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Duarte-Rodríguez DA, Flores-Lujano J, McNally RJQ, Pérez-Saldivar ML, Jiménez-Hernández E, Martín-Trejo JA, Espinoza-Hernández LE, Medina-Sanson A, Paredes-Aguilera R, Merino-Pasaye LE, Velázquez-Aviña MM, Torres-Nava JR, Espinosa-Elizondo RM, Amador-Sánchez R, Dosta-Herrera JJ, Mondragón-García JA, González-Ulibarri JE, Martínez-Silva SI, Espinoza-Anrubio G, Paz-Bribiesca MM, Salcedo-Lozada P, Landa-García RÁ, Ramírez-Colorado R, Hernández-Mora L, Santamaría-Ascencio M, López-Loyola A, Godoy-Esquivel AH, García-López LR, Anguiano-Ávalos AI, Mora-Rico K, Castañeda-Echevarría A, Rodríguez-Jiménez R, Cibrian-Cruz JA, Solís-Labastida KA, Cárdenas-Cardos R, López-Santiago N, Flores-Villegas LV, Peñaloza-González JG, González-Ávila AI, Sánchez-Ruiz M, Rivera-Luna R, Rodríguez-Villalobos LR, Hernández-Pérez F, Olvera-Durán JÁ, García-Cortés LR, Mata-Rocha M, Sepúlveda-Robles OA, Bekker-Méndez VC, Jiménez-Morales S, Meléndez-Zajgla J, Rosas-Vargas H, Vega E, Núñez-Enríquez JC, Mejía-Aranguré JM. Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia. Front Oncol 2024; 14:1304633. [PMID: 38420017 PMCID: PMC10899509 DOI: 10.3389/fonc.2024.1304633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
Background A heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC). Methods A population-based case-control study was conducted. Children <18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff's spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained. Results A total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p<0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed. Conclusions The identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL.
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Affiliation(s)
- David Aldebarán Duarte-Rodríguez
- División de Desarrollo de la Investigación en Salud, Coordinación de Investigación en Salud, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Richard J. Q. McNally
- Population Health Sciences Institute, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Elva Jiménez-Hernández
- Servicio de Oncología, Hospital Pediátrico “Moctezuma”, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematología, Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Laura Eugenia Espinoza-Hernández
- Servicio de Hematología, Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Aurora Medina-Sanson
- Departamento de Hemato-Oncología, Hospital Infantil de Mexico “Federico Gómez”, Secretaría de Salud (SS), Ciudad de Mexico, Mexico
| | | | - Laura Elizabeth Merino-Pasaye
- Servicio de Hematología Pediátrica, Centro Médico Nacional (CMN) “20 de Noviembre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Ciudad de Mexico, Mexico
| | | | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediátrico “Moctezuma”, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | | | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, Hospital General Regional (HGR) No 1 “Dr Carlos MacGregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Juan José Dosta-Herrera
- Servicio de Cirugía Pediátrica, Hospital General “Gaudencio González Garza”, Centro Médico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Javier Anastacio Mondragón-García
- Servicio de Cirugía Pediátrica, Hospital General Regional (HGR) No 1 “Dr Carlos MacGregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | | | - Sofía Irene Martínez-Silva
- Hospital Pediátrico de Iztapalapa, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Gilberto Espinoza-Anrubio
- Servicio de Pediatría, Hospital General Zona (HGZ) No 8 “Dr Gilberto Flores Izquierdo”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | | | - Perla Salcedo-Lozada
- Hospital General de Ecatepec “Las Américas”, Instituto de Salud del Estado de Mexico (ISEM), Ecatepec de Morelos, Mexico
| | | | - Rosario Ramírez-Colorado
- Hospital Pediátrico “La Villa”, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Luis Hernández-Mora
- Hospital Pediátrico “San Juan de Aragón”, Secretar´ıa de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Marlene Santamaría-Ascencio
- Servicio de Pediatría, Hospital General Regional (HGR) No 72 “Lic. Vicente Santos Guajardo”, Instituto Mexicano del Seguro Social (IMSS), Tlalnepantla de Baz, Mexico
| | - Anselmo López-Loyola
- Servicio de Cirugía Pediátrica, Hospital General Zona (HGZ) No. 32, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Arturo Hermilo Godoy-Esquivel
- Servicio de Cirugía Pediátrica, Hospital Pediátrico de Moctezuma, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Luis Ramiro García-López
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Alison Ireri Anguiano-Ávalos
- Urgencias Pediátricas, Hospital General Zona (HGZ) No 47, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Karina Mora-Rico
- Servicio de Cirugía Pediátrica, Hospital Regional “1° Octubre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Instituto Politécnico Nacional 1669, Revolución Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Alejandro Castañeda-Echevarría
- Servicio de Pediatría, Hospital General Regional (HGR) No. 25 Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Roberto Rodríguez-Jiménez
- Servicio de Pediatría, Hospital General de Zona con Medicina Familiar (HGZMF) No. 29, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - José Alberto Cibrian-Cruz
- Servicio de Cirugía Pediátrica, Hospital General Zona (HGZ) No. 27, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Karina Anastacia Solís-Labastida
- Servicio de Hematología, Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Rocío Cárdenas-Cardos
- Servicio de Oncología, Instituto Nacional de Pediatr´ıa (INP), SS, Ciudad de Mexico, Mexico
| | - Norma López-Santiago
- Servicio de Hematología, Instituto Nacional de Pediatría (INP), SS, Ciudad de Mexico, Mexico
| | - Luz Victoria Flores-Villegas
- Servicio de Hematología Pediátrica, Centro Médico Nacional (CMN) “20 de Noviembre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Ciudad de Mexico, Mexico
| | - José Gabriel Peñaloza-González
- Servicio de Onco-Pediatría, Hospital Juárez de Mexico, SS, Instituto Politécnico Nacional 5160, Ciudad de Mexico, Mexico
| | - Ana Itamar González-Ávila
- Servicio de Hematología Pediátrica, Hospital General Regional (HGR) No 1 “Dr Carlos MacGregor Sánchez Navarro” Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Martin Sánchez-Ruiz
- Hospital General de Ecatepec “Las Américas”, Instituto de Salud del Estado de Mexico (ISEM), Ecatepec de Morelos, Mexico
| | - Roberto Rivera-Luna
- Servicio de Oncología, Instituto Nacional de Pediatr´ıa (INP), SS, Ciudad de Mexico, Mexico
| | - Luis Rodolfo Rodríguez-Villalobos
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, Secretaría de Salud de la Ciudad de Mexico (SEDESA), Ciudad de Mexico, Mexico
| | - Francisco Hernández-Pérez
- Urgencias Pediátricas, Hospital General Zona (HGZ) No 47, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Jaime Ángel Olvera-Durán
- Servicio de Cirugía Pediátrica, Hospital Regional “1° Octubre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Instituto Politécnico Nacional 1669, Revolución Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Luis Rey García-Cortés
- Delegación Regional Estado de Mexico Oriente, Instituto Mexicano del Seguro Social (IMSS), Naucalpan de Juárez, Mexico
| | - Minerva Mata-Rocha
- Laboratorio de Biología Molecular, Unidad Me´dica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Me´dico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Omar Alejandro Sepúlveda-Robles
- Laboratorio de Biología Molecular, Unidad Me´dica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Me´dico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Vilma Carolina Bekker-Méndez
- Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología “Dr Daniel Méndez Hernández”, Centro Me´dico Nacional (CMN) “La Raza”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Silvia Jiménez-Morales
- Laboratory of Innovation and Precision Medicine, Nucleus A. Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de Mexico, Mexico
| | - Jorge Meléndez-Zajgla
- Laboratorio de Genómica Funcional del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de Mexico, Mexico
| | - Haydée Rosas-Vargas
- Unidad de Investigación Médica en Genética Humana, Unidad Me´dica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Me´dico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Elizabeth Vega
- Instituto de Ciencias de la Atmósfera y Cambio Climático, Universidad Nacional Autónoma de Mexico (UNAM), Ciudad de Mexico, Mexico
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
- División de Investigación en Salud, Unidad Me´dica de Alta Especialidad (UMAE) Hospital de Pediatría “Dr. Silvestre Frenk Freund”, Centro Me´dico Nacional (CMN) “Siglo XXI”, Instituto Mexicano del Seguro Social (IMSS), Ciudad de Mexico, Mexico
| | - Juan Manuel Mejía-Aranguré
- Laboratorio de Genómica Funcional del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de Mexico, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de Mexico (UNAM), Ciudad de Mexico, Mexico
