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British Journal of Cancer logoLink to British Journal of Cancer
. 1997;76(3):406–415. doi: 10.1038/bjc.1997.399

Leukaemia and non-Hodgkin's lymphoma in children and young adults: are prenatal and neonatal factors important determinants of disease?

E Roman 1, P Ansell 1, D Bull 1
PMCID: PMC2224068  PMID: 9252212

Abstract

A medical record-based study of leukaemia and non-Hodgkin's lymphoma diagnosed before the age of 30 years was carried out at three hospitals in the south of England. Findings for 177 cases and 354 age- and sex-matched controls are presented here. For documented viral infection in pregnancy, the odds ratio (OR) was 6.0 [95% confidence interval (CI) 1.2-29.7] for leukaemia and infinity (95% CI 1.24-infinity) for non-Hodgkin's lymphoma. Mothers of leukaemic cases were more likely to be anaemic, the OR for a pregnancy haemoglobin below 10 g being 3.8 (95% CI 1.3-11.1). An association with birthweight was found for acute myeloid leukaemia, the OR for birthweights > 3500 g being 6.2 (95% CI 1.3-29.8). Further, the preceding siblings of those diagnosed with any form of leukaemia were also more likely to weigh > 3500 g at birth (OR 2.2; 95% CI 1.1-4.4). Overall, leukaemic cases appeared to be comparatively robust at birth with respect to other indicators of well-being, the ORs for jaundice, phototherapy, admission to special care nursery and neonatal intensive care all being less than 1.0. Further, no relation between childhood leukaemia and neonatal administration of intramuscular vitamin K was noted (OR 0.6, 95% CI 0.3-1.4; for acute lymphoblastic leukaemia diagnosed between the ages of 1 and 6 years).

