Kulkarni Ketan, Stobart Kent, Witol Adrienne, Rosychuk Rhonda J
Department of Pediatrics , Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Pediatr Hematol Oncol. 2011 Nov;28(8):649-60. doi: 10.3109/08880018.2011.613091. Epub 2011 Oct 7.
There is a paucity of published literature on the epidemiology of childhood acute leukemias and lymphomas in Canada. This study was designed to describe children and youth (age <20 years) diagnosed with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL) in Alberta, Canada, during 22 fiscal years. The Alberta Cancer Registry was used to extract data all ALL, AML, HL, and NHL cases diagnosed between April 1, 1982, and March 31, 2004. Population data for Alberta were also obtained. Descriptive statistics and cluster detection tests were used. During 22 years, 525, 117, 257, and 111 children (total = 1010) were diagnosed with ALL, AML, HL, and NHL, respectively. The median ages at diagnosis were 4, 11, 16, and 12 years for ALL, AML, HL, and NHL, respectively. The majority were male for ALL (287/525, 55%), AML (64/117, 55%), and NHL (81/111, 73%), and female for HL (133/257, 52%). The crude rates per 100,000 children were variable, without significant trends, over time and for each diagnosis; the median annual rates, per 100,000 children, were 3.00 (ranging from 1.87 to 3.75) for ALL, 0.62 (ranging from 0.26 to 1.27) for AML, 1.42 (ranging from 0.76 to 2.67) for HL, and 0.54 (ranging from 0.24 to 1.40) for NHL. A few potential spatiotemporal clusters were identified. They are likely due to small number of cases and plausibly clinically insignificant. Overall, childhood leukemia and lymphoma rates in Alberta have remained relatively stable, with no clear epidemiological trends and no significant spatiotemporal clustering. Further investigations are warranted to see if such stability continues and if spatiotemporal patterns arise from longer studies and studies in larger geographic regions with a larger sample size, whilst analyzing for other causal/associated factors, individual susceptibilities, and disease outcomes.
关于加拿大儿童急性白血病和淋巴瘤的流行病学,已发表的文献数量很少。本研究旨在描述在22个财政年度期间,加拿大艾伯塔省被诊断为急性淋巴细胞白血病(ALL)、急性髓细胞白血病(AML)、霍奇金淋巴瘤(HL)和非霍奇金淋巴瘤(NHL)的儿童和青少年(年龄<20岁)。利用艾伯塔癌症登记处提取1982年4月1日至2004年3月31日期间确诊的所有ALL、AML、HL和NHL病例的数据。还获取了艾伯塔省的人口数据。采用描述性统计和聚类检测测试。在22年期间,分别有525名、117名、257名和111名儿童(总计1010名)被诊断为ALL、AML、HL和NHL。ALL、AML、HL和NHL的诊断中位年龄分别为4岁、11岁、16岁和12岁。ALL(287/525,55%)、AML(64/117,55%)和NHL(81/111,73%)的大多数为男性,HL(133/257,52%)的大多数为女性。每10万名儿童的粗发病率随时间和每种诊断情况而变化,无明显趋势;每10万名儿童的年发病率中位数,ALL为3.00(范围为1.87至3.75),AML为0.62(范围为0.26至1.27),HL为1.42(范围为0.76至2.67),NHL为0.54(范围为0.24至1.40)。识别出了一些潜在的时空聚类。它们可能是由于病例数量少,且在临床上可能无显著意义。总体而言,艾伯塔省儿童白血病和淋巴瘤发病率一直相对稳定,没有明显的流行病学趋势,也没有显著的时空聚类。有必要进行进一步调查,以了解这种稳定性是否持续,以及在分析其他因果/相关因素、个体易感性和疾病结局时,更长时间的研究以及更大地理区域、更大样本量的研究是否会出现时空模式。