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Flores-Lujano J, Duarte-Rodríguez DA, Jiménez-Hernández E, Martín-Trejo JA, Allende-López A, Peñaloza-González JG, Pérez-Saldivar ML, Medina-Sanson A, Torres-Nava JR, Solís-Labastida KA, Flores-Villegas LV, Espinosa-Elizondo RM, Amador-Sánchez R, Velázquez-Aviña MM, Merino-Pasaye LE, Núñez-Villegas NN, González-Ávila AI, del Campo-Martínez MDLÁ, Alvarado-Ibarra M, Bekker-Méndez VC, Cárdenas-Cardos R, Jiménez-Morales S, Rivera-Luna R, Rosas-Vargas H, López-Santiago NC, Rangel-López A, Hidalgo-Miranda A, Vega E, Mata-Rocha M, Sepúlveda-Robles OA, Arellano-Galindo J, Núñez-Enríquez JC, Mejía-Aranguré JM. Persistently high incidence rates of childhood acute leukemias from 2010 to 2017 in Mexico City: A population study from the MIGICCL. Front Public Health 2022; 10:918921. [PMID: 36187646 PMCID: PMC9518605 DOI: 10.3389/fpubh.2022.918921] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/09/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction Over the years, the Hispanic population living in the United States has consistently shown high incidence rates of childhood acute leukemias (AL). Similarly, high AL incidence was previously observed in Mexico City (MC). Here, we estimated the AL incidence rates among children under 15 years of age in MC during the period 2010-2017. Methods The Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia conducted a study gathering clinical and epidemiological information regarding children newly diagnosed with AL at public health institutions of MC. Crude age incidence rates (cAIR) were obtained. Age-standardized incidence rates worldwide (ASIRw) and by municipalities (ASIRm) were calculated by the direct and indirect methods, respectively. These were reported per million population <15 years of age; stratified by age group, sex, AL subtypes, immunophenotype and gene rearrangements. Results A total of 903 AL cases were registered. The ASIRw was 63.3 (cases per million) for AL, 53.1 for acute lymphoblastic leukemia (ALL), and 9.4 for acute myeloblastic leukemia. The highest cAIR for AL was observed in the age group between 1 and 4 years (male: 102.34 and female: 82.73). By immunophenotype, the ASIRw was 47.3 for B-cell and 3.7 for T-cell. The incidence did not show any significant trends during the study period. The ASIRm for ALL were 68.6, 66.6 and 62.8 at Iztacalco, Venustiano Carranza and Benito Juárez, respectively, whereas, other municipalities exhibited null values mainly for AML. Conclusion The ASIRw for childhood AL in MC is among the highest reported worldwide. We observed spatial heterogeneity of rates by municipalities. The elevated AL incidence observed in Mexican children may be explained by a combination of genetic background and exposure to environmental risk factors.
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Affiliation(s)
- Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Elva Jiménez-Hernández
- Servicio de Hematología Pediátrica, Centro Médico Nacional “La Raza, ” Hospital General “Gaudencio González Garza, ” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico,Servicio de Oncología, Hospital Pediátrico de Moctezuma, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematología Pediátrica, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional “Siglo XXI, ” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Aldo Allende-López
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | | | - María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Aurora Medina-Sanson
- Departamento de HematoOncología, Hospital Infantil de México Federico Gómez, Secretaría de Salud (SS), Mexico City, Mexico
| | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediátrico de Moctezuma, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Karina Anastacia Solís-Labastida
- Servicio de Hematología Pediátrica, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional “Siglo XXI, ” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Luz Victoria Flores-Villegas
- Servicio de Hematología Pediátrica, Centro Médico Nacional “20 de Noviembre, ” Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | | | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, Hospital General Regional 1 “Dr. Carlos McGregor Sánchez Navarro, ” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | | | - Laura Elizabeth Merino-Pasaye
- Servicio de Hematología Pediátrica, Centro Médico Nacional “20 de Noviembre, ” Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Nora Nancy Núñez-Villegas
- Servicio de Hematología Pediátrica, Centro Médico Nacional “La Raza, ” Hospital General “Gaudencio González Garza, ” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Ana Itamar González-Ávila
- Servicio de Hematología Pediátrica, Hospital General Regional 1 “Dr. Carlos McGregor Sánchez Navarro, ” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - María de los Ángeles del Campo-Martínez
- Servicio de Hematología Pediátrica, Centro Médico Nacional “La Raza, ” Hospital General “Gaudencio González Garza, ” Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Martha Alvarado-Ibarra
- Servicio de Hematología Pediátrica, Centro Médico Nacional “20 de Noviembre, ” Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Vilma Carolina Bekker-Méndez
- Hospital de Infectología “Dr. Daniel Méndez Hernández, ” “La Raza, ” Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunología e Infectología, Mexico City, Mexico
| | - Rocío Cárdenas-Cardos
- Servicio de Oncología Pediátrica, Instituto Nacional de Pediatría, Secretaría de Salud (SS), Mexico City, Mexico
| | - Silvia Jiménez-Morales
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Roberto Rivera-Luna
- Servicio de Oncología Pediátrica, Instituto Nacional de Pediatría, Secretaría de Salud (SS), Mexico City, Mexico
| | - Haydee Rosas-Vargas
- Unidad de Investigación Médica en Genética Humana, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Norma C. López-Santiago
- Servicio de Hematología Pediátrica, Instituto Nacional de Pediatría, Secretaría de Salud (SS), Mexico City, Mexico
| | - Angélica Rangel-López
- Coordinación de Investigación en Salud, Unidad Habilitada de Apoyo al Predictamen, Centro Médico Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Alfredo Hidalgo-Miranda
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Elizabeth Vega
- Instituto de Ciencias de la Atmósfera y Cambio Climático, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Minerva Mata-Rocha
- Unidad de Investigación Médica en Genética Humana, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Omar Alejandro Sepúlveda-Robles
- Unidad de Investigación Médica en Genética Humana, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - José Arellano-Galindo
- Unidad de Investigación en Enfermedades Infecciosas, Laboratorio de Virología Clínica y Experimental, Hospital Infantil de México Federico Gómez, Secretaría de Salud (SS), Mexico City, Mexico
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico,Juan Carlos Núñez-Enríquez
| | - Juan Manuel Mejía-Aranguré
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico,Unidad de Investigación Médica en Genética Humana, Unidad Médica de Alta Especialidad, Hospital de Pediatría “Dr. Silvestre Frenk Freund, ” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico,Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico,*Correspondence: Juan Manuel Mejía-Aranguré
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3
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Hernández-Regino LM, De Jesús Castillejos-López M, Aquino-Gálvez A, Velasco-Hidalgo L, García-Guzmán A, Aguilar-Ortiz M, Cárdenas-Cardos R, Torres-Espíndola LM. Clinical characteristics and mortality predictors of patients with cancer hospitalized by COVID-19 in a pediatric third-level referral center. Front Pediatr 2022; 10:960334. [PMID: 35967576 PMCID: PMC9366048 DOI: 10.3389/fped.2022.960334] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND More than 135 million COVID-19 cases (coronavirus disease 2019) have been reported worldwide until today, with over 2.9 million deaths. Several studies have demonstrated that disease severity is lower in the pediatric population than in adults; however, differences are described in patients with chronic diseases, including oncological patients. Current world literature suggests patients with comorbidities, including cancer, have an increased risk of unfortunate outcomes. Therefore, our objective was to describe the clinical characteristics and epidemiological factors associated with mortality in a cohort of pediatric cancer patients hospitalized for COVID-19. METHODS This is a retrospective, descriptive study of the cases of patients with cancer hospitalized for COVID-19. A total of 40 pediatrics were included in the analysis. Data from pediatric patients with COVID-19 included clinical and epidemiological records, laboratory, imaging studies, COVID-19 diagnostic methods, and medical treatment. RESULTS Of the 40 pediatric patients admitted with cancer with a confirmed diagnosis of COVID-19, 42.5% were solid tumors, 40% leukemias, and 17.5% lymphomas. The clinical parameters associated with mortality were stage IV tumor (p = 0.029) and intubation (p < 0.001). The biochemical factors associated with lower survival were thrombocytopenia under 25,000 cells/mm3 (p < 0.001), D-dimer over 1 μg/ml (p = 0.003), clinical malnutrition (p = 0.023), and disseminated intravascular coagulation (p = 0.03). CONCLUSION Our findings showed that the fever was the most frequent symptom, and the clinical parameters associated with mortality were stage IV tumor, intubation, saturation percentage, RDW, platelets, creatinine, ALT, D-dimer, ferritin, and FiO2 percentage. The thrombocytopenia, D-dimer, nutritional status, and disseminated intravascular coagulation were significantly associated with lower survival.
