Fetal growth and childhood acute lymphoblastic leukemia: Findings from the childhood leukemia international consortium |
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| Authors: | Elizabeth Milne Kathryn R. Greenop Laurent Orsi Jérémie Rudant Nick Dessypris Jill Simpson Tracy Lightfoot Peter Kaatsch Margarita Baka Alessandra Faro Patricia A. Buffler |
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| Affiliation: | 1. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, , WA, Australia, On behalf of the Aus‐ALL Consortium (Australia);2. INSERM U1018, , CESP Villejuif, France, On behalf of ESCALE, Electre, & Adele (France);3. Université Paris‐Sud, UMRS 1018, , Villejuif, France;4. National Registry of Childhood Hematopoietic Malignancies, , Villejuif, France;5. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, , Athens, Greece, On behalf of NARECHEM (Greece);6. Department of Health Science, University of York, , York, United Kingdom, On behalf of UKCCS (United Kingdom);7. German Childhood Cancer Registry at the Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg‐University Mainz, , Mainz, Germany, On behalf of GCCR (Germany);8. Department of Pediatric Hematology–Oncology, “Pan.&Agl. Kyriakou” Children's Hospital, , Athens, Greece, On behalf of NARECHEM (Greece);9. Pediatric Hematology‐Oncology Program, Research Program, Instituto Nacional de Cancer, , Rio de Janeiro, Brazil, On behalf of BCSG‐IAL (Brazil);10. School of Public Health, University of California, Berkeley, , Berkeley, CA, On behalf of NCCLS (California, USA) |
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| Abstract: | Positive associations have been reported between the measures of accelerated fetal growth and risk of childhood acute lymphoblastic leukemia (ALL). We investigated this association by pooling individual‐level data from 12 case–control studies participating in the Childhood Leukemia International Consortium. Two measures of fetal growth—weight‐for‐gestational‐age and proportion of optimal birth weight (POBW)—were analysed. Study‐specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression, and combined in fixed effects meta‐analyses. Pooled analyses of all data were also undertaken using multivariable logistic regression. Subgroup analyses were undertaken when possible. Data on weight for gestational age were available for 7,348 cases and 12,489 controls from all 12 studies and POBW data were available for 1,680 cases and 3,139 controls from three studies. The summary ORs from the meta‐analyses were 1.24 (95% CI: 1.13, 1.36) for children who were large for gestational age relative to appropriate for gestational age, and 1.16 (95% CI: 1.09, 1.24) for a one‐standard deviation increase in POBW. The pooled analyses produced similar results. The summary and pooled ORs for small‐for‐gestational‐age children were 0.83 (95% CI: 0.75, 0.92) and 0.86 (95% CI: 0.77, 0.95), respectively. Results were consistent across subgroups defined by sex, ethnicity and immunophenotype, and when the analysis was restricted to children who did not have high birth weight. The evidence that accelerated fetal growth is associated with a modest increased risk of childhood ALL is strong and consistent with known biological mechanisms involving insulin‐like growth factors. © 2013 UICC |
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| Keywords: | birth weight fetal growth leukemia childhood pooled analysis meta‐analysis |
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