, Chow EJ. Population-based impact of rurality and neighborhood-level socioeconomic disadvantage on pediatric cancer mortality in Washington State. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.6537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6537 Background: Emerging evidence suggests mortality among children with cancer differs based on socioeconomic factors. The effects of residential location in relation to these factors are not well-characterized. We examined associations of rurality and neighborhood-level socioeconomic (SE) disadvantage with mortality in pediatric patients with cancer. Methods: We conducted a retrospective cohort study using Washington State (WA) Cancer Registry data (1992-2013) linked to state birth (1974-2013) and death records (1992-2013) to identify all children born in WA diagnosed with cancer < 20 years. We defined rural residence as patient addresses within 2010 census tract level rural-urban commuting area (RUCA) codes of ≥4.0 at diagnosis. Neighborhood-level socioeconomic disadvantage was determined using 2010 census block-group level Area Deprivation Index (ADI) quintiles normalized to WA. Patient addresses within the highest ADI quintile were categorized as having SE disadvantage. children in four mutually exclusive groups was compared using Kaplan-Meier analysis, pairwise log rank testing, and Cox proportional hazard ratios (HR): non-rural with SE disadvantage, rural without SE disadvantage, rural with SE disadvantage, and non-rural without SE disadvantage (). Models were adjusted for sex, race and ethnicity, age at diagnosis, birth year, and cancer type. Results: We identified 4,417 children for analysis. Median length of follow up among survivors was 5.0 years (inter-quartile range: 1.0-11.5). SE disadvantaged and 13% were rural. Pairwise log rank tests showed mortality differences among children living in rural, SE disadvantaged, or rural and SE disadvantaged neighborhoods when compared with children without either factor (individual p-values all < 0.005); no other differences were noted. Relative to children in non-rural areas without SE disadvantage, the mortality HR for those in non-rural areas with SE disadvantage was 1.68 (95% confidence intervals [CI] 1.37-2.07). The HR for children in rural areas without SE disadvantage was 1.59 (95% CI 1.19-2.12). The HR for children in rural areas with SE disadvantage was 1.56 (95% CI 1.20-2.03). In sub-analyses, associations for rurality and SE disadvantage remained significant for leukemia mortality, but CNS and solid tumor mortality was only associated with SE disadvantage (but not rural) status. Acute lymphoblastic leukemia mortality was associated with rural (but not SE disadvantage) status. Conclusions: Children with cancer living in socioeconomically disadvantaged and/or rural neighborhoods at diagnosis had higher mortality relative to those in non-rural areas with lower neighborhood deprivation. Associations varied by disease type. The individual effects of SE disadvantage and rurality suggest that interventions should be designed to target both factors.
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Affiliation(s)
| | | | - Arti D Desai
- Department of Pediatrics, University of Washington, Seattle, WA
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18
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Schraw JM, Bailey HD, Bonaventure A, Mora AM, Roman E, Mueller BA, Clavel J, Petridou ET, Karalexi M, Ntzani E, Ezzat S, Rashed WM, Marcotte EL, Spector LG, Metayer C, Kang AY, Magnani C, Miligi L, Dockerty JD, Mejίa-Aranguré JM, Nuñez Enriquez JC, Infante-Rivard C, Milne E, Scheurer ME. Infant Feeding Practices And Childhood Acute Leukemia: Findings From The Childhood Cancer & Leukemia International Consortium. Int J Cancer 2022; 151:1013-1023. [PMID: 35532209 DOI: 10.1002/ijc.34062] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/11/2022] [Accepted: 04/12/2022] [Indexed: 11/08/2022]
Abstract
Increasing evidence suggests that breastfeeding may protect from childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). However, most studies have limited their analyses to any breastfeeding, and only a few data have examined exclusive breastfeeding, or other exposures such as formula milk. We performed pooled analyses and individual participant data meta-analyses of data from sixteen studies (N=17,189 controls; N=10,782 ALL and N=1,690 AML cases) from the Childhood Leukemia International Consortium (CLIC) to characterize the associations of breastfeeding duration with ALL and AML, as well as exclusive breastfeeding duration and age at introduction to formula with ALL. In unconditional multivariable logistic regression analyses of pooled data, we observed decreased odds of ALL among children breastfed 4-6 months (0.88, 95% CI 0.81-0.96) or 7-12 months (OR 0.85, 0.79-0.92). We observed a similar inverse association between breastfeeding ≥4 months and AML (0.82, 95% CI 0.71-0.95). Odds of ALL were reduced among children exclusively breastfed 4-6 months (OR 0.73, 95% CI 0.63-0.85) or 7-12 months (OR 0.70, 95% CI 0.53-0.92). Random effects meta-analyses produced similar estimates, and findings were unchanged in sensitivity analyses adjusted for race/ethnicity or mode of delivery, restricted to children diagnosed ≥1 year of age, or diagnosed with B-ALL. Our pooled analyses indicate that longer breastfeeding is associated with decreased odds of ALL and AML. Few risk factors for ALL and AML have been described, therefore our findings highlight the need to promote breastfeeding for leukemia prevention.
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Affiliation(s)
- Jeremy M Schraw
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX, USA.,Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Helen D Bailey
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Audrey Bonaventure
- CRESS, Université de Paris, INSERM UMR-1153, Epidemiology of childhood and adolescent cancers team, Villejuif, France
| | - Ana M Mora
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Jacqueline Clavel
- CRESS, Université de Paris, INSERM UMR-1153, Epidemiology of childhood and adolescent cancers team, Villejuif, France.,National Registry of Childhood Cancers, APHP, Hôpital Paul-Brousse, Villejuif, and CHU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Eleni T Petridou
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Hellenic Society for Social Pediatrics and Health Promotion, Greece
| | - Maria Karalexi
- Hellenic Society for Social Pediatrics and Health Promotion, Greece
| | - Evangelia Ntzani
- Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA.,Department of Hygeine and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Sameera Ezzat
- Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Cairo, Egypt
| | - Wafaa M Rashed
- Research Department, Children's Cancer Hospital-57357, Cairo, Egypt
| | - Erin L Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Catherine Metayer
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Alice Y Kang
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Corrado Magnani
- Dipartimento di Medicina Traslazionale, SCDU Epidemiologia del Tumori, Universitá del Piemonte Orientale, Novara, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch-Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - John D Dockerty
- Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Juan Manuel Mejίa-Aranguré
- 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), Mexico City, Mexico.,Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.,Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Juan Carlos Nuñez Enriquez
- 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), Mexico City, Mexico
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Houston, TX, USA.,Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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19
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Wartko PD, Weiss NS, Enquobahrie DA, Chan KCG, Stephenson-Famy A, Mueller BA, Dublin S. Maternal Gestational Weight Gain in Relation to Antidepressant Continuation in Pregnancy. Am J Perinatol 2021; 38:1442-1452. [PMID: 32604448 PMCID: PMC8487259 DOI: 10.1055/s-0040-1713652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Both excessive and inadequate gestational weight gain (GWG) are associated with adverse health outcomes for the woman and her child. Antidepressant use in pregnancy could affect GWG, based on evidence in nonpregnant women that some antidepressants may cause weight gain and others weight loss. Previous studies of antidepressant use and GWG were small with limited ability to account for confounding, including by maternal mental health status and severity. We assessed the association of antidepressant continuation in pregnancy with GWG among women using antidepressants before pregnancy. STUDY DESIGN Our retrospective cohort study included singleton livebirths from 2001 to 2014 within Kaiser Permanente Washington, an integrated health care system. Data were obtained from electronic health records and linked Washington State birth records. Among women with ≥1 antidepressant fill within 6 months before pregnancy, women who filled an antidepressant during pregnancy were considered "continuers;" women without a fill were "discontinuers." We calculated mean differences in GWG and relative risks (RR) of inadequate and excessive weight gain based on Institute of Medicine guidelines. Using inverse probability of treatment weighting with generalized estimating equations, we addressed differences in maternal characteristics, including mental health conditions. RESULTS Among the 2,887 births, 1,689 (59%) were to women who continued antidepressants in pregnancy and 1,198 (42%) were to discontinuers. After accounting for confounding, continuers had similar weight gain to those who discontinued (mean difference: 1.3 lbs, 95% confidence interval [CI]: -0.1 to 2.8 lbs) and similar risks of inadequate and excessive GWG (RR: 0.95, 95% CI: 0.80-1.14 and RR: 1.06, 95% CI: 0.98-1.14, respectively). Findings were comparable for specific antidepressants and trimesters of exposure. CONCLUSION We did not find evidence that continuation of antidepressants in pregnancy led to differences in GWG. KEY POINTS · Antidepressant use is associated with weight change in nonpregnant populations.. · Prior evidence on whether antidepressant use in pregnancy affects gestational weight gain is sparse.. · We accounted for confounding by characteristics such as mental health conditions and their severity.. · We found no association between pregnancy antidepressant continuation and gestational weight gain..
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Affiliation(s)
- Paige D Wartko
- Department of Epidemiology, University of Washington,
Seattle, Washington.,Kaiser Permanente Washington Health Research Institute,
Seattle, Washington
| | - Noel S Weiss
- Department of Epidemiology, University of Washington,
Seattle, Washington.,Public Health Sciences Division, Fred Hutchinson Cancer
Research Center, Seattle, WA, USA
| | | | - KC Gary Chan
- Department of Biostatistics, University of Washington,
Seattle, Washington
| | | | - Beth A Mueller
- Department of Epidemiology, University of Washington,
Seattle, Washington.,Public Health Sciences Division, Fred Hutchinson Cancer
Research Center, Seattle, WA, USA
| | - Sascha Dublin
- Department of Epidemiology, University of Washington,
Seattle, Washington.,Kaiser Permanente Washington Health Research Institute,
Seattle, Washington
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20
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Steineck A, Chow EJ, Doody DR, Mueller BA. Hospitalization and mortality outcomes in the first 5 years after a childhood cancer diagnosis: a population-based study. Cancer Causes Control 2021; 32:739-752. [PMID: 33835282 DOI: 10.1007/s10552-021-01425-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/25/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Children with cancer are frequently hospitalized. However, hospitalization and death by disease category are not well defined < 5 years from diagnosis. METHODS We conducted a retrospective cohort study using linked cancer registry-hospital discharge-vital records to identify cancer cases < 20 years at diagnosis during 1987-2012 (n = 4,567) and comparison children without cancer, matched on birth year and sex (n = 45,582). Data linkage identified serious morbidities resulting in cancer- and non-cancer-related hospitalizations or deaths < 5 years from diagnosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated to compare relative hospitalization and mortality by disease category and after excluding cancer-related outcomes. Among cancer cases, relative risks of these outcomes for children with solid tumors compared with children with leukemia/lymphoma were also estimated. RESULTS Greater rates of all-cause hospitalization (281.5/1,000 vs. 6.2/1,000 person years) and death (40.7/1,000 vs. 0.15/1,000 person years) were observed in childhood cancer cases than comparators and across all diagnosis categories. Increased hospitalization (31.0/1,000 vs. 6.2/1,000 person years; HR 5.0, 95% CI 4.5-5.5) and death (1.0/1,000 vs. 0.15/1,000 person years; HR 10.4, 95% CI 5.6-19.1) rates remained when cancer-related outcomes were excluded. Although HRs for hospitalization and death did not differ greatly by treatment era, absolute rates of hospitalization were greater (1987-1999: 233.3/1,000; 2000-2012: 320.0/1,000 person years) and death were lesser (1987-1999: 46.3/1,000; 2000-2012: 36.8/1,000 person years) in the later treatment era among cases. Children with solid tumors were less likely to have a cancer-related hospitalization than were those with leukemia/lymphoma (RR 0.91, 95% CI 0.84-0.98). CONCLUSION Even after excluding cancer-related diagnoses, children with cancer experience greater rates of hospitalization and death in all disease categories. Results may guide future toxicity mitigation initiatives and inform anticipatory guidance for families of children with cancer.
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Affiliation(s)
- Angela Steineck
- Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA, USA. .,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA. .,Center for Clinical and Translational Research, Seattle Children's Research Institute, 1900 9t h Ave, MS JMB 10-C, Seattle, WA, 98101, USA. .,Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, USA.
| | - Eric J Chow
- Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
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21
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Schiff MA, Doody DR, Crane DA, Mueller BA. Pregnancy outcomes among visually impaired women in Washington State, 1987-2014. Disabil Health J 2020; 14:101057. [PMID: 33384279 DOI: 10.1016/j.dhjo.2020.101057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/17/2020] [Accepted: 12/21/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Women with visual impairment may have reduced ability to access standard care resources, however, information on their pregnancy and neonatal outcomes is limited. OBJECTIVE To assess risk of adverse pregnancy and neonatal outcomes among visually impaired women in Washington State from 1987 to 2014. METHODS We conducted a retrospective cohort study using linked Washington State birth/fetal death hospital discharge records to compare outcomes among women with and without visual impairment noted at their delivery hospitalization. Pregnancy conditions and outcomes evaluated included gestational diabetes, pre-eclampsia, labor induction and cesarean delivery. Neonatal outcomes included preterm delivery and birth weight <2500 g. We assessed length of maternal and infant delivery hospitalization. We performed Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CIs) for each outcome, adjusting for year of delivery, maternal age, and parity. RESULTS Most adverse pregnancy and neonatal outcomes were similar for visually impaired (N = 232) and comparison women (N = 2362). However, visually impaired women had increased risks of severe pre-eclampsia (RR 3.77, 95% CI 1.69-8.43), labor induction (RR 1.33, 95% CI 1.10-1.61) and preterm delivery (RR 1.60, 95% CI 1.06-2.42). They were also more likely to have delivery hospitalizations of 3 or more days following a vaginal (RR 1.86, 95% CI 1.41-2.47). Among cesarean deliveries, infants of visually impaired women had increased risk (RR 1.24, 95% CI 1.02-1.51) of hospitalization for 3 or more days postpartum. CONCLUSION Our findings may be useful for obstetric providers in counseling their visually impaired patients.