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Affiliation(s)
| | - Manuel De Jesús Castillejos-López
- Department of Hospital Epidemiology and Infectology, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
| | - Arnoldo Aquino-Gálvez
- Laboratory of Molecular Biology, Pulmonary Fibrosis Department, National Institute of Respiratory Diseases "Ismael Cosío Villegas," Mexico City, Mexico
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Zapata-Tarrés M, Velasco-Hidalgo L, González-Garay A, Cárdenas-Cardos R, Rivera-Luna R. Does the Human Development Index relate with acute lymphoblastic leukemia incidence? Bol Med Hosp Infant Mex 2021; 78:301-305. [PMID: 33498061 DOI: 10.24875/bmhim.20000043] [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: 02/19/2020] [Accepted: 09/14/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The association between childhood cancer and socioeconomic status has been widely studied. However, none of the results are conclusive. This study aimed to analyze the association between the Human Development Index (HDI) and the acute lymphoblastic leukemia (ALL) incidence in children under the Popular Medical Insurance Care. METHODS We conducted an observational, descriptive, and population-based study covering 55% of the Mexican population (58 million). RESULTS The most impoverished states were located in the south east region of Mexico, while the north was more homogeneous, with HDIs varying between 0.73 and 0.79. Our findings emphasize that the metropolitan area of Mexico City and the State of Nuevo Leon have the highest levels of HDI. Regions were graded from I to IV according to their HDIs in ascending order. The HDIs varied from 0.667 to 0.830/100,000 children/year, with a national average of 0.746. The leukemia incidence for regions I, II, III, and IV was 6.12, 6.53, 4.96, and 9.95. An analysis of ALL incidence in Mexico showed significant differences for region IV in comparison with the other regions based on the HDI values (p = 0.0001). CONCLUSIONS Further in-depth studies, including the economic aspects of the different geographic regions and their ethnographic characteristics, would give a more comprehensive panorama.
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Affiliation(s)
- Marta Zapata-Tarrés
- Department of Oncology, Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | | | | | - Roberto Rivera-Luna
- Division of Hematology/Oncology. Instituto Nacional de Pediatría, Mexico City, Mexico
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Núñez-Enríquez JC, Correa-Correa V, Flores-Lujano J, Pérez-Saldivar ML, Jiménez-Hernández E, Martín-Trejo JA, Espinoza-Hernández LE, Medina-Sanson A, Cárdenas-Cardos R, Flores-Villegas LV, Peñaloza-González JG, Torres-Nava JR, Espinosa-Elizondo RM, Amador-Sánchez R, Rivera-Luna R, Dosta-Herrera JJ, Mondragón-García JA, González-Ulibarri JE, Martínez-Silva SI, Espinoza-Anrubio G, Duarte-Rodríguez DA, García-Cortés LR, Gil-Hernández AE, Mejía-Aranguré JM. Extremely Low-Frequency Magnetic Fields and the Risk of Childhood B-Lineage Acute Lymphoblastic Leukemia in a City With High Incidence of Leukemia and Elevated Exposure to ELF Magnetic Fields. Bioelectromagnetics 2020; 41:581-597. [PMID: 32965755 DOI: 10.1002/bem.22295] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 04/20/2020] [Revised: 08/21/2020] [Accepted: 08/31/2020] [Indexed: 01/04/2023]
Abstract
It is important to study the relationship between extremely low-frequency magnetic fields (ELF-MFs) and childhood leukemia, particularly in locations with a high incidence of this neoplasm in children and an elevated exposure to ELF-MF, such as Mexico City. The aim was to investigate the association between ELF-MF exposure and the risk of B-lineage acute lymphoblastic leukemia (B-ALL). A case-control study was conducted in Mexico City during the period from 2010 to 2011. Residential 24-h ELF-MF measurements were obtained for 290 incident B-ALL patients and 407 controls, aged less than 16 years. Controls were frequency-matched by sex, age (±18 months), and health institution. The adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were calculated. ELF-MF exposure at <0.2 μT was used to define the reference group. ELF-MF exposure at ≥0.3 μT was observed in 11.3% of the controls. Different ELF-MF intensity cutoff values were used to define the highest exposure category; the highest exposure category for each cutoff value was associated with an increased risk of B-ALL compared with the corresponding lower exposure categories. The aORs were as follows: ≥0.2 μT = 1.26 (95% CI: 0.84-1.89); ≥0.3 μT = 1.53 (95% CI: 0.95-2.48); ≥0.4 μT = 1.87 (95% CI: 1.04-3.35); ≥0.5 μT = 1.80 (95% CI 0.95-3.44); ≥0.6 μT = 2.32 (95% CI: 1.10-4.93). ELF-MF exposure as a continuous variable (per 0.2 μT intervals) was associated with B-ALL risk (aOR = 1.06; 95% CI: 1.01-1.12). In the present study, the proportion of children exposed to ≥0.3 μT is among the highest reported worldwide. Additionally, an ELF-MF exposure ≥0.4 μT may be associated with the risk of B-ALL. Bioelectromagnetics. © 2020 Bioelectromagnetics Society.