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Selected References

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  1. Adelstein A. M., Donovan J. W. Malignant disease in children whose mothers had chickenpox, mumps, or rubella in pregnancy. Br Med J. 1972 Dec 16;4(5841):629–631. doi: 10.1136/bmj.4.5841.629. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ansell P., Bull D., Roman E. Childhood leukaemia and intramuscular vitamin K: findings from a case-control study. BMJ. 1996 Jul 27;313(7051):204–205. doi: 10.1136/bmj.313.7051.204. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Ben-Sasson S. A., Davis D. L. Neonatal exposure to protoporphyrin-activating lighting as a contributing cause of childhood acute lymphocytic leukemia. Cancer Causes Control. 1992 Jul;3(4):383–387. doi: 10.1007/BF00146893. [DOI] [PubMed] [Google Scholar]
  4. Bithell J. F., Stiller C. A. A new calculation of the carcinogenic risk of obstetric X-raying. Stat Med. 1988 Aug;7(8):857–864. doi: 10.1002/sim.4780070804. [DOI] [PubMed] [Google Scholar]
  5. Cnattingius S., Zack M. M., Ekbom A., Gunnarskog J., Kreuger A., Linet M., Adami H. O. Prenatal and neonatal risk factors for childhood lymphatic leukemia. J Natl Cancer Inst. 1995 Jun 21;87(12):908–914. doi: 10.1093/jnci/87.12.908. [DOI] [PubMed] [Google Scholar]
  6. Doll R. Hazards of the first nine months: an epidemiologist's nightmare. J Ir Med Assoc. 1973 Mar 10;66(5):117–126. [PubMed] [Google Scholar]
  7. Ekbom A., Trichopoulos D., Adami H. O., Hsieh C. C., Lan S. J. Evidence of prenatal influences on breast cancer risk. Lancet. 1992 Oct 24;340(8826):1015–1018. doi: 10.1016/0140-6736(92)93019-j. [DOI] [PubMed] [Google Scholar]
  8. Ekelund H., Finnström O., Gunnarskog J., Källén B., Larsson Y. Administration of vitamin K to newborn infants and childhood cancer. BMJ. 1993 Jul 10;307(6896):89–91. doi: 10.1136/bmj.307.6896.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fasal E., Jackson E. W., Klauber M. R. Birth characteristics and leukemia in childhood. J Natl Cancer Inst. 1971 Sep;47(3):501–509. [PubMed] [Google Scholar]
  10. Fedrick J., Alberman E. D. Reported influenza in pregnancy and subsequent cancer in the child. Br Med J. 1972 May 27;2(5812):485–488. doi: 10.1136/bmj.2.5812.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Fine P. E., Adelstein A. M., Snowman J., Clarkson J. A., Evans S. M. Long term effects of exposure to viral infections in utero. Br Med J (Clin Res Ed) 1985 Feb 16;290(6467):509–511. doi: 10.1136/bmj.290.6467.509. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Ford A. M., Pombo-de-Oliveira M. S., McCarthy K. P., MacLean J. M., Carrico K. C., Vincent R. F., Greaves M. Monoclonal origin of concordant T-cell malignancy in identical twins. Blood. 1997 Jan 1;89(1):281–285. [PubMed] [Google Scholar]
  13. Ford A. M., Ridge S. A., Cabrera M. E., Mahmoud H., Steel C. M., Chan L. C., Greaves M. In utero rearrangements in the trithorax-related oncogene in infant leukaemias. Nature. 1993 May 27;363(6427):358–360. doi: 10.1038/363358a0. [DOI] [PubMed] [Google Scholar]
  14. GILES D., HEWITT D., STEWART A., WEBB J. Malignant disease in childhood and diagnostic irradiation in utero. Lancet. 1956 Sep 1;271(6940):447–447. doi: 10.1016/s0140-6736(56)91923-7. [DOI] [PubMed] [Google Scholar]
  15. Gilman E. A., Wilson L. M., Kneale G. W., Waterhouse J. A. Childhood cancers and their association with pregnancy drugs and illnesses. Paediatr Perinat Epidemiol. 1989 Jan;3(1):66–94. doi: 10.1111/j.1365-3016.1989.tb00371.x. [DOI] [PubMed] [Google Scholar]
  16. Golding J., Greenwood R., Birmingham K., Mott M. Childhood cancer, intramuscular vitamin K, and pethidine given during labour. BMJ. 1992 Aug 8;305(6849):341–346. doi: 10.1136/bmj.305.6849.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Golding J., Paterson M., Kinlen L. J. Factors associated with childhood cancer in a national cohort study. Br J Cancer. 1990 Aug;62(2):304–308. doi: 10.1038/bjc.1990.283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Hakulinen T., Hovi L., Karkinen-Jäskeläinen, Penttinen K., Saxén L. Association between influenza during pregnancy and childhood leukaemia. Br Med J. 1973 Nov 3;4(5887):265–267. doi: 10.1136/bmj.4.5887.265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Herbst A. L., Ulfelder H., Poskanzer D. C. Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women. N Engl J Med. 1971 Apr 15;284(15):878–881. doi: 10.1056/NEJM197104222841604. [DOI] [PubMed] [Google Scholar]
  20. Kinnier-Wilson L. M., Kneale G. W., Stewart A. M. Childhood cancer and pregnancy drugs. Lancet. 1981 Aug 8;2(8241):314–315. doi: 10.1016/s0140-6736(81)90573-0. [DOI] [PubMed] [Google Scholar]
  21. Leck I., Steward J. K. Incidence of neoplasms in children born after influenza epidemics. Br Med J. 1972 Dec 16;4(5841):631–634. doi: 10.1136/bmj.4.5841.631. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. MACMAHON B., NEWILL V. A. Birth characteristics of children dying of malignant neoplasms. J Natl Cancer Inst. 1962 Jan;28:231–244. [PubMed] [Google Scholar]
  23. MacMahon B. Is acute lymphoblastic leukemia in children virus-related? Am J Epidemiol. 1992 Oct 15;136(8):916–924. doi: 10.1093/oxfordjournals.aje.a116564. [DOI] [PubMed] [Google Scholar]