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Affiliation(s)
- Melissa A Schiff
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, WA, USA; Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Deborah A Crane
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, WA, USA
| | - Beth A Mueller
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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22
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Van de Winckel A, De Patre D, Rigoni M, Fiecas M, Hendrickson TJ, Larson M, Jagadeesan BD, Mueller BA, Elvendahl W, Streib C, Ikramuddin F, Lim KO. Exploratory study of how Cognitive Multisensory Rehabilitation restores parietal operculum connectivity and improves upper limb movements in chronic stroke. Sci Rep 2020; 10:20278. [PMID: 33219267 PMCID: PMC7680110 DOI: 10.1038/s41598-020-77272-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022] Open
Abstract
Cognitive Multisensory Rehabilitation (CMR) is a promising therapy for upper limb recovery in stroke, but the brain mechanisms are unknown. We previously demonstrated that the parietal operculum (parts OP1/OP4) is activated with CMR exercises. In this exploratory study, we assessed the baseline difference between OP1/OP4 functional connectivity (FC) at rest in stroke versus healthy adults to then explore whether CMR affects OP1/OP4 connectivity and sensorimotor recovery after stroke. We recruited 8 adults with chronic stroke and left hemiplegia/paresis and 22 healthy adults. Resting-state FC with the OP1/OP4 region-of-interest in the affected hemisphere was analysed before and after 6 weeks of CMR. We evaluated sensorimotor function and activities of daily life pre- and post-CMR, and at 1-year post-CMR. At baseline, we found decreased FC between the right OP1/OP4 and 34 areas distributed across all lobes in stroke versus healthy adults. After CMR, only four areas had decreased FC compared to healthy adults. Compared to baseline (pre-CMR), participants improved on motor function (MESUPES arm p = 0.02; MESUPES hand p = 0.03; MESUPES total score p = 0.006); on stereognosis (p = 0.03); and on the Frenchay Activities Index (p = 0.03) at post-CMR and at 1-year follow-up. These results suggest enhanced sensorimotor recovery post-stroke after CMR. Our results justify larger-scale studies.
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Affiliation(s)
- A Van de Winckel
- Division of Physical Therapy, Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, USA.
| | - D De Patre
- Centro Studi Di Riabilitazione Neurocognitiva - Villa Miari (Study Center for Cognitive Multisensory Rehabilitation), Santorso, Vicenza, Italy
| | - M Rigoni
- Centro Studi Di Riabilitazione Neurocognitiva - Villa Miari (Study Center for Cognitive Multisensory Rehabilitation), Santorso, Vicenza, Italy
| | - M Fiecas
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, USA
| | - T J Hendrickson
- University of Minnesota Informatics Institute, Office of the Vice President for Research, University of Minnesota, Minneapolis, USA
| | - M Larson
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, USA
| | - B D Jagadeesan
- Department of Radiology, Medical School, University of Minnesota, Minneapolis, USA
| | - B A Mueller
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, USA
| | - W Elvendahl
- Center of Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, USA
| | - C Streib
- Department of Neurology, Medical School, University of Minnesota, Minneapolis, USA
| | - F Ikramuddin
- Division of Physical Medicine and Rehabilitation, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, USA
| | - K O Lim
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, USA
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23
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Yang SW, Kernic MA, Mueller BA, Simon GE, Chan KCG, Vander Stoep A. Association of Parental Mental Illness With Child Injury Occurrence, Hospitalization, and Death During Early Childhood. JAMA Pediatr 2020; 174:e201749. [PMID: 32568391 PMCID: PMC7309091 DOI: 10.1001/jamapediatrics.2020.1749] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
IMPORTANCE Injury is a leading cause of childhood morbidity and mortality worldwide. Serious mental illness (SMI) is a major contributor to the global burden of disease. OBJECTIVE To compare injury event rates in children from birth to 5 years of age among Taiwanese children with and without parents with SMI, including schizophrenia, bipolar disorder, and major depressive disorder. DESIGN, SETTING, AND PARTICIPANTS This population-based, retrospective cohort study of an 11-year Taiwanese birth cohort used data from the Taiwan National Health Insurance Research Database (covering 99% of Taiwanese citizens), the Maternal and Child Health Database, and birth and death certificate databases. The study included 1 999 322 singletons with Taiwanese citizenship born from January 1, 2004, to December 31, 2014, and followed up from birth to their fifth birthday, December 31, 2014, or the date of death, yielding a total of 7 741 026 person-years. Data analysis was performed from April 20, 2017, to September 24, 2019. EXPOSURES Physician-diagnosed parental SMI defined using outpatient and inpatient records from 6 years before the child's birth to 5 years after delivery. MAIN OUTCOME AND MEASURES Rates of medically attended injury events, injury hospitalization, and injury death retrieved from outpatient records, inpatient records, and death certificates. Generalized estimating equation for log-linear models estimated injury incidence rate ratios (IRRs) comparing parental SMI-exposed children and unexposed children. RESULTS The study cohort included 1 999 322 singletons (52.1% males without parental SMI and 52.2% males with parental SMI). Incidence rates of child injury-related outcomes were higher among children exposed to parental SMI (294.8 injury events per 1000 person-years) compared with children who were unexposed (256.1 injury events per 1000 person-years). After adjustment for sociodemographic factors, children with parental SMI had higher rates of injury events (IRR, 1.14; 95% CI, 1.13-1.15), injury hospitalization (IRR, 1.49; 95% CI, 1.42-1.57), and injury death (IRR, 1.82; 95% CI, 1.38-2.39) compared with unexposed children. The results were confirmed in sensitivity analyses. Appendicitis, a negative control outcome, was not associated with parental SMI (IRR, 1.10; 95% CI, 0.94-1.28). In addition, children with and without parental SMI had similar patterns of preventive health care. The mean (SD) number of prenatal visits was 8.09 (2.50) for children with parental SMI and 8.17 (2.47) among unaffected children. The mean (SD) number of well-child visits was 5.70 (2.24) for children with parental SMI and 5.80 (2.21) among unaffected children. CONCLUSIONS AND RELEVANCE In this study, children with parental SMI had increased risk of injury, particularly serious injury. Excess risk may be reduced by providing effective mental health treatment, parenting support, and home safety education to parents with SMI who are raising young children.
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Affiliation(s)
- Shiow-Wen Yang
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
| | - Mary A. Kernic
- Department of Epidemiology, University of Washington, Seattle
| | - Beth A. Mueller
- Department of Epidemiology, University of Washington, Seattle,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | | | - Ann Vander Stoep
- Department of Epidemiology, University of Washington, Seattle,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
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Ording AG, Christensen LB, Bjørge T, Doody DR, Ekbom A, Glimelius I, Grotmol T, Larfors G, Mueller BA, Smedby KE, Tretli S, Troisi R, Sørensen HT. Birthweight and all-cause mortality after childhood and adolescent leukemia: a cohort of children with leukemia from Denmark, Norway, Sweden, and Washington State. Acta Oncol 2020; 59:949-958. [PMID: 32174251 DOI: 10.1080/0284186x.2020.1738546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: High birthweight may predispose children to acute lymphoid leukemia, whereas low birthweight is associated with childhood morbidity and mortality. Low and high birthweight have been inconsistently associated with mortality in children with leukemia.Material and methods: In a cohort of childhood and adolescent leukemia (0-19 years) patients from registries in Denmark, Norway, Sweden, and Washington State in the United States (1967-2015), five-year all-cause mortality was assessed by birthweight and other measures of fetal growth using the cumulative incidence function and Cox regression with adjustment for sex, diagnosis year, country, the presence of Down's syndrome or other malformations, and type of leukemia.Results: Among 7148 children and adolescents with leukemia (55% male), 4.6% were low (<2500 g) and 19% were high (≥4000 g) birthweight. Compared with average weight, hazard ratios (HRs) of death associated with low birthweight varied by age at leukemia diagnosis: 1.5 (95% confidence interval (CI): 0.7, 3.2) for patients 0-1 year old, 1.6 (95% CI: 1.0, 2.6) for >1-2 years old; 1.0 (95% CI: 0.6, 1.5) for 3-8 years old; 1.0 (95% CI: 0.6, 1.8) for 9-13 years old; and 1.2 (95% CI: 0.7, 2.1) for 14-19 years old, and were similar for size for gestational age and Ponderal index. In analyses restricted to children born full term (37-41 weeks of gestation), results were only slightly attenuated but risk was markedly increased for infants aged ≤1 year (HR for low birthweight = 3.2, 95% CI: 1.2, 8.8).Conclusion: This cohort study does not suggest that low birthweight or SGA is associated with increased five-year all-cause mortality risk among children with any type of childhood leukemia or acute lymphoblastic leukemia, specifically, beyond infancy.
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Affiliation(s)
- Anne Gulbech Ording
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - David R. Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anders Ekbom
- Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Glimelius
- Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | | | - Gunnar Larfors
- Department of Medical Sciences, Unit of Hematology, Uppsala University, Uppsala, Sweden
| | - Beth A. Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Karin E. Smedby
- Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | | | - Rebecca Troisi
- Division of Cancer Epidemiology and Biostatistics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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25
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Karalexi MA, Dessypris N, Ma X, Spector LG, Marcotte E, Clavel J, Pombo-de-Oliveira MS, Heck JE, Roman E, Mueller BA, Hansen J, Auvinen A, Lee PC, Schüz J, Magnani C, Mora AM, Dockerty JD, Scheurer ME, Wang R, Bonaventure A, Kane E, Doody DR, Erdmann F, Kang AY, Metayer C, Milne E, Petridou ET. Age-, sex- and disease subtype-related foetal growth differentials in childhood acute myeloid leukaemia risk: A Childhood Leukemia International Consortium analysis. Eur J Cancer 2020; 130:1-11. [PMID: 32163883 DOI: 10.1016/j.ejca.2020.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 12/18/2019] [Accepted: 01/14/2020] [Indexed: 02/01/2023]
Abstract
AIM Evidence for an association of foetal growth with acute myeloid leukaemia (AML) is inconclusive. AML is a rare childhood cancer, relatively more frequent in girls, with distinct features in infancy. In the context of the Childhood Leukemia International Consortium (CLIC), we examined the hypothesis that the association may vary by age, sex and disease subtype using data from 22 studies and a total of 3564 AML cases. METHODS Pooled estimates by age, sex and overall for harmonised foetal growth markers in association with AML were calculated using the International Fetal and Newborn Growth Consortium for the 21st Century Project for 17 studies contributing individual-level data; meta-analyses were, thereafter, conducted with estimates provided ad hoc by five more studies because of administrative constraints. Subanalyses by AML subtype were also performed. RESULTS A nearly 50% increased risk was observed among large-for-gestational-age infant boys (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.03-2.14), reduced to 34% in boys aged <2 years (OR: 1.34, 95% CI: 1.05-1.71) and 25% in boys aged 0-14 years (OR: 1.25, 95% CI: 1.06-1.46). The association of large for gestational age became stronger in boys with M0/M1subtype (OR: 1.80, 95% CI: 1.15-2.83). Large birth length for gestational age was also positively associated with AML (OR: 1.38, 95% CI: 1.00-1.92) in boys. By contrast, there were null associations in girls, as well as with respect to associations of decelerated foetal growth markers. CONCLUSIONS Accelerated foetal growth was associated with AML, especially in infant boys and those with minimally differentiated leukaemia. Further cytogenetic research would shed light into the underlying mechanisms.
