Childhood hematopoietic malignancies and parental use of tobacco and alcohol: the ESCALE study (SFCE)

Objectives

Investigating the role of parental smoking and maternal alcohol consumption in the etiology of childhood hematopoietic malignancies.

Methods

The national registry-based case–control study ESCALE was carried out in France over the period 2003–2004. Population controls were frequency matched with the cases on age and gender. Maternal smoking and alcohol consumption during pregnancy and paternal smoking since before conception were reported by the mothers in a structured telephone questionnaire. Odds ratios (OR) were estimated using unconditional regression models closely adjusted for potential confounders.

Results

A total of 765 cases of acute leukemia (AL), 130 of Hodgkin’s lymphoma (HL), 165 of non-Hodgkin’s lymphoma (NHL) and 1681 controls were included. Paternal smoking was significantly associated with childhood ALL (OR = 1.4 1.1–1.7]), AML (OR = 1.5 1.0–2.3]), Burkitt (OR = 2.0 1.2–3.2]), and anaplastic large cell (OR = 3.2 1.2–9.1]) NHL. For the four diseases, the ORs significantly increased with the number of cigarettes smoked. No association with HL or with other types of NHL was observed. The associations with maternal alcohol consumption and cigarette smoking during pregnancy were less consistent.

Conclusion

The results support the hypothesis that only paternal smoking, and not maternal alcohol consumption or cigarette smoking, plays a role in childhood hematopoietic malignancies.