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Affiliation(s)
- Juan C Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI," Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Víctor Correa-Correa
- Servicio de Neurocirugía, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez," "CMN Siglo XXI," IMSS, Mexico City, Mexico
| | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI," Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - María L Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI," Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | | | - Jorge A Martín-Trejo
- Servicio de Hematología, UMAE Hospital de Pediatría, CMN "Siglo XXI," IMSS, Mexico City, Mexico
| | - Laura E Espinoza-Hernández
- Servicio de Hematología Pediátrica, Hospital General "Dr. Gaudencio González Garza," CMN "La Raza," IMSS, Mexico City, Mexico
| | - Aurora Medina-Sanson
- Departamento de Hemato-Oncología, Hospital Infantil de México Federico Gómez, Secretaria de Salud (SS), Mexico City, Mexico
| | | | - Luz V Flores-Villegas
- Servicio de Hematología Pediátrica, CMN "20 de Noviembre," Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | | | - José R Torres-Nava
- Servicio de Oncología, Hospital Pediátrico "Moctezuma,", Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | | | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, Hospital General Regional (HGR) No. 1 "Dr. Carlos MacGregor Sánchez Navarro," IMSS, Mexico City, Mexico
| | | | - Juan J Dosta-Herrera
- Servicio de Cirugía Pediátrica, Hospital General "Gaudencio González Garza," CMN "La Raza," IMSS, Mexico City, Mexico
| | - Javier A Mondragón-García
- Servicio de Cirugía Pediátrica, HGR No. 1 "Dr. Carlos MacGregor Sánchez Navarro," IMSS, Mexico City, Mexico
| | | | | | - Gilberto Espinoza-Anrubio
- Servicio de Pediatría, Hospital General Zona (HGZ) No. 8 "Dr. Gilberto Flores Izquierdo," IMSS, Mexico City, Mexico
| | - David A Duarte-Rodríguez
- 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
| | | | - Ana E Gil-Hernández
- 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
| | - Juan M Mejía-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.,Coordinación de Investigación en Salud, CMN "Siglo XXI," IMSS, Mexico City, Mexico
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6
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Jiménez-Hernández E, Duarte-Rodríguez DA, Núñez-Enriquez JC, Flores-Lujano J, Martín-Trejo JA, Espinoza-Hernández LE, Arellano-Galindo J, Medina-Sanson A, García-Jiménez X, Paredes-Aguilera R, Flores-Villegas LV, Peñaloza-González JG, Torres-Nava JR, Espinosa-Elizondo RM, Amador-Sánchez R, Dosta-Herrera JJ, Mondragón-García JA, Valdés-Guzmán H, Mejía-Pérez L, Espinoza-Anrubio G, Paz-Bribiesca MM, Salcedo-Lozada P, Landa-García RÁ, Ramírez-Colorado R, Hernández-Mora L, Pérez-Saldivar ML, Santamaría-Ascencio M, López-Loyola A, Godoy-Esquivel AH, García-López LR, Anguiano-Ávalos AI, Mora-Rico K, Castañeda-Echevarría A, Rodríguez-Jiménez R, Cibrian-Cruz JA, Cárdenas-Cardos R, Altamirano-García MB, Sánchez-Ruiz M, Rivera-Luna R, Rodríguez-Villalobos LR, Hernández-Pérez F, Olvera-Durán JÁ, García-Cortés LR, Mata-Rocha M, Sepúlveda-Robles OA, Bekker-Méndez VC, Jiménez-Morales S, Rosas-Vargas H, Mejía-Aranguré JM. Maternal and paternal ages at conception of index child and risk of childhood acute leukaemia: A multicentre case-control study in Greater Mexico City. Cancer Epidemiol 2020; 67:101731. [PMID: 32447241 DOI: 10.1016/j.canep.2020.101731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The parental age at conception has been reported to be a risk factor for childhood acute leukaemia (AL); however, the relationship is controversial. The aim of the present study was to investigate the association between parental age at conception and the risk of AL in Mexican children, a population with a high incidence of the disease and a high prevalence of pregnancies in adolescents and young adults. METHODS A multicentre case-control study was conducted. Incident AL cases younger than 17 years of age diagnosed between 2010 and 2015 were included. Controls were matched with cases according to age, sex, and health institution. Using logistic regression analysis, adjusted odds ratios (aOR) and 95 % confidence intervals (95 % CI) were calculated for each maternal stratum after adjusting for paternal age at conception of index child. The maternal age between 25 and 29.99 years was selected as the reference category. RESULTS In most strata where maternal and paternal ages were assessed, no association was found with the risk of developing acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in their offspring. An increased risk for AML was observed when the mother was between 20 and 24.99 years of age and the father aged 25-29.99 years (aOR, 1.94; 95 % CI, 1.03-3.67). In addition, there was a positive association for ALL when the mother´s age was between 20 and 24.99 years and the father was <20 years of age, however, a very wide confidence interval was noted (aOR, 12.26; 95 % CI, 1.41-106.83). CONCLUSION In the present study, maternal and paternal ages assessed in different strata showed little association with risk of developing ALL and AML in children. Positive associations between risk of both types of childhood AL were observed with younger paternal and maternal ages.
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Affiliation(s)
- Elva Jiménez-Hernández
- Coordinación de Investigación en Salud, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico; Servicio de Hematología Pediátrica, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS. Calzada Vallejo y Jacarandas S/N Col. La Raza, Delegación Azcapotzalco, Mexico City, 02990, Mexico.
| | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Juan Carlos Núñez-Enriquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematología, UMAE Hospital de Pediatría, CMN "Siglo XXI", IMSS.Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Laura Eugenia Espinoza-Hernández
- Servicio de Hematología Pediátrica, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS. Calzada Vallejo y Jacarandas S/N Col. La Raza, Delegación Azcapotzalco, Mexico City, 02990, Mexico.
| | - José Arellano-Galindo
- Hospital Infantil de México Federico Gómez, Secretaria de Salud (SS). Calle Doctor Márquez 162, Col. Doctores, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Aurora Medina-Sanson
- Hospital Infantil de México Federico Gómez, Secretaria de Salud (SS). Calle Doctor Márquez 162, Col. Doctores, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Xochiketzalli García-Jiménez
- Servicio de Hematología, UMAE Hospital de Pediatría, CMN "Siglo XXI", IMSS.Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Rogelio Paredes-Aguilera
- Servicio de Hematología, Instituto Nacional de Pediatría (INP), SS. Insurgentes Sur 3700, Letra C, Col. Insurgentes Cuicuilco, Delegación Coyoacán, Mexico City, 04530, Mexico.
| | - Luz Victoria Flores-Villegas
- Servicio de Hematología Pediátrica, CMN "20 de Noviembre", Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE). Félix Cuevas 540, Col. Del Valle, Delegación Benito Juárez, Mexico City, 03229, Mexico.
| | - José Gabriel Peñaloza-González
- Servicio de Onco-Pediatría, Hospital Juárez de México, SS. Av. Instituto Politécnico Nacional 5160, Col. Magdalena de las Salinas, Delegación Gustavo A. Madero, Mexico City, 07760, Mexico.
| | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediátrico "Moctezuma", Secretaría de Salud de la Ciudad de México (SSCDMX). Oriente 158-189, Col. Moctezuma 2a Sección, Delegación Venustiano Carranza, Mexico City, 15530, Mexico.
| | - Rosa Martha Espinosa-Elizondo
- Servicio de Hematología Pediátrica, Hospital General de México, SSa. Eje 2A Sur (Dr. Balmis) 148, Col. Doctores, Delegación Cuauhtémoc, Mexico City, 06726, Mexico.
| | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, Hospital General Regional (HGR), No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS. Av. Gabriel Mancera No. 222, Col. Del Valle, Mexico City, 03100, Mexico.
| | - Juan José Dosta-Herrera
- Servicio de Cirugía Pediátrica, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS. Calzada Vallejo y Jacarandas S/N Col. La Raza, Delegación Azcapotzalco, Mexico City, 02990, Mexico.