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Affiliation(s)
- Maria A Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Centre, Yale School of Medicine, CT, USA
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Erin Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Jacqueline Clavel
- CRESS, UMR-S1153, INSERM, Paris-Descartes University, Villejuif, France; National Registry of Childhood Cancers, APHP, Hôpital Paul-Brousse, CHU de Nancy, France
| | | | - Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anssi Auvinen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France
| | - Corrado Magnani
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy
| | - Ana M Mora
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - John D Dockerty
- Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Michael E Scheurer
- Baylor College of Medicine, Department of Pediatrics Texas Children's Cancer Center, TX, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Centre, Yale School of Medicine, CT, USA
| | | | - Eleanor Kane
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Friederike Erdmann
- International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France; Danish Cancer Society Research Center, Childhood Cancer Research Group, Copenhagen, Denmark
| | - Alice Y Kang
- School of Public Health, University of California, Berkeley, CA, USA
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, CA, USA
| | - Elizabeth Milne
- Telethon Institute for Child Health Research, Center for Child Health Research, University of Western Australia, WA, Australia
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
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26
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de Smith AJ, Walsh KM, Morimoto LM, Francis SS, Hansen HM, Jeon S, Gonseth S, Chen M, Sun H, Luna-Fineman S, Antillón F, Girón V, Kang AY, Smirnov I, Shao X, Whitehead TP, Barcellos LF, Jolly KW, Healy J, Laverdière C, Sinnett D, Taub JW, Birch JM, Thompson PD, Pombo-de-Oliveira MS, Spector LG, DeWan AT, Mueller BA, Chiang C, Metayer C, Ma X, Wiemels JL. Heritable variation at the chromosome 21 gene ERG is associated with acute lymphoblastic leukemia risk in children with and without Down syndrome. Leukemia 2019; 33:2746-2751. [PMID: 31296947 PMCID: PMC6858994 DOI: 10.1038/s41375-019-0514-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/03/2019] [Accepted: 05/01/2019] [Indexed: 01/07/2023]
Affiliation(s)
- Adam J de Smith
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Kyle M Walsh
- Department of Neurosurgery, Duke University, Durham, NC, USA
- Duke Cancer Institute, Duke University, Durham, NC, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Libby M Morimoto
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Stephen S Francis
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Division of Epidemiology, School of Community Health Sciences, University of Nevada, Reno, NV, USA
| | - Helen M Hansen
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Soyoung Jeon
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Semira Gonseth
- Division of Chronic Disease, Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - Minhui Chen
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hanxiao Sun
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Federico Antillón
- Unidad Nacional de Oncología Pediatrica; and Universidad Francisco Marroquín, Guatemala City, Guatemala
| | - Verónica Girón
- Unidad Nacional de Oncología Pediatrica; and Universidad Francisco Marroquín, Guatemala City, Guatemala
| | - Alice Y Kang
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Ivan Smirnov
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Xiaorong Shao
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Todd P Whitehead
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Lisa F Barcellos
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Kent W Jolly
- Department of Pediatrics, Kaiser Permanente, Roseville, CA, USA
| | - Jasmine Healy
- Sainte-Justine University Health Center, Montreal, QC, Canada
| | | | - Daniel Sinnett
- Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Jeffrey W Taub
- Division of Hematology/Oncology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | | | | | | | - Logan G Spector
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Andrew T DeWan
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Beth A Mueller
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Charleston Chiang
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Catherine Metayer
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Joseph L Wiemels
- Center for Genetic Epidemiology, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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27
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Brown AL, de Smith AJ, Gant VU, Yang W, Scheurer ME, Walsh KM, Chernus JM, Kallsen NA, Peyton SA, Davies GE, Ehli EA, Winick N, Heerema NA, Carroll AJ, Borowitz MJ, Wood BL, Carroll WL, Raetz EA, Feingold E, Devidas M, Barcellos LF, Hansen HM, Morimoto L, Kang AY, Smirnov I, Healy J, Laverdière C, Sinnett D, Taub JW, Birch JM, Thompson P, Spector LG, Pombo-de-Oliveira MS, DeWan AT, Mullighan CG, Hunger SP, Pui CH, Loh ML, Zwick ME, Metayer C, Ma X, Mueller BA, Sherman SL, Wiemels JL, Relling MV, Yang JJ, Lupo PJ, Rabin KR. Inherited genetic susceptibility to acute lymphoblastic leukemia in Down syndrome. Blood 2019; 134:1227-1237. [PMID: 31350265 PMCID: PMC6788009 DOI: 10.1182/blood.2018890764] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 07/14/2019] [Indexed: 02/07/2023] Open
Abstract
Children with Down syndrome (DS) have a 20-fold increased risk of acute lymphoblastic leukemia (ALL) and distinct somatic features, including CRLF2 rearrangement in ∼50% of cases; however, the role of inherited genetic variation in DS-ALL susceptibility is unknown. We report the first genome-wide association study of DS-ALL, comprising a meta-analysis of 4 independent studies, with 542 DS-ALL cases and 1192 DS controls. We identified 4 susceptibility loci at genome-wide significance: rs58923657 near IKZF1 (odds ratio [OR], 2.02; Pmeta = 5.32 × 10-15), rs3731249 in CDKN2A (OR, 3.63; Pmeta = 3.91 × 10-10), rs7090445 in ARID5B (OR, 1.60; Pmeta = 8.44 × 10-9), and rs3781093 in GATA3 (OR, 1.73; Pmeta = 2.89 × 10-8). We performed DS-ALL vs non-DS ALL case-case analyses, comparing risk allele frequencies at these and other established susceptibility loci (BMI1, PIP4K2A, and CEBPE) and found significant association with DS status for CDKN2A (OR, 1.58; Pmeta = 4.1 × 10-4). This association was maintained in separate regression models, both adjusting for and stratifying on CRLF2 overexpression and other molecular subgroups, indicating an increased penetrance of CDKN2A risk alleles in children with DS. Finally, we investigated functional significance of the IKZF1 risk locus, and demonstrated mapping to a B-cell super-enhancer, and risk allele association with decreased enhancer activity and differential protein binding. IKZF1 knockdown resulted in significantly higher proliferation in DS than non-DS lymphoblastoid cell lines. Our findings demonstrate a higher penetrance of the CDKN2A risk locus in DS and serve as a basis for further biological insights into DS-ALL etiology.
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Affiliation(s)
- Austin L Brown
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - Adam J de Smith
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA
- Center for Genetic Epidemiology, University of Southern California, Los Angeles, CA
| | - Vincent U Gant
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - Wenjian Yang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - Kyle M Walsh
- Division of Neuro-epidemiology, Department of Neurosurgery, Duke University, Durham, NC
| | - Jonathan M Chernus
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | | | | | | | - Erik A Ehli
- Avera Institute for Human Genetics, Sioux Falls, SD
| | - Naomi Winick
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
| | - Nyla A Heerema
- Department of Pathology, The Ohio State University, Columbus, OH
| | - Andrew J Carroll
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL
| | - Michael J Borowitz
- Department of Pathology and
- Department of Oncology, Johns Hopkins Hospital, Baltimore, MD;
| | - Brent L Wood
- Department of Pathology and
- Department of Medicine, University of Washington Medical Center, Seattle, WA
| | - William L Carroll
- Department of Pediatrics, Perlmutter Cancer Center, New York University, New York, NY
| | - Elizabeth A Raetz
- Department of Pediatrics, Perlmutter Cancer Center, New York University, New York, NY
| | - Eleanor Feingold
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Meenakshi Devidas
- Department of Biostatistics, College of Medicine, Public Health and Health Professions, University of Florida, Gainesville, FL
| | - Lisa F Barcellos
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Helen M Hansen
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
| | - Libby Morimoto
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Alice Y Kang
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Ivan Smirnov
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
| | - Jasmine Healy
- Division of Hematology-Oncology, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Caroline Laverdière
- Division of Hematology-Oncology, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Daniel Sinnett
- Division of Hematology-Oncology, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Jeffrey W Taub
- Division of Hematology Oncology, Department of Oncology, Wayne State University, Detroit, MI
| | - Jillian M Birch
- Department of Paediatric and Adolescent Oncology, University of Manchester, Manchester, United Kingdom
| | - Pamela Thompson
- Department of Paediatric and Adolescent Oncology, University of Manchester, Manchester, United Kingdom
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | | | - Andrew T DeWan
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
| | | | - Stephen P Hunger
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Ching-Hon Pui
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Mignon L Loh
- Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA
| | - Michael E Zwick
- Department of Human Genetics, Emory University, Atlanta, GA; and
| | - Catherine Metayer
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Joseph L Wiemels
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA
- Center for Genetic Epidemiology, University of Southern California, Los Angeles, CA
| | - Mary V Relling
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN
| | - Jun J Yang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | - Karen R Rabin
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
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28
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Lupo PJ, Schraw JM, Desrosiers TA, Nembhard WN, Langlois PH, Canfield MA, Copeland G, Meyer RE, Brown AL, Chambers TM, Sok P, Danysh HE, Carozza SE, Sisoudiya SD, Hilsenbeck SG, Janitz AE, Oster ME, Scheuerle AE, Schiffman JD, Luo C, Mian A, Mueller BA, Huff CD, Rasmussen SA, Scheurer ME, Plon SE. Association Between Birth Defects and Cancer Risk Among Children and Adolescents in a Population-Based Assessment of 10 Million Live Births. JAMA Oncol 2019; 5:1150-1158. [PMID: 31219523 DOI: 10.1001/jamaoncol.2019.1215] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Birth defects affect approximately 1 in 33 children. Some birth defects are known to be strongly associated with childhood cancer (eg, trisomy 21 and acute leukemia). However, comprehensive evaluations of childhood cancer risk in those with birth defects have been limited in previous studies by insufficient sample sizes. Objectives To identify specific birth defect-childhood cancer (BD-CC) associations and characterize cancer risk in children by increasing number of nonchromosomal birth defects. Design, Setting, and Participants This multistate, population-based registry linkage study pooled statewide data on births, birth defects, and cancer from Texas, Arkansas, Michigan, and North Carolina on 10 181 074 children born from January 1, 1992, to December 31, 2013. Children were followed up to 18 years of age for a diagnosis of cancer. Data were retrieved between September 26, 2016, and September 21, 2017, and data analysis was performed from September 2, 2017, to March 21, 2019. Exposures Birth defects diagnoses (chromosomal anomalies and nonchromosomal birth defects) recorded by statewide, population-based birth defects registries. Main Outcomes and Measures Cancer diagnosis before age 18 years, as recorded in state cancer registries. Cox regression models were used to generate hazard ratios (HRs) and 95% CIs to evaluate BD-CC associations and the association between number of nonchromosomal defects and cancer risk. Results Compared with children without any birth defects, children with chromosomal anomalies were 11.6 (95% CI, 10.4-12.9) times more likely to be diagnosed with cancer, whereas children with nonchromosomal birth defects were 2.5 (95% CI, 2.4-2.6) times more likely to be diagnosed with cancer before 18 years of age. An increasing number of nonchromosomal birth defects was associated with a corresponding increase in the risk of cancer. Children with 4 or more major birth defects were 5.9 (95% CI, 5.3-6.4) times more likely to be diagnosed with cancer compared with those without a birth defect. In the analysis of 72 specific BD-CC patterns, 40 HRs were statistically significant (adjusted P < .05) after accounting for multiple comparisons. Cancers most frequently associated with nonchromosomal defects were hepatoblastoma and neuroblastoma. Conclusions and Relevance Several significant and novel associations were observed between specific birth defects and cancers. Among children with nonchromosomal birth defects, the number of major birth defects diagnosed was significantly and directly associated with cancer risk. These findings could inform clinical treatment for children with birth defects and may elucidate mechanisms that lead to these complex outcomes.
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Affiliation(s)
- Philip J Lupo
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston
| | - Jeremy M Schraw
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | | | - Wendy N Nembhard
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock.,Arkansas Children's Research Institute, Little Rock
| | - Peter H Langlois
- Birth Defects Epidemiology and Surveillance Branch,Texas Department of State Health Services, Austin
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch,Texas Department of State Health Services, Austin
| | - Glenn Copeland
- Division for Vital Records and Health Statistics, Michigan Department of Health and Human Services, Lansing, Michigan
| | - Robert E Meyer
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill
| | - Austin L Brown
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston
| | - Tiffany M Chambers
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston
| | - Pagna Sok
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston
| | - Heather E Danysh
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston
| | - Susan E Carozza
- School of Biological and Population Health Sciences, Oregon State University, Corvallis
| | - Saumya D Sisoudiya
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | | | - Amanda E Janitz
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Matthew E Oster
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Angela E Scheuerle
- Birth Defects Epidemiology and Surveillance Branch,Texas Department of State Health Services, Austin.,Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
| | - Joshua D Schiffman
- Division of Hematology and Oncology, Department of Pediatrics, Huntsman Cancer Institute, University of Utah, Salt Lake City
| | - Chunqiao Luo
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock
| | - Amir Mian
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Chad D Huff
- Department of Epidemiology, MD Anderson Cancer Center, Houston, Texas
| | - Sonja A Rasmussen
- Department of Pediatrics, University of Florida College of Medicine Gainsville.,Department of Epidemiology, University of Florida College of Medicine and College of Public Health and Health Professions, Gainesville
| | - Michael E Scheurer
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston
| | - Sharon E Plon
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer Center, Texas Children's Hospital, Houston.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
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29
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Wartko PD, Weiss NS, Enquobahrie DA, Chan KCG, Stephenson-Famy A, Mueller BA, Dublin S. Antidepressant continuation in pregnancy and risk of gestational diabetes. Pharmacoepidemiol Drug Saf 2019; 28:1194-1203. [PMID: 31298445 DOI: 10.1002/pds.4799] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/30/2019] [Accepted: 04/15/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE Previous studies observed modestly higher risk of gestational diabetes (GDM) associated with antidepressant use in pregnancy, potentially due to confounding by indication. We assessed the association of antidepressant continuation in pregnancy with GDM, as well as blood glucose levels, after accounting for confounding. METHODS We conducted a retrospective cohort study of singleton live births from 2001 to 2014 to women enrolled in Kaiser Permanente Washington, an integrated health care delivery system, utilizing electronic health data and linked Washington State birth records. We required that women have ≥1 antidepressant prescription fills ≤6 months before pregnancy. Women with an antidepressant fill during pregnancy were categorized as "continuers" (n = 1634); those without a fill were "discontinuers" (n = 1211). We calculated relative risks (RRs) for GDM and mean differences in screening blood glucose levels using generalized estimating equations with inverse probability of treatment weighting to account for baseline characteristics, including mental health conditions and indicators of mental health severity. RESULTS Compared with discontinuers, antidepressant continuers had comparable risk of GDM (RR: 1.10; 95% confidence interval [CI], 0.84-1.44) and blood glucose levels (mean difference: 2.3 mg/dL; 95% CI, -1.5 to 6.1 mg/dL). We observed generally similar results for specific antidepressants, with the potential exceptions of risk of GDM associated with sertraline (RR: 1.30; 95% CI, 0.90-1.88) and venlafaxine (RR: 1.52; 95% CI, 0.87-2.68), but neither association was statistically significant. CONCLUSIONS Our study suggests that overall, women who continue antidepressants in pregnancy are not at increased risk for GDM or higher blood glucose, although further study may be warranted for sertraline and venlafaxine.
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Affiliation(s)
- Paige D Wartko
- Department of Epidemiology, University of Washington, Seattle, Washington.,Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Noel S Weiss
- Department of Epidemiology, University of Washington, Seattle, Washington
| | | | - K C Gary Chan
- Department of Biostatistics, University of Washington, Seattle, Washington
| | | | - Beth A Mueller
- Department of Epidemiology, University of Washington, Seattle, Washington.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sascha Dublin
- Department of Epidemiology, University of Washington, Seattle, Washington.,Kaiser Permanente Washington Health Research Institute, Seattle, Washington
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30
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Pan TD, Mueller BA, Dugowson CE, Richardson ML, Nelson JL. Disease progression in relation to pre-onset parity among women with rheumatoid arthritis. Semin Arthritis Rheum 2019; 50:1-6. [PMID: 31324468 DOI: 10.1016/j.semarthrit.2019.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 06/10/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Rheumatoid arthritis (RA) often ameliorates during pregnancy and flares postpartum, but the relationship of pregnancy and childbirth to RA prognosis is unclear. We examined RA severity for association with parity prior to RA onset and asked whether time from birth (latency) and/or the mother's HLA genotype influenced results. METHODS A cohort study was conducted of 222 women previously identified in a prospective study of newly diagnosed RA, who returned for follow-up evaluation a median of 8 years later. Stratified analyses using Mantel-Haenszel methods were conducted to evaluate 5 RA severity measures based on hand and wrist radiographs, physical exams, and Health Assessment Questionnaires for association with parity. RESULTS Overall, we observed little evidence of altered risk of progression to severe RA in relation to pre-onset parity, adjusting for RA onset age and time to follow-up. Stratifying parous women who had only live births by latency (<15 years/15+ years) showed no difference in risk of severe RA compared to nulligravid women. Live birth deliveries were significantly protective for women with 0 but not for those with 1 or 2 copies of the RA risk-associated HLA-DRB1 shared epitope sequence for erosion score (RR 0.26 95% CI 0.09-0.89) and joint count (RR 0.28 95% CI 0.09-0.87). CONCLUSION We observed little evidence of difference in severe RA by pre-onset parity overall. However, among women not predisposed to RA by possessing the risk-associated HLA genotype, parous women who had only live births had lower risk of progression to severe RA as measured by erosion score and joint count.