  24. McKinney P. A., Cartwright R. A., Saiu J. M., Mann J. R., Stiller C. A., Draper G. J., Hartley A. L., Hopton P. A., Birch J. M., Waterhouse J. A. The inter-regional epidemiological study of childhood cancer (IRESCC): a case control study of aetiological factors in leukaemia and lymphoma. Arch Dis Child. 1987 Mar;62(3):279–287. doi: 10.1136/adc.62.3.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. McKinney P. A., Cartwright R. A., Stiller C. A., Hopton P. A., Mann J. R., Birch J. M., Hartley A. L., Waterhouse J. A., Johnston H. E. Inter-Regional Epidemiological Study of Childhood Cancer (IRESCC): childhood cancer and the consumption of debendox and related drugs in pregnancy. Br J Cancer. 1985 Dec;52(6):923–929. doi: 10.1038/bjc.1985.278. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Michels K. B., Trichopoulos D., Robins J. M., Rosner B. A., Manson J. E., Hunter D. J., Colditz G. A., Hankinson S. E., Speizer F. E., Willett W. C. Birthweight as a risk factor for breast cancer. Lancet. 1996 Dec 7;348(9041):1542–1546. doi: 10.1016/S0140-6736(96)03102-9. [DOI] [PubMed] [Google Scholar]
  27. Mole R. H. Childhood cancer after prenatal exposure to diagnostic X-ray examinations in Britain. Br J Cancer. 1990 Jul;62(1):152–168. doi: 10.1038/bjc.1990.249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Roman E., Watson A., Bull D., Baker K. Leukaemia risk and social contact in children aged 0-4 years in southern England. J Epidemiol Community Health. 1994 Dec;48(6):601–602. doi: 10.1136/jech.48.6.601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Ross J. A., Davies S. M., Potter J. D., Robison L. L. Epidemiology of childhood leukemia, with a focus on infants. Epidemiol Rev. 1994;16(2):243–272. doi: 10.1093/oxfordjournals.epirev.a036153. [DOI] [PubMed] [Google Scholar]
  30. Ross J. A., Perentesis J. P., Robison L. L., Davies S. M. Big babies and infant leukemia: a role for insulin-like growth factor-1? Cancer Causes Control. 1996 Sep;7(5):553–559. doi: 10.1007/BF00051889. [DOI] [PubMed] [Google Scholar]
  31. STEWART A., WEBB J., HEWITT D. A survey of childhood malignancies. Br Med J. 1958 Jun 28;1(5086):1495–1508. doi: 10.1136/bmj.1.5086.1495. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Salonen T. Prenatal and perinatal factors in childhood cancer. Ann Clin Res. 1976 Feb;8(1):27–42. [PubMed] [Google Scholar]
  33. Shaw G., Lavey R., Jackson R., Austin D. Association of childhood leukemia with maternal age, birth order, and paternal occupation. A case-control study. Am J Epidemiol. 1984 May;119(5):788–795. doi: 10.1093/oxfordjournals.aje.a113799. [DOI] [PubMed] [Google Scholar]
  34. Shu X. O., Gao Y. T., Brinton L. A., Linet M. S., Tu J. T., Zheng W., Fraumeni J. F., Jr A population-based case-control study of childhood leukemia in Shanghai. Cancer. 1988 Aug 1;62(3):635–644. doi: 10.1002/1097-0142(19880801)62:3<635::aid-cncr2820620332>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  35. Stark C. R., Mantel N. Effects of maternal age and birth order on the risk of mongolism and leukemia. J Natl Cancer Inst. 1966 Nov;37(5):687–698. [PubMed] [Google Scholar]
  36. Stiller C. A., Allen M. B., Eatock E. M. Childhood cancer in Britain: the National Registry of Childhood Tumours and incidence rates 1978-1987. Eur J Cancer. 1995 Nov;31A(12):2028–2034. doi: 10.1016/0959-8049(95)00428-9. [DOI] [PubMed] [Google Scholar]
  37. Swerdlow A. J., Huttly S. R., Smith P. G. Prenatal and familial associations of testicular cancer. Br J Cancer. 1987 May;55(5):571–577. doi: 10.1038/bjc.1987.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Wakeford R. The risk of childhood cancer from intrauterine and preconceptional exposure to ionizing radiation. Environ Health Perspect. 1995 Nov;103(11):1018–1025. doi: 10.1289/ehp.951031018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Wertelecki W., Mantel N. Increased birth weight in leukemia. Pediatr Res. 1973 Mar;7(3):132–138. doi: 10.1203/00006450-197303000-00005. [DOI] [PubMed] [Google Scholar]
  40. Zack M., Adami H. O., Ericson A. Maternal and perinatal risk factors for childhood leukemia. Cancer Res. 1991 Jul 15;51(14):3696–3701. [PubMed] [Google Scholar]
  41. Zipursky A. Vitamin K at birth. BMJ. 1996 Jul 27;313(7051):179–180. doi: 10.1136/bmj.313.7051.179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. van Steensel-Moll H. A., Valkenburg H. A., Vandenbroucke J. P., van Zanen G. E. Are maternal fertility problems related to childhood leukaemia? Int J Epidemiol. 1985 Dec;14(4):555–559. doi: 10.1093/ije/14.4.555. [DOI] [PubMed] [Google Scholar]
  43. van Steensel-Moll H. A., Valkenburg H. A., van Zanen G. E. Childhood leukemia and infectious diseases in the first year of life: a register-based case-control study. Am J Epidemiol. 1986 Oct;124(4):590–594. doi: 10.1093/oxfordjournals.aje.a114431. [DOI] [PubMed] [Google Scholar]
  44. von Kries R., Göbel U., Hachmeister A., Kaletsch U., Michaelis J. Vitamin K and childhood cancer: a population based case-control study in Lower Saxony, Germany. BMJ. 1996 Jul 27;313(7051):199–203. doi: 10.1136/bmj.313.7051.199. [DOI] [PMC free article] [PubMed] [Google Scholar]

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