Division of Epidemiology/Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Pediatr Blood Cancer. 2010 Jul 15;55(1):95-9. doi: 10.1002/pbc.22495.
Leukemia in infants is rare and has not been well studied apart from leukemia in older children. Differences in survival and the molecular characteristics of leukemia in infants versus older children suggest a distinct etiology, likely involving prenatal factors.
We examined the association between eight categories of maternally reported congenital abnormalities (CAs) (cleft lip or palate, spina bifida or other spinal defect, large or multiple birthmarks, other chromosomal abnormalities, small head or microcephaly, rib abnormalities, urogenital abnormalities, and other) and infant leukemia in a case-control study. The study included 443 cases diagnosed at <1 year of age at a Children's Oncology Group Institution in the United States or Canada from 1996 to 2006 and 324 controls. Controls were recruited from the cases' geographic area either by random digit dialing (1999-2002) or through birth certificates (2003-2008) and were frequency-matched to cases on birth year. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjustment for birth year and a measure of follow-up time to account for differences in the CA observation period.
No statistically significant associations were observed between infant leukemia and any CA (OR = 1.2; 95% CI: 0.8-1.9), birthmarks (OR = 1.4; 95% CI: 0.7-2.5), urogenital abnormalities (OR = 0.7; 95% CI: 0.2-2.0), or other CA (OR = 1.4; 95% CI: 0.7-2.8). Results were similar for acute lymphoblastic and myeloid leukemia cases. Fewer than five subjects were in the remaining CA categories precluding analysis.
Overall, we did not find evidence to support an association between CAs and infant leukemia.
婴儿白血病较为罕见，且除了儿童白血病之外，针对该疾病的研究也较少。婴儿白血病与儿童白血病在生存率和分子特征方面存在差异，这表明其病因不同，可能涉及产前因素。
我们在美国或加拿大儿童肿瘤学组机构中进行了一项病例对照研究，研究了 8 类母亲报告的先天性异常（CA）（唇裂或腭裂、脊柱裂或其他脊柱缺陷、大或多发性胎记、其他染色体异常、小头或小头畸形、肋骨异常、泌尿生殖异常和其他）与婴儿白血病之间的关联。该研究纳入了 1996 年至 2006 年期间在美国或加拿大儿童肿瘤学组机构中诊断为 1 岁以下的 443 例病例和 324 例对照。对照者通过随机数字拨号（1999-2002 年）或通过出生证明（2003-2008 年）从病例所在地区招募，且按照出生年份与病例进行频数匹配。采用非条件逻辑回归计算比值比（OR）和 95%置信区间（CI），并在调整出生年份和随访时间测量值以考虑 CA 观察期的差异后进行校正。
婴儿白血病与任何 CA（OR=1.2；95%CI：0.8-1.9）、胎记（OR=1.4；95%CI：0.7-2.5）、泌尿生殖异常（OR=0.7；95%CI：0.2-2.0）或其他 CA（OR=1.4；95%CI：0.7-2.8）之间均未观察到统计学显著关联。急性淋巴细胞白血病和髓系白血病病例的结果相似。其他 CA 类别中，每个类别少于 5 例病例，无法进行分析。
总体而言，我们没有发现证据支持 CA 与婴儿白血病之间存在关联。