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Affiliation(s)
- Tiffany D Pan
- Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195 USA; Department of Anthropology, University of Washington, Box 353100, Seattle, WA 98195 USA.
| | - Beth A Mueller
- Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195 USA; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., PO Box 19024, Seattle, WA 98109 USA
| | - Carin E Dugowson
- Division of Rheumatology, University of Washington, Box 356428, Seattle, WA 98195 USA
| | - Michael L Richardson
- Department of Radiology, University of Washington, Box 357115, Seattle, WA 98195 USA
| | - J Lee Nelson
- Division of Rheumatology, University of Washington, Box 356428, Seattle, WA 98195 USA; Division of Clinical Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., PO Box 19024, Seattle, WA 98109 USA
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31
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Crane DA, Doody DR, Schiff MA, Mueller BA. Pregnancy Outcomes in Women with Spinal Cord Injuries: A Population-Based Study. PM R 2019; 11:795-806. [PMID: 30729746 DOI: 10.1002/pmrj.12122] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 12/26/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pregnant women with congenital or acquired spinal cord injury face challenges due to compromised neurologic function and mobility, factors that may also affect fetal/infant health. Few studies have examined pregnancy course and longer-term outcomes in this population. OBJECTIVE To assess pregnancy outcomes among women with spinal cord injury, paralysis, or spina bifida using population-based data. DESIGN Retrospective cohort study. SETTING Washington state linked birth-hospital discharge records. PARTICIPANTS All women (N = 529) with spinal cord injury, paralysis, or spina bifida with singleton live birth deliveries 1987-2012, and a comparison group of women without disabilities (N = 5282). METHODS Diagnosis codes were screened to identify cases and a 10:1 random sample of comparison women. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated overall and separately for each condition using multivariable regression. Subsequent hospitalizations or death were identified via linkage to hospital discharge/death records for 2 years after delivery. MAIN OUTCOME MEASUREMENTS Pregnancy course (weight gain, gestational diabetes, preeclampsia, infection, venous thromboembolism), delivery/labor characteristics, infant characteristics (birthweight/size, gestational age), and longer-term outcomes (occurrence/reasons for maternal/infant rehospitalization, mortality). RESULTS Women with these spinal conditions had increased adjusted risks of prenatal urinary tract infection/pyelonephritis (RR 26.43, 95% CI 13.97-49.99), venous thromboembolism (RR 9.16, 95% CI 2.17-38.60), preterm rupture of membranes (RR 2.15, 95% CI 1.18-3.90), and cesarean delivery (RR 1.88, 95% CI 1.70-2.09). They had longer hospitalizations and increased rehospitalization (RR 1.54, 95% CI 1.28-1.87), including for postpartum depression (RR 8.15, 4.29-15.48) or injury (RR 13.05, 95% CI 6.60-25.81). Their infants were more often small for gestational age (RR 1.65, 95% CI 1.33-2.06), but had no increased risk of rehospitalization or death. CONCLUSIONS We observed no increased long-term morbidity among infants of women with these conditions. Possible increased maternal morbidities during the first postpartum years indicate areas for intervention. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Deborah A Crane
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Melissa A Schiff
- Department of Epidemiology, University of Washington, Seattle, WA.,Department of Obstetrics & Gynecology, University of Washington, Seattle, WA.,Department of Internal Medicine, Division of Epidemiology, Biostatistics & Preventive Medicine, University of New Mexico School of Medicine, Albuquerque, NM (current)
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
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32
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Niu X, Li CI, Mueller BA. Obstetrical and infant outcomes among women with neoplasms during pregnancy. Cancer Causes Control 2019; 30:651-661. [PMID: 30976958 DOI: 10.1007/s10552-019-01167-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 04/05/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE One in 1,000 pregnancies is complicated by malignancies. Prevalence is greater for benign neoplasms. Adverse outcomes among women with malignancies have been reported. Less is known of postpartum outcomes for infants, or outcomes among women with benign neoplasms. METHODS We conducted a population-based cohort study using Washington State-linked vital-hospital discharge records. Women with neoplasms (707 malignant; 13,156 benign) with deliveries in 1987-2012 were identified, and a randomly selected comparison cohort. Obstetrical/infant outcomes and rehospitalization < 2 years post-delivery were compared separately for each group by multivariable regressions to estimate risk ratios (RR) and 95% confidence intervals (CI). RESULTS Women with either condition had increased anemia, cesarean, and preterm delivery; their infants were more often < 2,500 g or jaundiced. Women with benign conditions had increased gestational diabetes (RR = 1.20; 95% CI 1.12-1.28) and preeclampsia (RR = 1.27; 95% CI 1.18-1.36); their infants had increased malformations (RR = 1.29; 95% CI 1.19-1.38). Women with neoplasms more often were hospitalized seven or more days or rehospitalized; their infants' hospitalizations were also longer. CONCLUSION Malignant and benign neoplasms were associated with several adverse outcomes. Reasons for relationships of benign neoplasms with gestational diabetes, preeclampsia, and congenital malformations merit further study.
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Affiliation(s)
- Xin Niu
- Department of Epidemiology, University of Washington (UW), Seattle, WA, USA
| | - Christopher I Li
- Department of Epidemiology, University of Washington (UW), Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center (FHCRC), PO 19024, Mailstop M4-C308, Seattle, WA, 98109-1024, USA
| | - Beth A Mueller
- Department of Epidemiology, University of Washington (UW), Seattle, WA, USA.
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center (FHCRC), PO 19024, Mailstop M4-C308, Seattle, WA, 98109-1024, USA.
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33
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Panagopoulou P, Skalkidou A, Marcotte E, Erdmann F, Ma X, Heck JE, Auvinen A, Mueller BA, Spector LG, Roman E, Metayer C, Magnani C, Pombo-de-Oliveira MS, Scheurer ME, Mora AM, Dockerty JD, Hansen J, Kang AY, Wang R, Doody DR, Kane E, Schüz J, Christodoulakis C, Ntzani E, Petridou ET. Parental age and the risk of childhood acute myeloid leukemia: results from the Childhood Leukemia International Consortium. Cancer Epidemiol 2019; 59:158-165. [PMID: 30776582 PMCID: PMC7098424 DOI: 10.1016/j.canep.2019.01.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Parental age has been associated with several childhood cancers, albeit the evidence is still inconsistent. AIM To examine the associations of parental age at birth with acute myeloid leukemia (AML) among children aged 0-14 years using individual-level data from the Childhood Leukemia International Consortium (CLIC) and non-CLIC studies. MATERIAL/METHODS We analyzed data of 3182 incident AML cases and 8377 controls from 17 studies [seven registry-based case-control (RCC) studies and ten questionnaire-based case-control (QCC) studies]. AML risk in association with parental age was calculated using multiple logistic regression, meta-analyses, and pooled-effect estimates. Models were stratified by age at diagnosis (infants <1 year-old vs. children 1-14 years-old) and by study design, using five-year parental age increments and controlling for sex, ethnicity, birthweight, prematurity, multiple gestation, birth order, maternal smoking and education, age at diagnosis (cases aged 1-14 years), and recruitment time period. RESULTS Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) derived from RCC, but not from the QCC, studies showed a higher AML risk for infants of mothers ≥40-year-old (OR = 6.87; 95% CI: 2.12-22.25). There were no associations observed between any other maternal or paternal age group and AML risk for children older than one year. CONCLUSIONS An increased risk of infant AML with advanced maternal age was found using data from RCC, but not from QCC studies; no parental age-AML associations were observed for older children.
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Affiliation(s)
- Paraskevi Panagopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Erin Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, U
| | - Friederike Erdmann
- International Agency for Research on Cancer, Section of Environment and Radiation, Lyon, France; Danish Cancer Society Research Center, Childhood Cancer Research Group, Copenhagen, Denmark
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Center, Yale School of Medicine, CT, USA
| | - Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Anssi Auvinen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, U
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, CA, USA
| | - Corrado Magnani
- Cancer Epidemiology Unit, Department of Translational Medicine, CPO Piedmont and University of Eastern Piedmont, Novara, Italy
| | - Maria S Pombo-de-Oliveira
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom; Pediatric Hematology-Oncology Program, Instituto Nacional de Cancer, Rio de Janeiro, Brazil
| | - Michael E Scheurer
- Baylor College of Medicine, Department of Pediatrics Texas Children's Cancer Center, TX, USA
| | - Ana-Maria Mora
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - John D Dockerty
- School of Public Health, University of California, Berkeley, CA, USA; Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Alice Y Kang
- School of Public Health, University of California, Berkeley, CA, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Center, Yale School of Medicine, CT, USA
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Eleanor Kane
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Joachim Schüz
- International Agency for Research on Cancer, Section of Environment and Radiation, Lyon, France
| | - Christos Christodoulakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Greece; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
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34
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Mueller BA, Crane D, Doody DR, Stuart SN, Schiff MA. Pregnancy course, infant outcomes, rehospitalization, and mortality among women with intellectual disability. Disabil Health J 2019; 12:452-459. [PMID: 30692054 DOI: 10.1016/j.dhjo.2019.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 01/09/2019] [Accepted: 01/14/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pregnant women with intellectual disability (ID) may have greater levels of comorbidity and decreased care access, social support, or ability to monitor their status and communicate needs, but few studies have examined their pregnancy course and outcome, and little is known about their longer-term maternal and infant health. OBJECTIVE We compared pre-pregnancy characteristics, pregnancy outcomes, and rehospitalization <2 years after delivery among women with and without ID. METHOD We identified all women with ID and randomly selected a 10:1 comparison group of women without ID with singleton live birth deliveries in Washington State population-based linked birth-hospital discharge data 1987-2012. Multivariable regressions estimated adjusted odds ratios comparing pre-pregnancy characteristics. In cohort analyses, we estimated relative risks (RR) and 95% confidence intervals (CI) for outcomes. RESULTS Women with ID (N = 103) more often had gestational diabetes (RR 3.39, 95% CI 1.81-6.37), preeclampsia (RR 1.88, 95% CI 1.03-3.42), and inadequate prenatal care (RR 2.48, 95% CI 1.67-3.70). Their infants more often were small for gestational age (RR 1.78, 95% CI 1.10-2.89). Need for rehospitalization postpartum was not increased among women with ID or their infants. CONCLUSION Reasons for increased preeclampsia and gestational diabetes among pregnant women with ID are unclear. Barriers to inadequate prenatal care are multifactorial and warrant further study, with consideration that wellness during pregnancy and other times involves social, familial and clinical support systems responsive to each woman's needs.
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Affiliation(s)
- Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | - Deborah Crane
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sally N Stuart
- Center on Human Development and Disability, University of Washington, Seattle, WA, USA
| | - Melissa A Schiff
- Department of Epidemiology, University of Washington, Seattle, WA, USA
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35
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Ferri J, Ford JM, Roach BJ, Turner JA, van Erp TG, Voyvodic J, Preda A, Belger A, Bustillo J, O'Leary D, Mueller BA, Lim KO, McEwen SC, Calhoun VD, Diaz M, Glover G, Greve D, Wible CG, Vaidya JG, Potkin SG, Mathalon DH. Resting-state thalamic dysconnectivity in schizophrenia and relationships with symptoms. Psychol Med 2018; 48:2492-2499. [PMID: 29444726 DOI: 10.1017/s003329171800003x] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Schizophrenia (SZ) is a severe neuropsychiatric disorder associated with disrupted connectivity within the thalamic-cortico-cerebellar network. Resting-state functional connectivity studies have reported thalamic hypoconnectivity with the cerebellum and prefrontal cortex as well as thalamic hyperconnectivity with sensory cortical regions in SZ patients compared with healthy comparison participants (HCs). However, fundamental questions remain regarding the clinical significance of these connectivity abnormalities. METHOD Resting state seed-based functional connectivity was used to investigate thalamus to whole brain connectivity using multi-site data including 183 SZ patients and 178 matched HCs. Statistical significance was based on a voxel-level FWE-corrected height threshold of p < 0.001. The relationships between positive and negative symptoms of SZ and regions of the brain demonstrating group differences in thalamic connectivity were examined. RESULTS HC and SZ participants both demonstrated widespread positive connectivity between the thalamus and cortical regions. Compared with HCs, SZ patients had reduced thalamic connectivity with bilateral cerebellum and anterior cingulate cortex. In contrast, SZ patients had greater thalamic connectivity with multiple sensory-motor regions, including bilateral pre- and post-central gyrus, middle/inferior occipital gyrus, and middle/superior temporal gyrus. Thalamus to middle temporal gyrus connectivity was positively correlated with hallucinations and delusions, while thalamus to cerebellar connectivity was negatively correlated with delusions and bizarre behavior. CONCLUSIONS Thalamic hyperconnectivity with sensory regions and hypoconnectivity with cerebellar regions in combination with their relationship to clinical features of SZ suggest that thalamic dysconnectivity may be a core neurobiological feature of SZ that underpins positive symptoms.
