Environmental, maternal, and reproductive risk factors for childhood acute lymphoblastic leukemia in Egypt: a case-control study

Abstract

BackgroundAcute lymphocytic leukemia (ALL) is the most common pediatric cancer. The exact cause is not known in most cases, but past epidemiological research has suggested a number of potential risk factors. This study evaluated associations between environmental and parental factors and the risk for ALL in Egyptian children to gain insight into risk factors in this developing country. Methods: We conducted a case-control design from May 2009 to February 2012. Cases were recruited from Children’s Cancer Hospital, Egypt (CCHE). Healthy controls were randomly selected from the general population to frequency-match the cumulative group of cases by sex, age groups (<1; 1 – 5; >5 – 10; >10 years) and region of residence (Cairo metropolitan region, Nile Delta region (North), and Upper Egypt (South)). Mothers provided answers to an administered questionnaire about their environmental exposures and health history including those of the father. Odds ratios (ORs) and 95 % confidence intervals (CI) were calculated using logistic regression with adjustment for covariates.ResultsTwo hundred ninety nine ALL cases and 351 population-based controls frequency-matched for age group, gender and location were recruited. The risk of ALL was increased with the mother’s use of medications for ovulation induction (ORadj = 2.5, 95 % CI =1.2 –5.1) and to a lesser extend with her age (ORadj = 1.8, 95 % CI = 1.1 – 2.8, for mothers ≥ 30 years old). Delivering the child by Cesarean section, was also associated with increased risk (ORadj = 2.01, 95 % CI =1.24–2.81).ConclusionsIn Egypt, the risk for childhood ALL appears to be associated with older maternal age, and certain maternal reproductive factors.

Association of Parental, Child, and Environmental Factors with the Occurrence of Childhood Leukemia in Upper Egypt

“…(14,15) Parental smoking or passive smoke exposure of mother or child also posed a potential risk for child leukemia. (16,17) Growing evidence revealed positive associations between childhood leukemia and childhood exposure to household or agriculture pesticides. (18)(19)(20)(21) Published Egyptian studies on risk factors of childhood leukemia are limited, (16) and no previous study explored these risk factors in Upper Egyptian children.…”

“…(16,17) Growing evidence revealed positive associations between childhood leukemia and childhood exposure to household or agriculture pesticides. (18)(19)(20)(21) Published Egyptian studies on risk factors of childhood leukemia are limited, (16) and no previous study explored these risk factors in Upper Egyptian children. This study aimed to identify potential child, parental, and environmental factors that contribute to leukemia risk among Egyptian children in Assiut Governorate.…”

GSTM1 and GSTT1 Genetic Susceptibility and Interaction with Chemical Exposures in Childhood Acute Lymphoblastic Leukemia: A Systematic Review and Meta-analysis

“…However, outcome of individual studies in this review showed that in distribution of GSTM1 genotype, three had increase risk of association with null genotype [19,27,44] and two had no significant difference in prevalence of null genotype [22,24] whiles one study with a gender stratified analysis showed that the null genotype was over-represented in boys [21]. In environmental exposures of chemical pesticides and tobacco smoke 83.3% shows increase risk of childhood ALL [20,23,[27][28][29][30][31][32][33]] and 16.7% shows no association with childhood acute lymphoblastic leukemia [34,35].…”

Angiogenic and FLT3 Receptors Expression in Acute Lymphoblastic Leukemia in Pediatric Age Group

“…Childhood acute lymphoblastic leukemia (ALL) comprises about 30% of malignancies in childhood [1], and constitutes 80% of childhood leukemias [2]. In Egypt, the annual incidence of childhood ALL is about 4 cases per 100,000 children and accounts for approximately 20% of pediatric malignancies [3].…”