Sex‐linked Difference in Blood‐group Distribution Among Patients Suffering From Acute Leukaemias

Abstract

Large numbers of papers have been published on the relationship of different diseases and human blood-groups. Comparing blood-group distribution of a great number of patients suffering from acute leukaemia (AL) to that of control persons, no significant differences could be detected (Shirley & Desai, 1965; Vogel & Helmbold, 1972; Harris et al, 1977).We found blood-group 0 frequency surprisingly high among female patients with AL treated in our clinic between 1974 and 1980. Therefore blood-group distribution of patients related to sex was studied. Data of 45 female and 69 male patients are summarized in Table 1. Women suffering from AL have significantly more blood-group 0 than men (51 % and 22%, respectively; x2 = 11.1 1, significant difference). Blood-group A occurred more often (46%) in men with AL than in women (33%). When comparing different types of AL-though our case-number is rather limited-it could be pointed out that blood-group 0 was in highest frequency in women with acute lymphoid leukaemia (62%), while it was less often present in men with acute myeloid leukaemia (21%).These results were compared to blood-group frequency in Hungary. Blood-group 0 occurs in 30-32% of the whole Hungarian population without considerable differences among the different regions (Rex-Kiss & Szabit, 1979). There was no difference when a comparison was made between blood-group distribution of patients with AL and that of a healthy population. However, in group 0 a sex-linked difference was evident. A similar difference in blood-group frequency of a healthy population seems to be rather improbable and no data supporting it are available in the literature.The probable importance of sex differences in blood-group distribution of patients with AL has not been emphasized yet. However, studying retrospectively Mustacchi's earlier report (1960) on 570 patients with AL a similar distribution could be detected. 41 % ofpatients Changes in blood-group characteristics of patients with AL in the course ofdisease are well known but it cannot be used for explaining sex differences in blood-group distribution.

Why is acute leukemia more common in males? A possible sex-determined risk linked to the ABO blood group genes

“…If our findings can be confirmed, they are compatible with the presence of a gene linked to the ABO genes on chromosome 9 which modifies the risk of AL. It may not be the ABO group itself that protects females from leukemia, because it seems that in different populations the actual ABO group with which this modifying gene is linked varies: in the only other study of this type, a Hungarian group obtained a result opposite to ours (fewer males than females with group O) [8]. Our population here is overwhelmingly Malay, whereas their population would presumably have been mainly white Caucasian.…”

“…A number of wellknown constitutional syndromes, such as Down and Bloom syndromes, also predispose to acute leukemia. ABO blood groups have been associated with altered risk for a number of malignancies [9,12], but previous studies have found no association of ABO blood group with acute leukemia [7,8]. This hospital treats virtually all the diagnosed cases of AL in northeastern peninsular Malaysia.…”

“…An estimate of the number of AL patients required for this study was based on the different proportions of group O among male and female AL patients (22% and 51%, respectively) in the study of Nagy et al [8]. Using the PS computer program (Vanderbilt University, Nashville) it was estimated that to have an 80% chance of achieving a significant result (ap0.05), 110 male and 55 female subjects were required.…”

Distribution of Abo Blood Groups in Childhood Acute Leukemia

“…Increased proportion of O blood group in female patients with acute leukemia was reported in two previous studies [11,12]. On the other hand, Jackson and colleagues obtained the reverse result in their recent study [10].…”

“…Various studies have reported conflicting results about the distribution of blood groups among patients with acute leukemia [8,[9][10][11][12][13][14]. Therefore, we opted to determine the distribution of ABO blood groups among a large number of children with ALL and AML in a multicenter study and compare it with that in normal subjects.…”