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Affiliation(s)
- J Ferri
- Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA
| | - J M Ford
- Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA
| | - B J Roach
- San Francisco VA Health Care System,San Francisco, CA,USA
| | - J A Turner
- The Mind Research Network,Albuquerque, NM,USA
| | - T G van Erp
- Department of Psychiatry and Human Behavior,University of California,Irvine, Irvine, CA,USA
| | - J Voyvodic
- Department of Psychiatry,Duke University,Raleigh-Durham, NC,USA
| | - A Preda
- Department of Psychiatry and Human Behavior,University of California,Irvine, Irvine, CA,USA
| | - A Belger
- Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA
| | - J Bustillo
- Department of Psychiatry,University of New Mexico,Albuquerque, NM,USA
| | - D O'Leary
- Department of Psychiatry,University of Iowa,Iowa City, IA,USA
| | - B A Mueller
- Department of Psychiatry,University of Minnesota,Minneapolis, MN,USA
| | - K O Lim
- Department of Psychiatry,University of Minnesota,Minneapolis, MN,USA
| | - S C McEwen
- Department of Psychiatry,University of California,Los Angeles, Los Angeles, CA,USA
| | - V D Calhoun
- The Mind Research Network,Albuquerque, NM,USA
| | - M Diaz
- Department of Psychiatry,Duke University,Raleigh-Durham, NC,USA
| | - G Glover
- Department of Radiology,Stanford University,Stanford, CA,USA
| | - D Greve
- Department of Radiology,Massachusetts General Hospital,Boston, MA,USA
| | - C G Wible
- Department of Psychiatry,Harvard University,Boston, MA,USA
| | - J G Vaidya
- Department of Psychiatry,University of Iowa,Iowa City, IA,USA
| | - S G Potkin
- Department of Psychiatry and Human Behavior,University of California,Irvine, Irvine, CA,USA
| | - D H Mathalon
- Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA
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36
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Petridou ET, Georgakis MK, Erdmann F, Ma X, Heck JE, Auvinen A, Mueller BA, Spector LG, Roman E, Metayer C, Magnani C, Pombo-de-Oliveira MS, Ezzat S, Scheurer ME, Mora AM, Dockerty JD, Hansen J, Kang AY, Wang R, Doody DR, Kane E, Rashed WM, Dessypris N, Schüz J, Infante-Rivard C, Skalkidou A. Advanced parental age as risk factor for childhood acute lymphoblastic leukemia: results from studies of the Childhood Leukemia International Consortium. Eur J Epidemiol 2018; 33:965-976. [PMID: 29761423 PMCID: PMC6384148 DOI: 10.1007/s10654-018-0402-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/25/2018] [Indexed: 12/12/2022]
Abstract
Advanced parental age has been associated with adverse health effects in the offspring including childhood (0-14 years) acute lymphoblastic leukemia (ALL), as reported in our meta-analysis of published studies. We aimed to further explore the association using primary data from 16 studies participating in the Childhood Leukemia International Consortium. Data were contributed by 11 case-control (CC) studies (7919 cases and 12,942 controls recruited via interviews) and five nested case-control (NCC) studies (8801 cases and 29,690 controls identified through record linkage of population-based health registries) with variable enrollment periods (1968-2015). Five-year paternal and maternal age increments were introduced in two meta-analyses by study design using adjusted odds ratios (OR) derived from each study. Increased paternal age was associated with greater ALL risk in the offspring (ORCC 1.05, 95% CI 1.00-1.11; ORNCC 1.04, 95% CI 1.01-1.07). A similar positive association with advanced maternal age was observed only in the NCC results (ORCC 0.99, 95% CI 0.91-1.07, heterogeneity I2 = 58%, p = 0.002; ORNCC 1.05, 95% CI 1.01-1.08). The positive association between parental age and risk of ALL was most marked among children aged 1-5 years and remained unchanged following mutual adjustment for the collinear effect of the paternal and maternal age variables; analyses of the relatively small numbers of discordant paternal-maternal age pairs were not fully enlightening. Our results strengthen the evidence that advanced parental age is associated with increased childhood ALL risk; collinearity of maternal with paternal age complicates causal interpretation. Employing datasets with cytogenetic information may further elucidate involvement of each parental component and clarify underlying mechanisms.
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Affiliation(s)
- Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 11527, Athens, Greece.
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
| | - Marios K Georgakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 11527, Athens, Greece
| | - Friederike Erdmann
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
- Unit of Survivorship, Childhood Cancer Survivorship Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anssi Auvinen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Logan G Spector
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Corrado Magnani
- Dipartimento di Medicina Traslazionale, SCDU Epidemiologia del Tumori, Universitá del Piemonte Orientale, Novara, Italy
| | | | - Sameera Ezzat
- Department of Epidemiology and Preventive Medicine, NLI-SSI Collaborative Research Center, National Liver Institute, Menoufia University, Cairo, Egypt
| | - Michael E Scheurer
- Department of Pediatrics Texas Children's Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Ana Maria Mora
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - John D Dockerty
- Department of Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Alice Y Kang
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Cancer Prevention and Control, Yale Comprehensive Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Eleanor Kane
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, Heslington, York, UK
| | - Waffa M Rashed
- Research Department, Children's Cancer Hospital Egypt, Cairo, Egypt
- Biomedical Research Department, Armed Forces College of Medicine, Cairo, Egypt
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 11527, Athens, Greece
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Williams LA, Richardson M, Kehm RD, McLaughlin CC, Mueller BA, Chow EJ, Spector LG. The association between sex and most childhood cancers is not mediated by birthweight. Cancer Epidemiol 2018; 57:7-12. [PMID: 30248472 DOI: 10.1016/j.canep.2018.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/07/2018] [Accepted: 09/10/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Male sex is associated with an increased risk of childhood cancer as is high birthweight. Given that sex determination precedes birthweight we conducted a mediation analysis to estimate the direct effect of sex in association with childhood cancer tumor type with birthweight as the mediator. METHODS Cases (n = 12,632) and controls (n = 64,439) (ages 0-14 years) were identified from population-based cancer and birth registries in Minnesota, New York, and Washington states (1970-2014). An inverse odds weighting (IOW) mediation analysis was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) as the measure of association between sex and cancer. RESULTS A significant indirect effect was observed for sex and lymphoid leukemia, mediated by birthweight (indirectOR: 1.03; 95% CI: 1.02-1.04). We observed significant direct effects for male sex and lymphoid leukemia (directOR: 1.16; 95% CI: 1.08-1.25), Hodgkin lymphoma (directOR: 1.48; 95% CI: 1.22-1.81), Burkitt lymphoma (directOR: 5.02; 95% CI: 3.40-7.42), other non-Hodgkin lymphoma (directOR: 1.42; 95% CI: 1.18-1.70), intracranial embryonal tumors (directOR: 1.49; 95% CI: 1.26-1.76), hepatoblastoma (directOR: 1.90; 95% CI: 1.40-2.59), and rhabdomyosarcoma (directOR: 1.47; 95% CI: 1.19-1.81). There were also inverse associations for extracranial GCTs (directOR: 0.41; 95% CI: 0.26-0.63) and thyroid carcinoma (directOR: 0.35; 95% CI: 0.25-0.50). CONCLUSION Significant direct effects for sex and numerous childhood cancer types suggests sex-specific factors such as differences in gene expression from the autosomes or the X chromosome, rather than birthweight, may underlie sex differences in tumor risk.
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Affiliation(s)
- Lindsay A Williams
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Michaela Richardson
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Rebecca D Kehm
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, United States
| | | | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Eric J Chow
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States; Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States.
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Mueller BA, Doody DR, Weiss NS, Chow EJ. Hospitalization and mortality among pediatric cancer survivors: a population-based study. Cancer Causes Control 2018; 29:1047-1057. [PMID: 30187228 DOI: 10.1007/s10552-018-1078-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/29/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE We examined serious long-term outcomes among childhood cancer survivors using population-based data. METHODS We used 1982-2014 Washington State data to compare hospitalization and/or death (including cause-specific) during up to 27 years follow-up among all 5+ year childhood cancer survivors < 20 years at diagnosis (n = 3,152) and a sample of comparison children within birth cohorts, with assessment by cancer type and child/family characteristics. RESULTS During follow-up (9 years median), 12% of survivors had hospitalizations; 4% died. Greatest absolute risks/1,000 person-years were for hospitalization/deaths due to cancers (8.1), infection (6.2), injuries (6.0), and endocrine/metabolic disorders (5.8). Hazard ratios (HR) and 95% confidence intervals (CI) for hospitalization (2.7, 95% CI 2.4-3.0) and any-cause death (14.7, 95% CI 11.3-19.1) were increased, and for all cause-specific outcomes examined, most notably cancer- (35.1, 95% CI 23.7-51.9), hematological- (6.7, 95% CI 5.3-8.5), nervous system- (6.4, 95% CI 5.2-7.8), and circulatory- (5.2, 95% CI 4.1-6.5) related outcomes. Hospitalizations occurred more often among females and those receiving radiation, with modest differences by urban/rural birth residence and race/ethnicity. Cause-specific outcomes varied by cancer type. CONCLUSIONS This study suggests increased risks for the rarely-studied outcomes of long-term fracture and injury, and confirms increased risks of selected other conditions among survivors. Multi-state pooling of population-based data would increase the ability to evaluate outcomes for uncommon cancer types and by racial/ethnic groups under-represented in many studies.
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Affiliation(s)
- Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center (FHCRC), PO 19024, Mailstop M4-C308, Seattle, WA, USA. .,Department of Epidemiology, University of Washington (UW), Seattle, WA, USA.
| | - David R Doody
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center (FHCRC), PO 19024, Mailstop M4-C308, Seattle, WA, USA
| | - Noel S Weiss
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center (FHCRC), PO 19024, Mailstop M4-C308, Seattle, WA, USA.,Department of Epidemiology, University of Washington (UW), Seattle, WA, USA
| | - Eric J Chow
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center (FHCRC), PO 19024, Mailstop M4-C308, Seattle, WA, USA.,Clinical Research Division, FHCRC, Seattle, WA, USA.,Department of Pediatrics, Seattle Children's Hospital, UW, Seattle, WA, USA
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Brown AL, Smith AJD, Scheurer ME, Kallsen NA, Peyton SA, Davies GE, Ehli EA, Zwick ME, Winick N, Maloney K, Angiolillo AL, Schore R, Burke MIM, Salzer WL, Heerema NA, Carroll AJ, Borowitz MJ, Wood BL, Carroll WL, Raetz EA, Feingold E, Sherman SL, Yang W, Devidas M, Walsh K, DeWan AT, Pombo-de-Oliveira MS, Taub JW, Sinnett D, Healy J, Birch JM, Barcellos LF, Hansen H, Smirnov I, Mullighan CG, Hunger SP, Pui CH, Loh M, Wiemels JL, Ma X, Metayer C, Mueller BA, Relling MV, Yang JJ, Lupo PJ, Rabin KR. Abstract 222: Genome-wide association study of acute lymphoblastic leukemia in children with Down syndrome. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: Children with Down syndrome (DS) have a 20-fold increased risk of acute lymphoblastic leukemia (ALL) compared to children without DS. While genome-wide association studies (GWAS) have identified several susceptibility loci in childhood ALL, studies of ALL in children with DS are lacking. Therefore, we conducted the first GWAS of DS-ALL.
Methods: We analyzed independent cohorts of: 1) 226 newly diagnosed DS-ALL cases from Children's Oncology Group (COG) ALL trials (2000-2013) and 436 DS controls from the National Down Syndrome Project (NDSP), 2) 124 additional COG ALL cases (2011-2015) and 336 additional NDSP DS controls, 3) 20 DS-ALL cases and 275 DS controls from Michigan neonatal bloodspots, and 4) 157 DS-ALL cases and 145 DS controls largely from neonatal bloodspots from California and Washington. Genotyping was performed with Affymetrix or Illumina single nucleotide polymorphism (SNP) arrays. STRUCTURE software was used to define European (372 cases, 1,056 controls), Hispanic (140 cases, 136 controls), and African (15 cases, 62 controls) genetic ancestry. After genome-wide imputation and quality control, ancestry- and cohort-specific associations were evaluated at >6,000,000 autosomal SNPs with minor allele frequency ≥1%. Associations were meta-analyzed across cohort and ancestry groups, assuming additive allelic effects.
Results: Genome-wide significant (p<5x10-8) association signals were identified for known ALL susceptibility loci, including rs58923657 near IKZF1 (Odds Ratio [OR]=2.02, p=5.32x10-15), CDKN2A missense mutation rs3731249 (OR=3.63, p=3.91x10-10), rs3781093 near GATA3 (OR=1.73, p=2.89x10-8), and rs7090445 near ARID5B (OR=1.57, p=2.93x10-8). A novel potential risk locus was identified at chromosome 20q11.21 (rs78019519, OR=3.17, p=5.11x10-7) with consistent effects observed across each cohort and ancestry group. This SNP is in the promoter region of the oncogene TPX2 and is also associated with expression of HM13 in whole blood in the Genotype-Tissue Expression (GTEx) Portal.
Conclusion: We confirmed that known ALL susceptibility loci in children without DS, including IKZF1, CDKN2A, GATA3, PIP4K2A and ARID5B, also confer risk of ALL in children with DS, with CDKN2A showing the largest effect size. We also identified a potentially novel locus associated with ALL susceptibility in DS at chromosome 20q11.21. Additional investigation of these loci is ongoing and may advance our understanding of DS-ALL etiology and biology.
Citation Format: Austin L. Brown, Adam J. de Smith, Michael E. Scheurer, Noah A. Kallsen, Shanna A. Peyton, Gareth E. Davies, Erik A. Ehli, Michael E. Zwick, Naomi Winick, Kelly Maloney, Anne L. Angiolillo, Reuven Schore, MIchael M. Burke, Wanda L. Salzer, Nyla A. Heerema, Andrew J. Carroll, Michael J. Borowitz, Brent L. Wood, William L. Carroll, Elizabeth A. Raetz, Elanor Feingold, Stephanie L. Sherman, Wenjian Yang, Meenakshi Devidas, Kyle Walsh, Andrew T. DeWan, Maria S. Pombo-de-Oliveira, Jeffrey W. Taub, Daniel Sinnett, Jasmine Healy, Jillian M. Birch, Lisa F. Barcellos, Helen Hansen, Ivan Smirnov, Charles G. Mullighan, Stephen P. Hunger, Ching-Hon Pui, Mignon Loh, Joe L. Wiemels, Xiaomei Ma, Catherine Metayer, Beth A. Mueller, Mary V. Relling, Jun J. Yang, Philip J. Lupo, Karen R. Rabin. Genome-wide association study of acute lymphoblastic leukemia in children with Down syndrome [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 222.
