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Reproductive history, infertility treatment, and the risk of acute leukemia in children with down syndrome
Author(s) -
Puumala Susan E.,
Ross Julie A.,
Olshan Andrew F.,
Robison Leslie L.,
Smith Franklin O.,
Spector Logan G.
Publication year - 2007
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23025
Subject(s) - medicine , infertility , odds ratio , myeloid leukemia , down syndrome , population , acute leukemia , pediatrics , leukemia , confidence interval , pregnancy , childhood leukemia , obstetrics , gynecology , lymphoblastic leukemia , psychiatry , genetics , environmental health , biology
Abstract BACKGROUND. Children with Down syndrome (DS) have from 10 to 20 times the risk of developing acute leukemia than the general pediatric population. There is mixed evidence for associations between reproductive history or infertility and acute leukemia among children without DS. METHODS. The authors conducted a case‐control study of acute leukemia among children with DS to investigate possible risk factors in this population. From 1997 to 2002, 158 children aged <20 years with DS who had a diagnosis of acute leukemia (97 children with acute lymphoblastic leukemia [ALL] and 61 children with acute myeloid leukemia [AML]) were enrolled at Children's Oncology Group (COG) institutions. Controls with DS (n = 173) were selected from the cases' primary care clinic and frequency matched to cases on age. Telephone interviews were conducted with mothers of cases and controls assessing reproductive history, infertility, and infertility treatment. RESULTS. Null results were observed overall and by subtype for reproductive factors, including previous pregnancy outcomes and contraceptive use, and for most infertility outcomes. There was an increased risk of AML among children with DS whose parents had ever tried for ≥1 year to become pregnant (odds ratio [OR], 2.22; 95% confidence interval [95% CI], 1.14–4.33). A 1‐year increase in maternal age also was associated with AML (OR, 1.06; 95% CI, 1.01–1.12). CONCLUSIONS. Although the questionnaire was limited in this area, the results suggested that the risk for AML may be raised in children with DS because of infertility. In that the risk of infertility, along with having a child with DS, increase with age, these results warrant more research. Cancer 2007. © 2007 American Cancer Society.