| | - Javier Anastacio Mondragón-García
- Servicio de Cirugía Pediátrica, HGR No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS. Av. Gabriel Mancera No. 222, Col. Del Valle, Mexico City, 03100, Mexico.
| | - Heriberto Valdés-Guzmán
- Hospital Pediátrico de Iztacalco, SSCDMX. Av. Coyuya y Terraplén de Rio Frio S/N, Col. La Cruz. Iztacalco, Mexico City, 08310 Mexico.
| | - Laura Mejía-Pérez
- Hospital Pediátrico de Iztapalapa, SSCDMX. Av. Ermita Iztapalapa 780, Col. Granjas San Antonio. Delegación Iztapalapa, Mexico City, 09070. Mexico.
| | - Gilberto Espinoza-Anrubio
- Servicio de Pediatría, Hospital General Zona (HGZ) No. 8 "Dr. Gilberto Flores Izquierdo"IMSS. Av. Rio Magdalena 289 Ciudad De México, Col.Tizapan San Angel, Delegación Álvaro Obregón, Mexico City, 1090, Mexico.
| | - María Minerva Paz-Bribiesca
- Servicio de Pediatría, Hospital Juárez del Centro, SS. Jesus María 13, Col Centro, Delegación Cuahtemoc, Mexico City, 06000, Mexico.
| | - Perla Salcedo-Lozada
- Hospital General de Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM). Av. Simón Bolivar 1, Fraccionamiento Las Américas, Municipio Ecatepec de Morelos. State of Mexico, 55076. Mexico.
| | - Rodolfo Ángel Landa-García
- Hospital General "Dr. Manuel Gea González" SS. Calz. de Tlalpan 4800, Tlalpan Centro I, Belisario Domínguez Secc 16, Delegación Tlalpan, Mexico City,14080, Mexico.
| | - Rosario Ramírez-Colorado
- Hospital Pediátrico "La Villa", SSCDMX. Av. Cantera, Esq. Av. Hidalgo S/n, Col. Estanzuela. Delegación Gustavo A. Madero, Mexico City, 07050, Mexico.
| | - Luis Hernández-Mora
- Hospital Pediátrico "San Juan de Aragón", SSCDMX. Av. 506, S/N San Juan de Aragón 1A. Delegación Gustavo A. Madero, 07969, Mexico.
| | - María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Marlene Santamaría-Ascencio
- Servicio de Pediatría, HGR No. 72 "Lic. Vicente Santos Guajardo", IMSS. Calle Filiberto Gómez; S/N, Tlalnepantla, Edo. de Mexico, CP54030. México.
| | - Anselmo López-Loyola
- Servicio de Cirugía Pediátrica, HGZ No. 32, IMSS. Clzd. del Hueso S/N, Col. EX-Ex Hacienda Coapa, Delegación Coyoacán, Mexico City, 14310, Mexico.
| | - Arturo Hermilo Godoy-Esquivel
- Servicio de Cirugía Pediátrica, Hospital Pediátrico de Moctezuma, SSCDMX. Oriente 158-189, Col. Moctezuma 2a Sección, Delegación Venustiano Carranza, Mexico City, 15530, Mexico.
| | - Luis Ramiro García-López
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, SSCDMX. Carlos Lazo 25, Col. Tacubaya, Delegación Miguel Hidalgo, México City, 11870, Mexico.
| | - Alison Ireri Anguiano-Ávalos
- Urgencias Pediátricas, HGZ No. 47, IMSS. Av. Campaña de Ébano S/N Col. Unidad Vicente Guerrero, Dlegación Iztapalapa, México City, 09200. Mexico.
| | - Karina Mora-Rico
- Servicio de Cirugía Pediátrica, Hospital Regional "1° Octubre", ISSSTE. Av Instituto Politécnico Nacional 1669, Revolución IMSS, Delegación Gustavo A Madero, 07300 Mexico.
| | - Alejandro Castañeda-Echevarría
- Servicio de Pediatría, HGR No. 25 IMSS.Clzd. Ignacio Zaragoza 1840, Col. Juan Escutia, Delegación Iztapalapa, Mexico City, 09100 Mexico.
| | - Roberto Rodríguez-Jiménez
- Servicio de Pediatría, Hospital General de Zona con Medicina Familiar (HGZMF) No. 29, IMSS. AV. 510, S/N, Col. Unidad San Juan de Aragón. Delegación Gustavo A. Madero, Mexico City, 07950, Mexico.
| | - José Alberto Cibrian-Cruz
- Servicio de Cirugía Pediátrica, HGZ No. 27, IMSS. AV. Lázaro Cárdenas, S/N Tlaltelolco, Delegación Cuauhtémoc, México City, 06900 Mexico.
| | - Rocío Cárdenas-Cardos
- Servicio de Oncología, INP, SSa. Insurgentes Sur 3700, Letra C, Col. Insurgentes Cuicuilco, Delegación Coyoacán, Mexico City, 04530, Mexico.
| | - Martha Beatriz Altamirano-García
- Servicio de Pediatría, Hospital General Zona (HGZ) No. 8 "Dr. Gilberto Flores Izquierdo"IMSS. Av. Rio Magdalena 289 Ciudad De México, Col.Tizapan San Angel, Delegación Álvaro Obregón, Mexico City, 1090, Mexico.
| | - Martin Sánchez-Ruiz
- Hospital General de Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM). Av. Simón Bolivar 1, Fraccionamiento Las Américas, Municipio Ecatepec de Morelos. State of Mexico, 55076. Mexico.
| | - Roberto Rivera-Luna
- Servicio de Oncología, INP, SSa. Insurgentes Sur 3700, Letra C, Col. Insurgentes Cuicuilco, Delegación Coyoacán, Mexico City, 04530, Mexico.
| | - Luis Rodolfo Rodríguez-Villalobos
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, SSCDMX. Carlos Lazo 25, Col. Tacubaya, Delegación Miguel Hidalgo, México City, 11870, Mexico.
| | - Francisco Hernández-Pérez
- Urgencias Pediátricas, HGZ No. 47, IMSS. Av. Campaña de Ébano S/N Col. Unidad Vicente Guerrero, Dlegación Iztapalapa, México City, 09200. Mexico.
| | - Jaime Ángel Olvera-Durán
- Servicio de Cirugía Pediátrica, Hospital Regional "1° Octubre", ISSSTE. Av Instituto Politécnico Nacional 1669, Revolución IMSS, Delegación Gustavo A Madero, 07300 Mexico.
| | - Luis Rey García-Cortés
- Delegación Regional Estado de México Oriente, IMSS. Calle 4 25, Fracc. Industrial Alce Blanco, Municipio de Naucalpan de Juárez, State of Mexico, 53370, Mexico.
| | - Minerva Mata-Rocha
- Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Omar Alejandro Sepúlveda-Robles
- Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Vilma Carolina Bekker-Méndez
- Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología "Dr.Daniel Méndez Hernández", CMN "La Raza", IMSS. Address. Av. Río Consulado, Col La Raza S/N. Delegación Azcapotzalco, Mexico City, 02990 Mexico.
| | - Silvia Jiménez-Morales
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Mexico City,14610 Mexico.
| | - Haydee Rosas-Vargas
- Unidad de Investigación Médica en Genética Humana, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
| | - Juan Manuel Mejía-Aranguré
- Coordinación de Investigación en Salud, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico; Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de AltaEspecialidad (UMAE) Hospital de Pediatría, Centro Médico Nacional (CMN) "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS). Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico; Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS. Av. Cuauhtemoc 330, Delegación Cuauhtémoc, Mexico City, 06720, Mexico.
