Li Xinjun, Sundquist Kristina, Sundquist Jan, Försti Asta, Hemminki Kari
Center for Primary Health Care Research Lund University Malmö Sweden.
Department of Family Medicine and Community Health Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York New York.
EJHaem. 2021 May 3;2(3):421-427. doi: 10.1002/jha2.166. eCollection 2021 Aug.
Acute lymphoblastic leukemia (ALL) is the most common childhood leukemia, while the other types, acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML) are much rarer. While data on familial risks for childhood ALL have been emerging, such data for the other childhood leukemias are hardly available. We aim to fill in the gap of knowledge by assessing familial clustering of each childhood leukemia with childhood and adult leukemia and with any cancer. We identified 4461 childhood leukemias from the Swedish Cancer Registry and obtained their family members from the Multigeneration Register. Standardized incidence ratios (SIRs) were 3.34 for singleton siblings both diagnosed with ALL before age 20 years and 1.64 for those who had a family member diagnosed with ALL in adult age. Other childhood leukemias showed no familial risk, but childhood ALL risk was increased to 1.40 when adult family members were diagnosed with CLL. Childhood ALL was associated with endometrial cancer, and female ALL patients showed increased risk when family members were diagnosed with testicular cancer, melanoma, and skin squamous cell carcinoma. Childhood CLL was associated with rectal cancer, and childhood AML was associated with pancreatic and bladder cancers. As most of these associations are reported for the first time, there is a need to replicate the findings from independent sources.
急性淋巴细胞白血病（ALL）是儿童期最常见的白血病，而其他类型，如急性髓细胞白血病（AML）、慢性淋巴细胞白血病（CLL）和慢性髓细胞白血病（CML）则较为罕见。虽然关于儿童ALL家族风险的数据不断涌现，但关于其他儿童白血病的此类数据却几乎没有。我们旨在通过评估每种儿童白血病与儿童及成人白血病以及与任何癌症的家族聚集性来填补知识空白。我们从瑞典癌症登记处识别出4461例儿童白血病病例，并从多代登记处获取了他们的家庭成员信息。20岁前均被诊断为ALL的单卵双胞胎的标准化发病比（SIRs）为3.34，有成年家庭成员被诊断为ALL的儿童的标准化发病比为1.64。其他儿童白血病未显示出家族风险，但当成年家庭成员被诊断为CLL时，儿童ALL风险增加至1.40。儿童ALL与子宫内膜癌有关，当家庭成员被诊断为睾丸癌、黑色素瘤和皮肤鳞状细胞癌时，女性ALL患者的风险增加。儿童CLL与直肠癌有关，儿童AML与胰腺癌和膀胱癌有关。由于这些关联大多是首次报道，因此需要从独立来源重复这些发现。
