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Perinatal risk factors for acute myeloid leukemia

Crump, Casey; Sundquist, Jan LU ; Sieh, Weiva; Winkleby, Marilyn A. and Sundquist, Kristina LU (2015) In European Journal of Epidemiology 30(12). p.1277-1285
Abstract
Infectious etiologies have been hypothesized for acute leukemias because of their high incidence in early childhood, but have seldom been examined for acute myeloid leukemia (AML). We conducted the first large cohort study to examine perinatal factors including season of birth, a proxy for perinatal infectious exposures, and risk of AML in childhood through young adulthood. A national cohort of 3,569,333 persons without Down syndrome who were born in Sweden in 1973-2008 were followed up for AML incidence through 2010 (maximum age 38 years). There were 315 AML cases in 69.7 million person-years of follow-up. We found a sinusoidal pattern in AML risk by season of birth (P < 0.001), with peak risk among persons born in winter. Relative to... (More)
Infectious etiologies have been hypothesized for acute leukemias because of their high incidence in early childhood, but have seldom been examined for acute myeloid leukemia (AML). We conducted the first large cohort study to examine perinatal factors including season of birth, a proxy for perinatal infectious exposures, and risk of AML in childhood through young adulthood. A national cohort of 3,569,333 persons without Down syndrome who were born in Sweden in 1973-2008 were followed up for AML incidence through 2010 (maximum age 38 years). There were 315 AML cases in 69.7 million person-years of follow-up. We found a sinusoidal pattern in AML risk by season of birth (P < 0.001), with peak risk among persons born in winter. Relative to persons born in summer (June-August), incidence rate ratios for AML were 1.72 (95 % CI 1.25-2.38; P = 0.001) for winter (December-February), 1.37 (95 % CI 0.99-1.90; P = 0.06) for spring (March-May), and 1.27 (95 % CI 0.90-1.80; P = 0.17) for fall (September-November). Other risk factors for AML included high fetal growth, high gestational age at birth, and low maternal education level. These findings did not vary by sex or age at diagnosis. Sex, birth order, parental age, and parental country of birth were not associated with AML. In this large cohort study, birth in winter was associated with increased risk of AML in childhood through young adulthood, possibly related to immunologic effects of early infectious exposures compared with summer birth. These findings warrant further investigation of the role of seasonally varying perinatal exposures in the etiology of AML. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cohort studies, Fetal development, Gestational age, Leukemia, Risk, factors, Seasons
in
European Journal of Epidemiology
volume
30
issue
12
pages
1277 - 1285
publisher
Springer
external identifiers
  • wos:000367331900005
  • scopus:84952639445
ISSN
1573-7284
DOI
10.1007/s10654-015-0063-0
language
English
LU publication?
yes
id
192f1e87-3d0b-4381-ba8c-655ef4c24f34 (old id 8767570)
date added to LUP
2016-03-01 07:19:53
date last changed
2017-07-30 03:26:54
@article{192f1e87-3d0b-4381-ba8c-655ef4c24f34,
  abstract     = {Infectious etiologies have been hypothesized for acute leukemias because of their high incidence in early childhood, but have seldom been examined for acute myeloid leukemia (AML). We conducted the first large cohort study to examine perinatal factors including season of birth, a proxy for perinatal infectious exposures, and risk of AML in childhood through young adulthood. A national cohort of 3,569,333 persons without Down syndrome who were born in Sweden in 1973-2008 were followed up for AML incidence through 2010 (maximum age 38 years). There were 315 AML cases in 69.7 million person-years of follow-up. We found a sinusoidal pattern in AML risk by season of birth (P &lt; 0.001), with peak risk among persons born in winter. Relative to persons born in summer (June-August), incidence rate ratios for AML were 1.72 (95 % CI 1.25-2.38; P = 0.001) for winter (December-February), 1.37 (95 % CI 0.99-1.90; P = 0.06) for spring (March-May), and 1.27 (95 % CI 0.90-1.80; P = 0.17) for fall (September-November). Other risk factors for AML included high fetal growth, high gestational age at birth, and low maternal education level. These findings did not vary by sex or age at diagnosis. Sex, birth order, parental age, and parental country of birth were not associated with AML. In this large cohort study, birth in winter was associated with increased risk of AML in childhood through young adulthood, possibly related to immunologic effects of early infectious exposures compared with summer birth. These findings warrant further investigation of the role of seasonally varying perinatal exposures in the etiology of AML.},
  author       = {Crump, Casey and Sundquist, Jan and Sieh, Weiva and Winkleby, Marilyn A. and Sundquist, Kristina},
  issn         = {1573-7284},
  keyword      = {Cohort studies,Fetal development,Gestational age,Leukemia,Risk,factors,Seasons},
  language     = {eng},
  number       = {12},
  pages        = {1277--1285},
  publisher    = {Springer},
  series       = {European Journal of Epidemiology},
  title        = {Perinatal risk factors for acute myeloid leukemia},
  url          = {http://dx.doi.org/10.1007/s10654-015-0063-0},
  volume       = {30},
  year         = {2015},
}