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Affiliation(s)
| | | | | | | | | | | | - Erik A. Ehli
- 3Avera Institute for Human Genetics, Sioux Falls, SD
| | | | - Naomi Winick
- 5University of Texas Southwestern Medical Center, Dallas, TX
| | | | | | | | | | | | | | | | | | - Brent L. Wood
- 13University of Washington Medical Center, Seattle, WA
| | | | | | | | | | - Wenjian Yang
- 18St. Jude Children's Research Hospital, Memphis, TN
| | | | | | | | | | | | | | | | | | | | - Helen Hansen
- 2University of California San Francisco, San Francisco, CA
| | - Ivan Smirnov
- 2University of California San Francisco, San Francisco, CA
| | | | | | - Ching-Hon Pui
- 18St. Jude Children's Research Hospital, Memphis, TN
| | - Mignon Loh
- 2University of California San Francisco, San Francisco, CA
| | - Joe L. Wiemels
- 2University of California San Francisco, San Francisco, CA
| | - Xiaomei Ma
- 21Yale School of Public Health, New Haven, CT
| | - Catherine Metayer
- 28University of California Berkeley School of Public Health, Berkeley, CA
| | | | | | - Jun J. Yang
- 18St. Jude Children's Research Hospital, Memphis, TN
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Kelly S, Jahanshad N, Zalesky A, Kochunov P, Agartz I, Alloza C, Andreassen OA, Arango C, Banaj N, Bouix S, Bousman CA, Brouwer RM, Bruggemann J, Bustillo J, Cahn W, Calhoun V, Cannon D, Carr V, Catts S, Chen J, Chen JX, Chen X, Chiapponi C, Cho KK, Ciullo V, Corvin AS, Crespo-Facorro B, Cropley V, De Rossi P, Diaz-Caneja CM, Dickie EW, Ehrlich S, Fan FM, Faskowitz J, Fatouros-Bergman H, Flyckt L, Ford JM, Fouche JP, Fukunaga M, Gill M, Glahn DC, Gollub R, Goudzwaard ED, Guo H, Gur RE, Gur RC, Gurholt TP, Hashimoto R, Hatton SN, Henskens FA, Hibar DP, Hickie IB, Hong LE, Horacek J, Howells FM, Hulshoff Pol HE, Hyde CL, Isaev D, Jablensky A, Jansen PR, Janssen J, Jönsson EG, Jung LA, Kahn RS, Kikinis Z, Liu K, Klauser P, Knöchel C, Kubicki M, Lagopoulos J, Langen C, Lawrie S, Lenroot RK, Lim KO, Lopez-Jaramillo C, Lyall A, Magnotta V, Mandl RCW, Mathalon DH, McCarley RW, McCarthy-Jones S, McDonald C, McEwen S, McIntosh A, Melicher T, Mesholam-Gately RI, Michie PT, Mowry B, Mueller BA, Newell DT, O'Donnell P, Oertel-Knöchel V, Oestreich L, Paciga SA, Pantelis C, Pasternak O, Pearlson G, Pellicano GR, Pereira A, Pineda Zapata J, Piras F, Potkin SG, Preda A, Rasser PE, Roalf DR, Roiz R, Roos A, Rotenberg D, Satterthwaite TD, Savadjiev P, Schall U, Scott RJ, Seal ML, Seidman LJ, Shannon Weickert C, Whelan CD, Shenton ME, Kwon JS, Spalletta G, Spaniel F, Sprooten E, Stäblein M, Stein DJ, Sundram S, Tan Y, Tan S, Tang S, Temmingh HS, Westlye LT, Tønnesen S, Tordesillas-Gutierrez D, Doan NT, Vaidya J, van Haren NEM, Vargas CD, Vecchio D, Velakoulis D, Voineskos A, Voyvodic JQ, Wang Z, Wan P, Wei D, Weickert TW, Whalley H, White T, Whitford TJ, Wojcik JD, Xiang H, Xie Z, Yamamori H, Yang F, Yao N, Zhang G, Zhao J, van Erp TGM, Turner J, Thompson PM, Donohoe G. Widespread white matter microstructural differences in schizophrenia across 4322 individuals: results from the ENIGMA Schizophrenia DTI Working Group. Mol Psychiatry 2018; 23:1261-1269. [PMID: 29038599 PMCID: PMC5984078 DOI: 10.1038/mp.2017.170] [Citation(s) in RCA: 412] [Impact Index Per Article: 68.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/02/2017] [Accepted: 06/07/2017] [Indexed: 12/15/2022]
Abstract
The regional distribution of white matter (WM) abnormalities in schizophrenia remains poorly understood, and reported disease effects on the brain vary widely between studies. In an effort to identify commonalities across studies, we perform what we believe is the first ever large-scale coordinated study of WM microstructural differences in schizophrenia. Our analysis consisted of 2359 healthy controls and 1963 schizophrenia patients from 29 independent international studies; we harmonized the processing and statistical analyses of diffusion tensor imaging (DTI) data across sites and meta-analyzed effects across studies. Significant reductions in fractional anisotropy (FA) in schizophrenia patients were widespread, and detected in 20 of 25 regions of interest within a WM skeleton representing all major WM fasciculi. Effect sizes varied by region, peaking at (d=0.42) for the entire WM skeleton, driven more by peripheral areas as opposed to the core WM where regions of interest were defined. The anterior corona radiata (d=0.40) and corpus callosum (d=0.39), specifically its body (d=0.39) and genu (d=0.37), showed greatest effects. Significant decreases, to lesser degrees, were observed in almost all regions analyzed. Larger effect sizes were observed for FA than diffusivity measures; significantly higher mean and radial diffusivity was observed for schizophrenia patients compared with controls. No significant effects of age at onset of schizophrenia or medication dosage were detected. As the largest coordinated analysis of WM differences in a psychiatric disorder to date, the present study provides a robust profile of widespread WM abnormalities in schizophrenia patients worldwide. Interactive three-dimensional visualization of the results is available at www.enigma-viewer.org.
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Affiliation(s)
- S Kelly
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA,Harvard Medical School, Boston, MA, USA,Imaging Genetics Center, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA. E-mail:
| | - N Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - A Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - P Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - I Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - C Alloza
- University of Edinburgh, Edinburgh, UK
| | | | - C Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - N Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - S Bouix
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - C A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Department of General Practice, The University of Melbourne, Parkville, VIC, Australia,Swinburne University of Technology, Melbourne, VIC, Australia
| | - R M Brouwer
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Bruggemann
- Neuroscience Research Australia and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - J Bustillo
- University of New Mexico, Albuquerque, NM, USA
| | - W Cahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - V Calhoun
- The Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA,The Mind Research Network, Albuquerque, NM, USA
| | - D Cannon
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - V Carr
- Neuroscience Research Australia and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - S Catts
- Discipline of Psychiatry, School of Medicine, University of Queensland, Herston, QLD, Australia
| | - J Chen
- Department of Computer Science and Engineering, The Ohio State University, Columbus, OH, USA
| | - J-x Chen
- Beijing Huilongguan Hospital, Beijing, China
| | - X Chen
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | | | - Kl K Cho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - V Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - A S Corvin
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - B Crespo-Facorro
- University Hospital Marqués de Valdecilla, IDIVAL, Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain
| | - V Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - P De Rossi
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy,Department NESMOS, Faculty of Medicine and Psychology, University ‘Sapienza’ of Rome, Rome, Italy,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - C M Diaz-Caneja
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - E W Dickie
- Center for Addiction and Mental Health, Toronto, ON, Canada
| | - S Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
| | - F-m Fan
- Beijing Huilongguan Hospital, Beijing, China
| | - J Faskowitz
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - H Fatouros-Bergman
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - L Flyckt
- University of New South Wales, School of Psychiatry, Sydney, NSW, Australia,The University of Queensland, Queensland Brain Institute and Centre for Advanced Imaging, Brisbane, QLD, Australia
| | - J M Ford
- University of California, VAMC, San Francisco, CA, USA
| | - J-P Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - M Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Aichi, Japan
| | - M Gill
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - D C Glahn
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - R Gollub
- Harvard Medical School, Boston, MA, USA,Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - E D Goudzwaard
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - H Guo
- Zhumadian Psychiatry Hospital, Henan Province, China
| | - R E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - R C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - T P Gurholt
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - R Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan,Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - S N Hatton
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - F A Henskens
- School of Electrical Engineering and Computer Science, University of Newcastle, Callaghan, NSW, Australia,Health Behaviour Research Group, University of Newcastle, Callaghan, NSW, Australia,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - D P Hibar
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - I B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - L E Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J Horacek
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - F M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - H E Hulshoff Pol
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C L Hyde
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - D Isaev
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - A Jablensky
- University of Western Australia, Perth, WA, Australia
| | - P R Jansen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J Janssen
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain,Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E G Jönsson
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - L A Jung
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - R S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Z Kikinis
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - K Liu
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - P Klauser
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia,Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Clayton, VIC, Australia,Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - C Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - M Kubicki
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J Lagopoulos
- Sunshine Coast Mind and Neuroscience Institute, University of the Sunshine Coast QLD, Australia, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - C Langen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S Lawrie
- University of Edinburgh, Edinburgh, UK
| | - R K Lenroot
- Neuroscience Research Australia and School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - K O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - C Lopez-Jaramillo
- Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Mood Disorder Program, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - A Lyall
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - R C W Mandl
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D H Mathalon
- University of California, VAMC, San Francisco, CA, USA
| | | | - S McCarthy-Jones
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - C McDonald
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - S McEwen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - T Melicher
- Third Faculty of Medicine, Charles University, Prague, Czech Republic,The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - R I Mesholam-Gately
- Harvard Medical School and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess, Medical Center, Boston, MA, USA
| | - P T Michie
- Hunter Medical Research Institute, Newcastle, NSW, Australia,The University of Newcastle, Newcastle, NSW, Australia,Schizophrenia Research Institute, Sydney, NSW, Australia
| | - B Mowry
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia and Queensland Centre for Mental Health Research, Brisbane and Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - B A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - D T Newell
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - P O'Donnell
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - V Oertel-Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - L Oestreich
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia and Queensland Centre for Mental Health Research, Brisbane and Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - S A Paciga
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Schizophrenia Research Institute, Sydney, NSW, Australia,Centre for Neural Engineering (CfNE), Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, VIC, Australia
| | - O Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - G Pearlson
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - G R Pellicano
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - A Pereira
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - F Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy,School of Biomedical Sciences, Faculty of Health, the University of Newcastle, Callaghan, NSW, Australia
| | - S G Potkin
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - A Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - P E Rasser
- Hunter Medical Research Institute, Newcastle, NSW, Australia,Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, NSW, Australia
| | - D R Roalf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - R Roiz
- University Hospital Marqués de Valdecilla, IDIVAL, Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain
| | - A Roos
- SU/UCT MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - D Rotenberg
- Center for Addiction and Mental Health, Toronto, ON, Canada
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - P Savadjiev
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - U Schall
- Hunter Medical Research Institute, Newcastle, NSW, Australia,Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, NSW, Australia
| | - R J Scott
- Hunter Medical Research Institute, Newcastle, NSW, Australia,School of Biomedical Sciences, Faculty of Health, the University of Newcastle, Callaghan, NSW, Australia
| | - M L Seal
- Murdoch Childrens Research Institute, The Royal Children’s Hospital, Parkville, VIC, Australia
| | - L J Seidman
- Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Harvard Medical School and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess, Medical Center, Boston, MA, USA
| | - C Shannon Weickert
- Schizophrenia Research Institute, Sydney, NSW, Australia,Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - C D Whelan
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - M E Shenton
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA,VA Boston Healthcare System, Boston, MA, USA
| | - J S Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - G Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy,Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - F Spaniel
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - E Sprooten
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - M Stäblein
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,Department of Psychiatry and MRC Unit on Anxiety and Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - S Sundram
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Department of Psychiatry, School of Clinical Sciences, Monash University and Monash Health, Clayton, VIC, Australia
| | - Y Tan
- Beijing Huilongguan Hospital, Beijing, China
| | - S Tan
- Beijing Huilongguan Hospital, Beijing, China
| | - S Tang
- Chongqing Three Gorges Central Hospital, Chongqing, China
| | - H S Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - L T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - S Tønnesen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - D Tordesillas-Gutierrez
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain,Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Spain
| | - N T Doan
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - J Vaidya
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - N E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C D Vargas
- Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - D Vecchio
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - D Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - A Voineskos
- Kimel Family Translational Imaging-Genetics Research Laboratory, Campbell Family Mental Health Research Institute, CAMH Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - J Q Voyvodic
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Z Wang
- Beijing Huilongguan Hospital, Beijing, China
| | - P Wan
- Zhumadian Psychiatry Hospital, Henan Province, China
| | - D Wei
- Luoyang Fifth People's Hospital, Henan Province, China
| | - T W Weickert
- Schizophrenia Research Institute, Sydney, NSW, Australia,Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - H Whalley
- University of Edinburgh, Edinburgh, UK
| | - T White
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - T J Whitford
- University of New South Wales, School of Psychiatry, Sydney, NSW, Australia
| | - J D Wojcik
- Harvard Medical School and Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess, Medical Center, Boston, MA, USA
| | - H Xiang
- Chongqing Three Gorges Central Hospital, Chongqing, China
| | - Z Xie
- Worldwide Research and Development, Pfizer, Cambridge, MA, USA
| | - H Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - F Yang
- Beijing Huilongguan Hospital, Beijing, China
| | - N Yao
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - G Zhang
- Department of Computer Science and Electrical Engineering, University of Maryland, Baltimore, MD, USA
| | - J Zhao
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland,School of Psychology, Shaanxi Normal University and Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, Xi’an, Shaanxi, China
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
| | - J Turner
- Psychology Department & Neuroscience Institute, Georgia State University, Atlanta, GA, USA
| | - P M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - G Donohoe
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
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Bender Ignacio RA, Madison AT, Moshiri A, Weiss NS, Mueller BA. A Population-based Study of Perinatal Infection Risk in Women with and without Systemic Lupus Erythematosus and their Infants. Paediatr Perinat Epidemiol 2018; 32:81-89. [PMID: 29194681 PMCID: PMC5771993 DOI: 10.1111/ppe.12430] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Increased risk of adverse birth outcomes is well described in women with systemic lupus erythematosus (SLE), but risk of maternal or infant infection in the peripartum period has not been well studied. We conducted a population-based cohort study of infection risk in women with and without SLE and their infants. METHODS Linked birth-hospital discharge data identified 1297 deliveries to women with SLE and a 4:1 comparison cohort of deliveries to women without SLE in Washington State, 1987-2013. Maternal and infant infections during the first 30 days after delivery were identified. Relative risks (RR) and 95% confidence intervals (CI) were estimated. RESULTS Women with SLE were 1.7 times more likely (95% CI 1.4, 2.0) to have an infection during the birth hospitalisation and more likely to receive antibiotics during labour (RR 1.3, 95% CI 1.1, 1.5), though there was no increased risk of chorioamnionitis in women with SLE. Infants of women with SLE had an increased risk for an infection during the birth hospitalisation (RR 2.2, 95% CI 1.3, 3.5), although the size of the difference was smaller when adjusted for gestational age (RR 1.4, 95% CI 0.9, 2.1). Risks of neonatal infection, sepsis, receipt of antibiotics, and admission to neonatal intensive care were also increased, and were also attenuated after adjustment for gestational age. CONCLUSIONS Women with SLE have an increased risk of peripartum infections and antibiotic exposure. Their neonates have a greater likelihood of infection, much of which is attributable to preterm birth.