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Damasco-Ávila E, Velasco-Hidalgo L, Zapata-Tarrés M, Cárdenas-Cardos R, Rivera-Luna R. Feeding difficulties and eating disorders in pediatric patients with cancer. Bol Med Hosp Infant Mex 2019; 76:113-119. [PMID: 31116711 DOI: 10.24875/bmhim.19000072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Feeding difficulties and disorders are a common problem in the pediatric population, which involve a series of deficient behaviors about nutrition processes that can adversely affect psychomotor, psychosocial, and physical development of children. This study aimed to describe the frequency of feeding difficulties or disorders in pediatric patients with cancer. Methods A prospective study which included 125 children from 1-19 years treated at the Department of Oncology of the Instituto Nacional de Pediatría, Mexico City, was conducted. The diagnosis of eating disorders and feeding difficulties was determined during the first 48 h since admission, and the age of the patient influenced the type of disorder and feeding difficulties. Results Children older than 11 years presented more frequently an intense resistance of feeding because of discomfort pain (fear of feeding) than younger children (11.4 ± 4.7 vs. 7.4 ± 4.9, p ≤ 0.001). The most frequent alteration associated with malnutrition was loss of appetite (odds ratio [OR]: 8.8, confidence interval [CI] 95% 2.9-26.9, p<0.001), followed by fear of feeding (OR: 3.14, CI 95% 1.24-7.9, p=0.015), and the organic causes showed the highest risk for malnutrition (OR: 3.1, CI 95% 0.98-9.7, p=0.054). Conclusions Over 90% of the studied population demonstrated at least one eating disorder or feeding difficulty. The principal effect is inadequate nutritional intake due to limited appetite and fear of feeding, which can result in undernutrition. For this reason, the identification of alterations in nutrition processes should be part of the comprehensive assessment of cancer patients.
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Affiliation(s)
| | | | | | | | - Roberto Rivera-Luna
- Subdirección de Hematología/Oncología Instituto Nacional de Pediatría, Mexico City, Mexico
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8
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Jiménez-Hernández E, Fajardo-Gutiérrez A, Núñez-Enriquez JC, Martín-Trejo JA, Espinoza-Hernández LE, Flores-Lujano J, Arellano-Galindo J, Medina-Sanson A, Paredes-Aguilera R, Merino-Pasaye LE, Velázquez-Aviña MM, Torres-Nava JR, Espinosa-Elizondo RM, Amador-Sánchez R, Dosta-Herrera JJ, Mondragón-García JA, Valdés-Guzmán H, Mejía-Pérez L, Espinoza-Anrubio G, Paz-Bribiesca MM, Salcedo-Lozada P, Landa-García RÁ, Ramírez-Colorado R, Hernández-Mora L, Pérez-Saldivar ML, Santamaría-Ascencio M, López-Loyola A, Godoy-Esquivel AH, García-López LR, Anguiano-Ávalos AI, Mora-Rico K, Castañeda-Echevarría A, Rodríguez-Jiménez R, Cibrian-Cruz JA, Solís-Labastida KA, Cárdenas-Cardos R, Martínez-Avalos A, Flores-Villegas LV, Peñaloza-González JG, González-Ávila AI, Altamirano-García MB, López-Santiago N, Sánchez-Ruiz M, Rivera-Luna R, Rodríguez-Villalobos LR, Hernández-Pérez F, Olvera-Durán JÁ, García-Cortés LR, Mata-Rocha M, Sepúlveda-Robles OA, González-Bonilla CR, Bekker-Méndez VC, Jiménez-Morales S, Rosas-Vargas H, Mejía-Aranguré JM. A greater birthweight increases the risk of acute leukemias in Mexican children-experience from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia (MIGICCL). Cancer Med 2018. [PMID: 29533016 PMCID: PMC5911591 DOI: 10.1002/cam4.1414] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In Mexico, due to the high rates of diabetes, overweight, and obesity, there has also been noted an increased newborn weight, which may be contributing to the elevated incidence rate of childhood acute leukemia (AL). We conducted a case-control study in public hospitals of Mexico City aimed to know whether a greater weight at birth is associated with a higher risk of developing leukemia. We included incident cases with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) diagnosed between 2010 and 2015. Controls were frequency-matched to the cases by age, sex, and health institution. Logistic regression analysis was performed adjusting risks by child's sex, overcrowding index, birth order, and mother's age at the time of pregnancy. Adjusted odds ratios (aORs) and 95% confidence intervals were calculated. A total of 1455 cases and 1455 controls were included. An evident association between ALL and child's birthweight ≥2500 g was found (aOR 2.06; 95% CI: 1.59, 2.66) and also, in those with birthweight ≥3500 g (aOR 1.19; 95% CI: 1.00, 1.41). In AML patients with birthweight ≥2500 g and ≥3500 g, an aOR of 1.77 (95% CI: 1.07, 2.94) and 1.42 (95% CI: 1.03-1.95) was observed, respectively. No association was noticed with either type of AL and a birthweight ≥4000 g. To sum up, we found a moderate association between not having a low birthweight and an increased risk of acute leukemias. Birthweight ≥3500 g was also a risk factor for both types of leukemia. This suggests that a greater birthweight may increase the risk of acute leukemias in Mexican children.
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Affiliation(s)
- Elva Jiménez-Hernández
- Health Research Coordination, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.,Pediatric Hematology Services, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS, Mexico City, Mexico
| | - Arturo Fajardo-Gutiérrez
- Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | - Juan Carlos Núñez-Enriquez
- Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | | | | | - Janet Flores-Lujano
- Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | - José Arellano-Galindo
- Children's Hospital of Mexico, Federico Gómez, Secretaria de Salud (SS), Mexico City, Mexico
| | - Aurora Medina-Sanson
- Children's Hospital of Mexico, Federico Gómez, Secretaria de Salud (SS), Mexico City, Mexico
| | | | - Laura Elizabeth Merino-Pasaye
- Pediatric Hematology Services, CMN "20 de Noviembre", Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | | | - José Refugio Torres-Nava
- Oncology Services, Hospital Pediátrico "Moctezuma", Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | | | - Raquel Amador-Sánchez
- Pediatric Hematology Service, Hospital General Regional (HGR) No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS, Mexico City, Mexico
| | - Juan José Dosta-Herrera
- Pediatric Surgery Service, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS, Mexico City, Mexico
| | | | | | | | - Gilberto Espinoza-Anrubio
- Servicio de Pediatría, Hospital General Zona (HGZ) No. 8 "Dr. Gilberto Flores Izquierdo" IMSS, Mexico City, Mexico
| | | | - Perla Salcedo-Lozada
- General Hospital of Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM), Mexico City, Mexico
| | | | | | | | - María Luisa Pérez-Saldivar
- Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | | | | | | | | | | | - Karina Mora-Rico
- Pediatric Surgery Service, Hospital Regional "1° Octubre", ISSSTE, Mexico City, Mexico
| | | | - Roberto Rodríguez-Jiménez
- Pediatric Services, Hospital General de Zona con Medicina Familiar (HGZMF) No. 29 IMSS, Mexico City, Mexico
| | | | | | | | | | - Luz Victoria Flores-Villegas
- Pediatric Hematology Services, CMN "20 de Noviembre", Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | | | - Ana Itamar González-Ávila
- Pediatric Hematology Service, Hospital General Regional (HGR) No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS, Mexico City, Mexico
| | | | - Norma López-Santiago
- Hematology Services, Instituto Nacional de Pediatría (INP), SS, Mexico City, Mexico
| | - Martin Sánchez-Ruiz
- General Hospital of Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM), Mexico City, Mexico
| | | | | | | | | | | | - Minerva Mata-Rocha
- Molecular Biology Laboratory, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | | | - Cesar Raúl González-Bonilla
- Laboratory of the Coordination of Epidemiological Surveillance and Support in Contingencies, Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología "Dr. Daniel Méndez Hernández", CMN "La Raza", IMSS, Mexico City, Mexico
| | - Vilma Carolina Bekker-Méndez
