Infant Acute Leukemia and Maternal Exposures during Pregnancy

• Published in: Cancer epidemiology, biomarkers & prevention Vol. 15; no. 12; pp. 2336 - 2341
• Main Authors: Pombo-de-Oliveira, Maria S., Koifman, Sergio
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 01-12-2006
• Subjects: Acute Disease; Biological and medical sciences; Brazil - epidemiology; Case-Control Studies; environmental risk factors; Female; Hematologic and hematopoietic diseases; Histone-Lysine N-Methyltransferase; Hospitals; Humans; Infant; infant leukemia; Infant, Newborn; Leukemia, Myeloid - epidemiology; Leukemia, Myeloid - etiology; Leukemia, Myeloid - genetics; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Maternal Exposure; Maternal-Fetal Exchange; Medical sciences; Myeloid-Lymphoid Leukemia Protein - genetics; Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics; Pregnancy; Prenatal Exposure Delayed Effects; risk; Translocation, Genetic; transplacental exposure; Tumors; South America; Brazil; America; Human; Hormone therapy; Acute leukemia; Infant; Malignant hemopathy; Exposure; Case control study; Epidemiology; Pregnancy; Cancerology; Gene; Mother; Risk factor; Genetics; Mutation; Public health
• ISSN: 1055-9965; 1538-7755
• DOI: 10.1158/1055-9965.EPI-06-0031

Infant acute leukemia (IAL) has a unique profile characterized by the high incidence of translocations involving the MLL gene located at the 11q23 region. To test the potential role of intrauterine and perinatal factors linked to the risk of
IAL development, a hospital-based case-control study was conducted in different cities of Brazil. A total of 202 children
(ages 0-21 months) with newly diagnosed IAL was enrolled (1999-2005), and 440 age-matched controls were selected from the
same hospitals wherein IAL cases were treated. A statistically significant association between maternal use of hormones during
pregnancy and IAL was observed [odds ratio (OR), 8.76; 95% confidence interval (95% CI), 2.85-26.93] in a multivariable analysis.
The association of certain exposures during pregnancy (hormones, dipyrone, metronidazole, and misoprostol) and MLL gene rearrangements was tested using a case-case approach. Despite the lack of statistical significance, the magnitude of
the OR for maternal exposure to dipyrone (OR, 1.45; 95% CI, 0.75-2.86), metronidazole (OR, 1.72; 95% CI, 0.64-4.58), quinolones
(OR, 2.25; 95% CI, 0.70-25.70), and hormones (OR, 1.88; 95% CI, 0.50-7.01) may suggest the occurrence of interactions between
such maternal exposures during pregnancy and MLL rearrangements, yielding into IAL development. The strong and statistically significant association between IAL and estrogen
exposure during pregnancy observed in this study deserves further investigation to investigate its role in intrauterine leukemogenesis.
(Cancer Epidemiol Biomarkers Prev 2006;15(12):2336–41)