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MESH Headings
- Adult
- Anti-Bacterial Agents/therapeutic use
- Case-Control Studies
- Female
- Gestational Age
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/etiology
- Infant, Newborn, Diseases/microbiology
- Infections/epidemiology
- Infections/etiology
- Intensive Care Units, Neonatal/statistics & numerical data
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/microbiology
- Pregnancy
- Pregnancy Complications, Infectious/epidemiology
- Pregnancy Complications, Infectious/etiology
- Risk
- Risk Factors
- Sepsis/epidemiology
- Sepsis/etiology
- Young Adult
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Affiliation(s)
- Rachel A. Bender Ignacio
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle WA
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Amy T. Madison
- Department of Epidemiology, University of Washington, Seattle, WA
- Deschutes Rheumatology, Bend, OR
| | - Ata Moshiri
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA
| | - Noel S. Weiss
- Department of Epidemiology, University of Washington, Seattle, WA
- Public Health Sciences, Fred Hutchinson Cancer Research Center
| | - Beth A. Mueller
- Department of Epidemiology, University of Washington, Seattle, WA
- Public Health Sciences, Fred Hutchinson Cancer Research Center
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Marcotte EL, Druley TE, Johnson KJ, Richardson M, von Behren J, Mueller BA, Carozza S, McLaughlin C, Chow EJ, Reynolds P, Spector LG. Parental Age and Risk of Infant Leukaemia: A Pooled Analysis. Paediatr Perinat Epidemiol 2017; 31:563-572. [PMID: 28940632 PMCID: PMC5901723 DOI: 10.1111/ppe.12412] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Infant leukaemia (IL) is extremely rare with fewer than 150 cases occurring each year in the United States. Little is known about its causes. However, recent evidence supports a role of de novo mutations in IL aetiology. Parental age has been associated with several adverse outcomes in offspring, including childhood cancers. Given the role of older parental age in de novo mutations in offspring, we carried out an analysis of parental age and IL. METHODS We evaluated the relationship between parental age and IL in a case-control study using registry data from New York, Minnesota, California, Texas, and Washington. Records from 402 cases [219 acute lymphoblastic leukaemia (ALL), 131 acute myeloid leukaemia (AML), and 52 other] and 45 392 controls born during 1981-2004 were analysed. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by logistic regression. Estimates were adjusted for infant sex, birth year category, maternal race, state, and mutually adjusted for paternal or maternal age, respectively. RESULTS Infants with mothers' age ≥40 years had an increased risk of developing AML (OR 4.80, 95% CI 1.80, 12.76). In contrast, paternal age <20 was associated with increased risk of ALL (OR 3.69, 95% CI 1.62, 8.41). CONCLUSION This study demonstrates increased risk of infant ALL in relation to young paternal age. Given record linkage, there is little concern with recall or selection bias, although data are lacking on MLL gene status and other potentially important variables. Parent of origin effects, de novo mutations, and/or carcinogenic exposures may be involved in IL aetiology.
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Affiliation(s)
- Erin L Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN,Masonic Cancer Center, Minneapolis, MN,Corresponding author: Erin L Marcotte, PhD, Department of Pediatrics, Division of Epidemiology & Clinical Research, MMC 715, 420 Delaware St. S.E., Minneapolis, MN 55455; phone: 612-626-3281, fax: 612-624-7147,
| | - Todd E Druley
- Departments of Pediatrics and Genetics, Washington University, St Louis, MO
| | - Kimberly J Johnson
- Brown School and Department of Pediatrics, Washington University, St Louis, MO
| | - Michaela Richardson
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | | | - Beth A Mueller
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Susan Carozza
- Epidemiology Program, College of Public Health & Human Sciences, Oregon State University, Corvallis, OR
| | - Colleen McLaughlin
- Department of Population Health Sciences, Albany College of Pharmacy and Health Sciences, Albany, NY
| | - Eric J Chow
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN,Masonic Cancer Center, Minneapolis, MN
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Pocobelli G, Dublin S, Enquobahrie DA, Mueller BA. Birth Weight and Birth Weight for Gestational Age in Relation to Risk of Hospitalization with Primary Hypertension in Children and Young Adults. Matern Child Health J 2017; 20:1415-23. [PMID: 26979614 DOI: 10.1007/s10995-016-1939-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction Low birth weight has been associated with an increased risk of hypertension in children. Less clear is whether high birth weight is also associated with risk. We evaluated overall and age-specific risks of primary hypertension in children and young adults associated with birth weight and birth weight for gestational age. Methods We conducted a population-based case-control study using linked Washington State birth certificate and hospital discharge data from 1987 to 2003. Cases were persons hospitalized with primary hypertension at 8-24 years of age (n = 533). Controls were randomly selected among those born in the same years who were not hospitalized with hypertension (n = 25,966). Results Birth weight was not related to risk of primary hypertension overall, except for a suggestion of an increased risk associated with birth weight ≥4500 g relative to 3500-3999 g (odds ratio (OR) 1.55; 95 % confidence interval (CI) 0.96-2.49). Compared to children born appropriate weight for gestational age, those born small (SGA) (OR 1.32; 95 % CI 1.02-1.71) and large for gestational age (LGA) (OR 1.30; 95 % CI 1.00-1.71) had increased risks of primary hypertension. These overall associations were due to increased risks of hypertension at 15-24 years of age; no associations were observed with risk at 8-14 years of age. Discussion In this study, both SGA and LGA were associated with increased risks of primary hypertension. Our findings suggest a possible nonlinear (U-shaped) association between birth weight for gestational age and primary hypertension risk in children and young adults.
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Affiliation(s)
- Gaia Pocobelli
- Department of Epidemiology, University of Washington, Box 357236, 1959 NE Pacific Street, Health Sciences Building F-262, Seattle, WA, 98195-7236, USA.
| | - Sascha Dublin
- Department of Epidemiology, University of Washington, Box 357236, 1959 NE Pacific Street, Health Sciences Building F-262, Seattle, WA, 98195-7236, USA
- Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA
| | - Daniel A Enquobahrie
- Department of Epidemiology, University of Washington, Box 357236, 1959 NE Pacific Street, Health Sciences Building F-262, Seattle, WA, 98195-7236, USA
- Cardiovascular Health Research Unit, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Beth A Mueller
- Department of Epidemiology, University of Washington, Box 357236, 1959 NE Pacific Street, Health Sciences Building F-262, Seattle, WA, 98195-7236, USA
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Box 358080, 1100 Fairview Ave N., Arnold Building, Mailstop: M4-C308, P.O. Box 1192024, Seattle, WA, 98109-1024, USA
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44
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Lomakina O, Alekseeva E, Valieva S, Bzarova T, Nikishina I, Zholobova E, Rodionovskaya S, Kaleda M, Nakagishi Y, Shimizu M, Mizuta M, Yachie A, Sugita Y, Okamoto N, Shabana K, Murata T, Tamai H, Smith EM, Yin P, Jorgensen AL, Beresford MW, Smith EM, Eleuteri A, Goilav B, Lewandowski L, Phuti A, Wahezi D, Rubinstein T, Jones C, Newland P, Marks S, Corkhill R, Ekdawy D, Pilkington C, Tullus K, Putterman C, Scott C, Fisher AC, Beresford MW, Smith EM, Lewandowski L, Phuti A, Jorgensen A, Scott C, Beresford MW, Batu ED, Kosukcu C, Taskiran E, Akman S, Ozturk K, Sozeri B, Unsal E, Ekinci Z, Bilginer Y, Alikasifoglu M, Ozen S, Lythgoe H, Beresford MW, Brunner HI, Gulati G, Jones JT, Altaye M, Eaton J, Difrancesco M, Yeo JG, Leong J, Bathi LDT, Arkachaisri T, Albani S, Abdelrahman N, Beresford MW, Leone V, Groot N, Shaikhani D, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Wright RD, Smith EM, Beresford MW, Abdawani R, Al Shaqshi L, Al Zakwani I, Gormezano NW, Kern D, Pereira OL, Esteves GCC, Sallum AM, Aikawa NE, Pereira RM, Silva CA, Bonfa E, Beckmann J, Bartholomä N, Foeldvari I, Bohnsack J, Milojevic D, Rabinovich C, Kingsbury D, Marzan K, Quartier P, Minden K, Chalom E, Horneff G, Venhoff N, Kuester RM, Dare J, Heinrich M, Kupper H, Kalabic J, Martini A, Brunner HI, Consolaro A, Horneff G, Burgos-Vargas R, Henneke P, Constantin T, Foeldvari I, Vojinovic J, Dehoorne J, Panaviene V, Susic G, Stanevica V, Kobusinska K, Zuber Z, Mouy R, Salzer U, Rumba-Rozenfelde I, Dolezalova P, Job-Deslandre C, Wulffraat N, Pederson R, Bukowski J, Hinnershitz T, Vlahos B, Martini A, Ruperto N, Janda A, Keskitalo P, Kangas S, Vähäsalo P, Valencia RAC, Martino D, Munro J, Ponsonby AL, Chiaroni-Clarke R, Meyer B, Allen RC, Boteanu AL, Akikusa JD, Craig JM, Saffrey R, Ellis JA, Davì S, Minoia F, Horne A, Wulffraat N, Wouters C, Wallace C, Corral SG, Uziel Y, Sterba G, Schneider R, Russo R, Ramanan AV, Schmid JP, Ozen S, Nichols KE, 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Sundberg E, Horne A, Ehl S, Ammann S, Lehmberg K, De Benedetti F, Beutel K, Foell D, Minoia F, Horne A, Bovis F, Davì S, Pagani L, Espada G, Gao YJ, Insalaco A, Lehmberg K, Sanner H, Shenoi S, Weitzman S, Ruperto N, Martini A, Cron RQ, Ravelli A, Prencipe G, Caiello I, Pascarella A, Bracaglia C, Ferlin WG, Chatel L, Strippoli R, de Min C, De Benedetti F, Jacqmin P, De Graaf K, Ballabio M, Nelson R, Johnson Z, Ferlin W, Lapeyre G, de Benedetti F, Cristina DM, Wakiguchi H, Hasegawa S, Hirano R, Okazaki F, Nakamura T, Kaneyasu H, Ohga S, Yamazaki K, Nozawa T, Kanetaka T, Ito S, Yokota S, McLellan K, MacGregor I, Martin N, Davidson J, Kuemmerle-Deschner J, Hansmann S, Wulffraat N, Eikelberg A, Haug I, Schuller S, Benseler SM, Nazarova LS, Danilko KV, Malievsky VA, Viktorova TV, Mauro A, Omoyinmi E, Barnicoat A, Brogan P, Foley C, Killeen O, MacDermott E, Veale D, Foley C, Killeen O, MacDermott E, Veale D, Gomes SM, Omoyinmi E, Hurst J, Canham N, Eleftheriou D, Klein N, Lacassagne S, Brogan P, Wiener A, Hügle B, Denecke B, Costa-Filho I, Haas JP, Tenbrock K, Popp D, Boltjes A, Rühle F, Herresthal S, de Jager W, van Wijk F, Schultze J, Stoll M, Klotz L, Vogl T, Roth J, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Sánchez AMM, Borrell RP, Barril SM, Gallo MM, Caballero CM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Giner T, Hackl L, Albrecht J, Würzner R, Brunner J, Pastore S, Minute M, Parentin F, Tesser A, Nocerino A, Taddio A, Tommasini A, Nørgaard M, Herlin T, Alberdi-Saugstrup M, Zak MS, Nielsen SM, Herlin T, Nordal E, Berntson L, Fasth A, Rygg M, Müller KG, Avramovič MZ, Dolžan V, Toplak N, Avčin T, Ruperto N, Lovell DJ, Wallace C, Toth M. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461533 DOI: 10.1186/s12969-017-0142-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bell SW, Shenoi S, Nelson JL, Bhatti P, Mueller BA. Juvenile idiopathic arthritis in relation to perinatal and maternal characteristics: a case control study. Pediatr Rheumatol Online J 2017; 15:36. [PMID: 28494794 PMCID: PMC5425970 DOI: 10.1186/s12969-017-0167-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/01/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Existing data on associations between maternal and early childhood exposures and juvenile idiopathic arthritis (JIA) risk is scant and inconsistent with previous studies showing potential role for prematurity, number of siblings and infections. We explored JIA and International League of Associations for Rheumatology (ILAR) JIA categories in relation to selected infant (birthweight, size-for-gestational-age, gestational age), and maternal (parity, delivery type, prior fetal loss) characteristics that may be markers for exposures related to two pathways (hygiene hypothesis, microchimerism) potentially associated with autoimmune disorder occurrence. METHODS A case-control analysis with 1,234 JIA cases and 5,993 birth year-matched controls was conducted. Exposure information was obtained from WA state birth certificates. Multivariable logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for associations with maternal and early life exposures for JIA and JIA categories. RESULTS Greater maternal parity was associated with a decreased OR for JIA (most marked for persistent oligoarticular JIA, OR 0.32, 95% CI 0.15; 0.71, p for trend = 0.0001). Prior fetal loss (except for oligoarticular JIA) was associated with an increased OR for JIA. Prematurity was associated with increased risk of enthesitis related arthritis (OR 1.9, 95% CI: 1.3-2.9) and rheumatoid factor positive polyarticular JIA (OR 2.2, 95% CI: 1.0-4.8). CONCLUSIONS We observed associations of selected maternal factors with JIA, some of which varied across JIA categories. The findings of decreased ORs for JIA in relation to greater maternal parity may be consistent with the hygiene and microchimerism hypotheses. Future studies with biomarkers relevant to these hypotheses will help elucidate any associations.