- Medical Research Unit in Immunology and Infectology, Hospital de Infectología "Dr. Daniel Méndez Hernández", CMN "La Raza", IMSS, Mexico City, Mexico
| | - Silvia Jiménez-Morales
- Cancer Genomics Laboratory, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Haydee Rosas-Vargas
- Medical Research Unit in Human Genetics, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS, Mexico City, Mexico
| | - Juan Manuel Mejía-Aranguré
- Health Research Coordination, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.,Medical Research Unit in Clinical Epidemiology, UMAE Hospital de Pediatría CMN "Siglo XXI", IMSS, Mexico City, Mexico.,Molecular Biology Laboratory, UMAE, Hospital de Pediatría, CMN "Siglo XXI", IMSS, Mexico City, Mexico
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Rivera-Luna R, Velasco-Hidalgo L, Zapata-Tarrés M, Cárdenas-Cardos R, Aguilar-Ortiz MR. Current outlook of childhood cancer epidemiology in a middle-income country under a public health insurance program. Pediatr Hematol Oncol 2017; 34:43-50. [PMID: 28287336 DOI: 10.1080/08880018.2016.1276236] [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: 10/20/2022]
Abstract
In Mexico, childhood cancer (0-18 years) is treated in a multidisciplinary way while providing care for more than half of the affected children through a public medical insurance. This insurance is given to all children who do not have any health care coverage in Mexico. This program is offered to the poorest of all Mexicans. All the children with this disease are submitted to pathology diagnosis and treatment according to national treatment protocols from 57 accredited medical institutions. From 2007 to 2015, a total of 24,039 children with cancer have been registered; the male gender predominates by 55%. The highest incidence was in the group aged between 0 and 4 years. Every year, there has been an increment in registration. In 2015, there were 3,433 new patients with an incidence of 150.1/million. In the same year, the incidence for all types of leukemia increased to 89.5/million. But for acute lymphoblastic leukemia, the incidence was found to be 79.8/million, which is extremely high. The mortality rate for all these patients in 2015 was 5.3/100,000. However, with regard to children aged between 15 and 18 years, the mortality rate was 8.5/100,000. Abandonment rate was 10%, and there were nine state institutions that had a mortality rate between 25% and 50% among their patients. Coincidentally, as per the Human Development Index, the parameters for education, health, and income were low for those nine institutions. The purpose of this work is to show the epidemiology and the burden we are facing due to this disease.
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Affiliation(s)
- Roberto Rivera-Luna
- a Technical Committee of the National Council for the Prevention and Treatment of Childhood Cancer/Department of Pediatric Oncology , UNAM/Division of Pediatric Hematology/Oncology, National Institute of Pediatrics (NIP) , Mexico City , Mexico
| | - Liliana Velasco-Hidalgo
- b Department of Pediatric Oncology , National Institute of Pediatrics (NIP) , Mexico City , Mexico
| | - Marta Zapata-Tarrés
- b Department of Pediatric Oncology , National Institute of Pediatrics (NIP) , Mexico City , Mexico
| | - Rocío Cárdenas-Cardos
- c Department of Pediatric Oncology, UNAM/Department of Oncology , National Institute of Pediatrics (NIP)/Program of the National Council for the Prevention and Treatment of Childhood Cancer , Mexico City , Mexico
| | - Marco R Aguilar-Ortiz
- b Department of Pediatric Oncology , National Institute of Pediatrics (NIP) , Mexico City , Mexico
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Riveros-Ramos LC, Velasco-Hidalgo L, Shalkow-Klincovstein J, Rojas-Maruri CM, Cárdenas-Cardos R, Rivera-Luna R. Tumor neuroectodérmico primitivo primario de páncreas en un paciente pediátrico. Reporte de caso y revisión de la literatura. Acta Pediatr Mex 2016. [DOI: 10.18233/apm37no1pp26-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
<p>Los tumores neuroectodérmicos primitivos son tumores de células pequeñas y redondas derivadas del tejido blando, pertenecen a la familia del sarcoma de Ewing. El tumor neuroectodérmico primario del páncreas es muy poco frecuente, en la literatura sólo se han reportado 17 casos. Reportamos el caso de una paciente de 9 años de edad, con diagnóstico de tumor neuroectodérmico primario del páncreas a la que se le realizó una cirugía de Whipple e inició tratamiento de quimioterapia con ciclofosfamida, vincristina, doxorrubicina pegilada, etopósido e ifosfamida y radioterapia. Desde marzo de 2013 la paciente se encuentra en vigilancia, con un periodo de seguimiento de 23 meses. Actualmente, se encuentra en buenas condiciones generales y sin evidencia de actividad tumoral.</p>
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11
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Cárdenas-Cardos R, Aguilar-Ortiz MR, Velasco-Hidalgo L, Pasquel García-Vázquez PM, Rivera-Luna R, Marhx-Bracho A. Linfoma no Hodgkin primario de sistema nervioso central en un paciente pediátrico sin inmunodeficiencia relacionada. Acta Pediatr Mex 2015. [DOI: 10.18233/apm36no5pp389-396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
<p>El linfoma no Hodgkin primario de sistema nervioso central es una afección poco frecuente en la población pediátrica. No existen (o son pocas) las recomendaciones o estudios clínicos que sean útiles para definir la mejor opción terapéutica. El objetivo de este trabajo es describir el caso de una niña con linfoma primario de sistema nervioso central, sin ninguna inmunodeficiencia asociada, y realizar de una revisión cualitativa de la literatura especializada sobre esta enfermedad en niños.</p><p>Se ha postulado la posibilidad de cambios citogenéticos que pudieran explicar la heterogeneidad en el comportamiento de esta enfermedad pues se ha visto que es distinto al de otros linfomas en presentaciones habituales. La experiencia de tratamiento en niños con linfoma se basa en resultados de tratamientos obtenidos en pacientes adultos, con regímenes basados principalmente en antimetabolitos como metotrexato y citarabina. Aún es controvertida la utilidad de la radioterapia craneal, la cual sólo se recomienda en casos específicos.</p>
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12
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Núñez-Enríquez JC, Fajardo-Gutiérrez A, Buchán-Durán EP, Bernáldez-Ríos R, Medina-Sansón A, Jiménez-Hernández E, Amador-Sanchez R, Peñaloza-Gonzalez JG, Paredes-Aguilera R, Alvarez-Rodriguez FJ, Bolea-Murga V, de Diego Flores-Chapa J, Flores-Lujano J, Bekker-Mendez VC, Rivera-Luna R, Del Carmen Rodriguez-Zepeda M, Rangel-López A, Dorantes-Acosta EM, Núñez-Villegas N, Velazquez-Aviña MM, Torres-Nava JR, Reyes-Zepeda NC, Cárdenas-Cardos R, Flores-Villegas LV, Martinez-Avalos A, Salamanca-Gómez F, Gorodezky C, Arellano-Galindo J, Mejía-Aranguré JM. Allergy and acute leukaemia in children with Down syndrome: a population study. Report from the Mexican inter-institutional group for the identification of the causes of childhood leukaemia. Br J Cancer 2013; 108:2334-8. [PMID: 23695017 PMCID: PMC3681010 DOI: 10.1038/bjc.2013.237] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background: Allergies have been described as protective factors against the development of childhood acute leukaemia (AL). Our objective was to investigate the associations between allergy history and the development of AL and acute lymphoblastic leukaemia (ALL) in children with Down syndrome (DS). Methods: A case–control study was performed in Mexico City. The cases (n=97) were diagnosed at nine public hospitals, and the controls (n=222) were recruited at institutions for children with DS. Odds ratios (OR) were calculated. Results: Asthma was positively associated with AL development (OR=4.18; 95% confidence interval (CI): 1.47–11.87), whereas skin allergies were negatively associated (OR=0.42; 95% CI: 0.20–0.91). Conclusion: Our findings suggest that allergies and AL in children with DS share biological and immune mechanisms. To our knowledge, this is the first study reporting associations between allergies and AL in children with DS.