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Affiliation(s)
- Samantha W. Bell
- 0000000122986657grid.34477.33Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA USA ,0000 0001 2297 6811grid.266102.1School of Medicine, University of California, San Francisco, San Francisco, CA USA ,0000 0001 2297 6811grid.266102.1University of California, San Francisco, 513 Parnassus Ave., Room S245, San Francisco, CA 94143 USA
| | - Susan Shenoi
- Department of Pediatrics, Division of Rheumatology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA USA
| | - J. Lee Nelson
- 0000 0001 2180 1622grid.270240.3Public Health Sciences Division, Fred Hutchison Cancer Research Center, Seattle, WA USA
| | - Parveen Bhatti
- 0000000122986657grid.34477.33Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA USA ,0000 0001 2180 1622grid.270240.3Public Health Sciences Division, Fred Hutchison Cancer Research Center, Seattle, WA USA
| | - Beth A. Mueller
- 0000000122986657grid.34477.33Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA USA ,0000 0001 2180 1622grid.270240.3Public Health Sciences Division, Fred Hutchison Cancer Research Center, Seattle, WA USA
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Ncube CN, Mueller BA. Daughters of Mothers Who Smoke: A Population-based Cohort Study of Maternal Prenatal Tobacco use and Subsequent Prenatal Smoking in Offspring. Paediatr Perinat Epidemiol 2017; 31:14-20. [PMID: 27935093 PMCID: PMC5195902 DOI: 10.1111/ppe.12330] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Prenatal exposure to tobacco is associated with adverse health outcomes for the mother and child, and has been associated with an increased risk of tobacco smoking and nicotine dependence in offspring. The objective of this study was to examine the risk of prenatal smoking, among daughters, associated with maternal prenatal smoking. METHODS We used a population-based cohort study design, with linked vital records data of mothers and daughters delivering 1984-96 and 1996-2013, respectively, in Washington State. The exposure of interest was mothers' prenatal smoking (any vs. no smoking at any time during pregnancy), while the outcome was daughters' prenatal smoking (similarly assessed). We used multivariable log-binomial regression to obtain estimates of the relative risk (RR) and 95% confidence interval (CI). RESULTS Daughters exposed to maternal prenatal smoking were more likely to smoke during their pregnancy, compared to unexposed daughters (RR 1.78, 95% CI 1.72, 1.84, adjusted for the year the daughter delivered, her marital status and educational attainment, and the mothers' race/ethnicity). CONCLUSIONS In this relatively young population, we found that daughters exposed to maternal prenatal smoking have an increased risk of smoking later on during their own pregnancy, emphasizing the importance of exposures during the prenatal period. The mechanisms leading to prenatal smoking are multifactorial and likely include behavioural, genetic, epigenetic and environmental factors. An understanding of this risk factor for prenatal smoking may guide health care providers to better target smoking cessation interventions to at-risk populations.
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Affiliation(s)
- Collette N. Ncube
- Department of Epidemiology, School of Public Health, University of
Washington, 1959 NE Pacific Street, Health Sciences Building, Seattle, WA
98195-7236
| | - Beth A. Mueller
- Department of Epidemiology, School of Public Health, University of
Washington, 1959 NE Pacific Street, Health Sciences Building, Seattle, WA
98195-7236,Public Health Sciences Division, Fred Hutchinson Cancer Research
Center, PO Box 19024, Mailstop M4-C308, Seattle, WA 98109-1024
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Chow EJ, Cushing-Haugen KL, Cheng GS, Boeckh M, Khera N, Lee SJ, Leisenring WM, Martin PJ, Mueller BA, Schwartz SM, Baker KS. Morbidity and Mortality Differences Between Hematopoietic Cell Transplantation Survivors and Other Cancer Survivors. J Clin Oncol 2016; 35:306-313. [PMID: 27870568 DOI: 10.1200/jco.2016.68.8457] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Purpose To compare the risks of serious health outcomes among hematopoietic cell transplantation (HCT) survivors versus a matched population of patients with cancer who did not undergo HCT, where the primary difference may be exposure to HCT. Methods Two-year HCT survivors treated at a comprehensive cancer center from 1992 through 2009 who were Washington State residents (n = 1,792; 52% allogeneic and 90% hematologic malignancies) were frequency matched by demographic characteristics and underlying cancer diagnosis (as applicable) to non-HCT 2-year cancer survivors, using the state cancer registry (n = 5,455) and the general population (n = 16,340) using driver's license files. Late outcomes for all three cohorts were ascertained from the state hospital discharge and death registries; subsequent cancers were ascertained from the state cancer registry. Results After median follow-up of 7.1 years, HCT survivors experienced significantly greater rates of hospitalization compared with matched non-HCT cancer survivors (280 v 173 episodes per 1,000 person-years, P < .001) and greater all-cause mortality (hazard ratio [HR], 1.1; 95% CI, 1.01 to 1.3). HCT survivors had more hospitalizations or death with infections (10-year cumulative incidence, 31% v 22%; HR, 1.4; 95% CI, 1.3 to 1.6) and respiratory complications (cumulative incidence, 27% v 20%; HR, 1.4; 95% CI, 1.2 to 1.5). Risks of digestive, skin, and musculoskeletal complications also were greater among HCT versus non-HCT cancer survivors. The two groups had similar risks of circulatory complications and second cancers. Both HCT and non-HCT cancer survivors had significantly greater 10-year cumulative incidences of all major organ-system outcomes versus the general population. Conclusion History of HCT was associated with late morbidity and mortality among cancer survivors. In particular, clinicians who care for HCT survivors should be aware of their high rates of late respiratory and infectious complications.
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Affiliation(s)
- Eric J Chow
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - Kara L Cushing-Haugen
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - Guang-Shing Cheng
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - Michael Boeckh
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - Nandita Khera
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - Stephanie J Lee
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - Wendy M Leisenring
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - Paul J Martin
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - Beth A Mueller
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - Stephen M Schwartz
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
| | - K Scott Baker
- Eric J. Chow, Kara L. Cushing-Haugen, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Wendy M. Leisenring, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, Fred Hutchinson Cancer Research Center; Eric J. Chow, Guang-Shing Cheng, Michael Boeckh, Stephanie J. Lee, Paul J. Martin, Beth A. Mueller, Stephen M. Schwartz, and K. Scott Baker, University of Washington, Seattle, WA; and Nandita Khera, Mayo Clinic, Scottsdale, AZ
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Zamora-Kapoor A, Nelson LA, Buchwald DS, Walker LR, Mueller BA. Pre-eclampsia in American Indians/Alaska Natives and Whites: The Significance of Body Mass Index. Matern Child Health J 2016; 20:2233-2238. [PMID: 27461024 PMCID: PMC5106312 DOI: 10.1007/s10995-016-2126-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction The prevalence of pre-eclampsia, a major cause of maternal morbidity, varies by race, being greater in African Americans, and lower in Asians and Hispanics than in White women. Little is known about its prevalence in American Indians/Alaska Natives (AI/ANs). We estimated pre-eclampsia risk in AI/ANs compared to Whites, with consideration of the potential effect of obesity, a major risk factor for pre-eclampsia, and a condition disproportionately affecting AI/AN women. Methods This retrospective cohort study of linked birth-hospital discharge data from Washington State (2003-2013) included all AI/AN women and a sample of White first-time mothers with singleton deliveries. Logistic regression was used to estimate odds ratio (OR) and 95 % confidence intervals (CI) for pre-eclampsia risk in AI/ANs compared to Whites, first controlling for several important risk factors, and subsequently with additional adjustment for pre-pregnancy body mass index (BMI). Results AI/ANs had an increased risk of pre-eclampsia compared to Whites after controlling for all covariates except BMI (OR 1.17, 95 % CI 1.06-1.29). After further adjustment for BMI, the racial disparity in pre-eclampsia risk was greatly attenuated (OR 1.05, 95 % CI 0.95-1.16). Discussion This population-based study suggests that any increased risk in AI/ANs relative to Whites may be at least partly due to differences in BMI.
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Affiliation(s)
- Anna Zamora-Kapoor
- Initiative for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA.
- Department of Pediatrics, University of Washington, Seattle, WA, USA.
| | - Lonnie A Nelson
- Initiative for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA
| | - Dedra S Buchwald
- Initiative for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA
- College of Medicine, Washington State University, Spokane, WA, USA
| | - Leslie R Walker
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Beth A Mueller
- Department of Epidemiology, University of Washington, Seattle, WA, USA
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Metayer C, Petridou E, Aranguré JMM, Roman E, Schüz J, Magnani C, Mora AM, Mueller BA, de Oliveira MSP, Dockerty JD, McCauley K, Lightfoot T, Hatzipantelis E, Rudant J, Flores-Lujano J, Kaatsch P, Miligi L, Wesseling C, Doody DR, Moschovi M, Orsi L, Mattioli S, Selvin S, Kang AY, Clavel J. Parental Tobacco Smoking and Acute Myeloid Leukemia: The Childhood Leukemia International Consortium. Am J Epidemiol 2016; 184:261-73. [PMID: 27492895 PMCID: PMC4983653 DOI: 10.1093/aje/kww018] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/15/2016] [Indexed: 12/17/2022] Open
Abstract
The association between tobacco smoke and acute myeloid leukemia (AML) is well established in adults but not in children. Individual-level data on parental cigarette smoking were obtained from 12 case-control studies from the Childhood Leukemia International Consortium (CLIC, 1974-2012), including 1,330 AML cases diagnosed at age <15 years and 13,169 controls. We conducted pooled analyses of CLIC studies, as well as meta-analyses of CLIC and non-CLIC studies. Overall, maternal smoking before, during, or after pregnancy was not associated with childhood AML; there was a suggestion, however, that smoking during pregnancy was associated with an increased risk in Hispanics (odds ratio = 2.08, 95% confidence interval (CI): 1.20, 3.61) but not in other ethnic groups. By contrast, the odds ratios for paternal lifetime smoking were 1.34 (95% CI: 1.11, 1.62) and 1.18 (95% CI: 0.92, 1.51) in pooled and meta-analyses, respectively. Overall, increased risks from 1.2- to 1.3-fold were observed for pre- and postnatal smoking (P < 0.05), with higher risks reported for heavy smokers. Associations with paternal smoking varied by histological type. Our analyses suggest an association between paternal smoking and childhood AML. The association with maternal smoking appears limited to Hispanic children, raising questions about ethnic differences in tobacco-related exposures and biological mechanisms, as well as study-specific biases.
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Affiliation(s)
- Catherine Metayer
- Correspondence to Dr. Catherine Metayer, School of Public Health, University of California, Berkeley, 1995 University Avenue, Suite 460, Berkeley, CA 94704-7392 (e-mail: )
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Tully HM, Kukull WA, Mueller BA. Clinical and Surgical Factors Associated With Increased Epilepsy Risk in Children With Hydrocephalus. Pediatr Neurol 2016; 59:18-22. [PMID: 27050777 PMCID: PMC6464813 DOI: 10.1016/j.pediatrneurol.2016.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/17/2016] [Accepted: 02/20/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Children with hydrocephalus are at risk for epilepsy both due to their underlying condition and as a consequence of surgical treatment; however, the relative contributions of these factors remain unknown. OBJECTIVE The authors sought to characterize epilepsy among children with infancy-onset hydrocephalus and to examine the risks of epilepsy associated with hydrocephalus subtype and with factors related to surgical treatment. METHODS We conducted a longitudinal cohort study of all children with infancy-onset hydrocephalus treated at a major regional children's hospital during 2002 to 2012, with follow-up to ascertain risk factors and epilepsy outcome through April 2015. Poisson regression was used to calculate adjusted risk ratios and 95% confidence intervals for associations. RESULTS Among 379 children with hydrocephalus, 86 (23%) developed epilepsy (mean onset age = 2.7 years), almost one fifth of whom had a history of infantile spasms. Relative to spina bifida-associated hydrocephalus, children with other major hydrocephalus subtypes had fourfold higher risks of developing epilepsy. Among children who underwent surgery, surgical infection doubled the risk of epilepsy (risk ratio = 2.0, 95% confidence interval = 1.4 to 3.0). Epilepsy was associated with surgical failure for intracranial reasons but not extracranial reasons (risk ratio = 1.7, 95% confidence interval = 1.1 to 2.7; risk ratio = 1.1, 95% confidence interval = 0.7 to 1.9, respectively). CONCLUSIONS Epilepsy is common among children with hydrocephalus. Compared with children with spina bifida-associated hydrocephalus, children with other major hydrocephalus subtypes have a markedly increased risk of epilepsy. Surgical infection doubles the risk of epilepsy.
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Affiliation(s)
- Hannah M Tully
- Division of Pediatric Neurology, University of Washington, Seattle, Washington.
| | - Walter A Kukull
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Beth A Mueller
- Department of Epidemiology, University of Washington, Seattle, Washington; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
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