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Affiliation(s)
- J C Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiologia Clínica, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo XXI, Instituto Mexicano del Seguro Social, Avenida Cuauhtémoc 330, Delegación Cuauhtémoc, México D.F. 06720, México.
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13
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Pérez-Saldivar ML, Fajardo-Gutiérrez A, Bernáldez-Ríos R, Martínez-Avalos A, Medina-Sanson A, Espinosa-Hernández L, Flores-Chapa JDD, Amador-Sánchez R, Peñaloza-González JG, Alvarez-Rodríguez FJ, Bolea-Murga V, Flores-Lujano J, Rodríguez-Zepeda MDC, Rivera-Luna R, Dorantes-Acosta EM, Jiménez-Hernández E, Alvarado-Ibarra M, Velázquez-Aviña MM, Torres-Nava JR, Duarte-Rodríguez DA, Paredes-Aguilera R, Del Campo-Martínez MDLÁ, Cárdenas-Cardos R, Alamilla-Galicia PH, Bekker-Méndez VC, Ortega-Alvarez MC, Mejia-Arangure JM. Childhood acute leukemias are frequent in Mexico City: descriptive epidemiology. BMC Cancer 2011; 11:355. [PMID: 21846410 PMCID: PMC3171387 DOI: 10.1186/1471-2407-11-355] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [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: 03/17/2011] [Accepted: 08/17/2011] [Indexed: 11/15/2022] Open
Abstract
Background Worldwide, acute leukemia is the most common type of childhood cancer. It is particularly common in the Hispanic populations residing in the United States, Costa Rica, and Mexico City. The objective of this study was to determine the incidence of acute leukemia in children who were diagnosed and treated in public hospitals in Mexico City. Methods Included in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in 2006 and 2007 with leukemia, as determined by using the International Classification of Childhood Cancer. The average annual incidence rates (AAIR), and the standardized average annual incidence rates (SAAIR) per million children were calculated. We calculated crude, age- and sex-specific incidence rates and adjusted for age by the direct method with the world population as standard. We determined if there were a correlation between the incidence of acute leukemias in the various boroughs of Mexico City and either the number of agricultural hectares, the average number of persons per household, or the municipal human development index for Mexico (used as a reference of socio-economic level). Results Although a total of 610 new cases of leukemia were registered during 2006-2007, only 228 fit the criteria for inclusion in this study. The overall SAAIR was 57.6 per million children (95% CI, 46.9-68.3); acute lymphoblastic leukemia (ALL) was the most frequent type of leukemia, constituting 85.1% of the cases (SAAIR: 49.5 per million), followed by acute myeloblastic leukemia at 12.3% (SAAIR: 6.9 per million), and chronic myeloid leukemia at 1.7% (SAAIR: 0.9 per million). The 1-4 years age group had the highest SAAIR for ALL (77.7 per million). For cases of ALL, 73.2% had precursor B-cell immunophenotype (SAAIR: 35.8 per million) and 12.4% had T-cell immunophenotype (SAAIR 6.3 per million). The peak ages for ALL were 2-6 years and 8-10 years. More than half the children (58.8%) were classified as high risk. There was a positive correlation between the average number of persons per household and the incidence of the pre-B immunophenotype (Pearson's r, 0.789; P = 0.02). Conclusions The frequency of ALL in Mexico City is among the highest in the world, similar to those found for Hispanics in the United States and in Costa Rica.
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Affiliation(s)
- María Luisa Pérez-Saldivar
- Unidad de Investigación en Epidemiología Clínica, Unidad Médica de Alta Especialidad UMAE Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano de Seguridad Social, México DF, México
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Rivera-Luna R, Olaya-Vargas A, Meza-Coria C, Cárdenas-Cardos R, Leal-Leal C, Amador-Zarco J. Is autologous bone marrow transplant (ABMT) and high-dose chemotherapy an approach that can rescue some children with advanced cancer disease? Pediatr Hematol Oncol 2001; 18:443-51. [PMID: 11594707 DOI: 10.1080/088800101750476023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The object was to determine the role ABMT in children with advanced cancer Those included had failed to respond to conventional treatment with 4 different ablative chemotherapy regimens. Bone marrow stem cells were identified with CD34. Cellular viability was determined after the bone marrow extraction and before the infusion. Fifteen patients were included, whose ages ranged from 1 to 13 years old with a median of 7. Six had acute leukemia, 6 with primitive neuroectodermic tumors, and 3 with other tumors. The median disease-free survival for the whole group was of 2 months, range of 1 to 29 months and SD of 10.1. A total of 6 children are alive (40%) and without evidence of tumor activity from 1 to 29 months. The disease-free survival rate for these group was of 19.1 months, with an SD of 7.9 months.
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Affiliation(s)
- R Rivera-Luna
- Division of Hematology/Oncology, Instituto Nacional de Pediatría, México, DF.
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Rivera-Luna R, Cárdenas-Cardos R, Martínez-Guerra G, Ayón A, Leal C, Rivera-Ortegón F. Childhood acute leukemia and intestinal parasitosis. Leukemia 1989; 3:825-6. [PMID: 2811482] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Infectious complications are the leading cause of mortality in children with acute leukemia. Despite the fact that intestinal parasitosis is a rather frequent finding and a health problem in underdeveloped countries, in our experience the incidence of helminthic and protozoan infections among children with leukemia is uncommon. We analyzed 54 consecutive patients with leukemia in a period of 5 years, and only seven (12.9%) had intestinal parasites, four of whom died because of the infection or complication by the parasites. One hundred children without any malignancy were the control group, 26 (26%) of whom had intestinal parasitosis. When we compared the frequency of parasitosis in the control group with the children with leukemia and parasitosis, we found a statistical difference (p less than 0.05). We speculate that parasitic infections may reduce the risk of childhood leukemia.
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Affiliation(s)
- R Rivera-Luna
- Department of Pediatric Oncology, National Institute of Pediatrics, Mexico City
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16
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Martínez-Avalos A, Rivera-Luna R, Altamirano-Alvarez E, Martínez-Guerra G, Ayón-Cárdenas AE, Cárdenas-Cardos R. [Meningeal sarcoma in childhood. Experiences with 17 cases]. Bol Med Hosp Infant Mex 1989; 46:47-50. [PMID: 2713049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A total of 17 patients with meningeal sarcoma were diagnosed and treated at the National Institute of Pediatrics in Mexico City in a period of 15 years. Among the diagnostic methodology used in this group we found that angiography is still the best to be used so far. On the other hand, the chemotherapy protocol employed did not improve the survival obtained with surgery and radiotherapy. Therefore we suggest that a new chemotherapy protocol has to be designed in order to obtain better results. Of particular interest, we found in this group of patients that the time elapsed between the first sign of disease to the moment of diagnosis varied from 2 months to 10 years without any prognostic significance.
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