A chromosomal-effect study of intensive phototherapy versus conventional phototherapy in newborns with jaundice

Karadağ, Ahmet; Yeşilyurt, Ahmet; Unal, Suna; Keskin, Ipek; Demırın, Hilmi; Uraş, Nurdan; Dilmen, Uğur; Tatlı, Mustafa Mansur

doi:10.1016/j.mrgentox.2009.03.008

Cited by 34 publications

(30 citation statements)

References 23 publications

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“…Christensen et al (14) and Wu et al (15) showed increased cytotoxicity and DNA damage in newborn lymphocytes that were exposed to blue light especially. Similar to our study, Karadag et al (16) reported that both enhanced and conventional phototherapy increased the frequency of SCE.…”

Section: Discussionsupporting

confidence: 92%

“…However, the number of patients in this study was considerably low compared with the other studies and a complex patient group was included in the study. Karadag et al (16) showed that bilirubin levels in addition to phototherapy affected the frequency of SCE and demonstrated a linear relationship. However, we did not find a relationship between bilirubin levels and the frequency of SCE in our study.…”

Section: Discussionmentioning

confidence: 99%

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The effect of phototherapy on sister chromatid exchange with different light density in newborn hyperbilirubinemia

Kanmaz¹,

Okur²,

Díllí³

et al. 2018

Turk Pediatri Ars

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Aim: Concerns of possible genotoxic effects of hyperbilirubinemia and phototherapy were raised from experimental and observational studies in neonates. The purpose of this study was to assess the effect of hyperbilirubinemia and phototherapy with three different methods on DNA damage by investigating sister chromatid exchange frequency. Material and Methods: Patients whose gestational ages were >37 weeks and bilirubin levels above phototherapy limits were enrolled into three groups and each group was planned to receive 25 babies. Group 1 received enhanced light-emitting diode phototherapy, group 2 had light-emitting diode phototherapy, and group 3 received conventional phototherapy. Infants with hyperbilirubinemia but did not require phototherapy comprised the control group, which was subdivided into two groups regarding bilirubin levels (10mg/dL). Blood samples were collected before and after phototherapy for sister chromatid exchange frequency and samples were examined by a biologist who was blinded to the study groups. Results: The mean pre-treatment sister chromatid exchange frequency was 1.41±0.34/cell, post-treatment 2.65±0.68/cell, and 1.61±0.61/ cell for the control group (p<0.05). A statistically significant increase in sister chromatid exchange frequency after phototherapy was observed in all three intervention groups (p values: 0.01, 0.01, and 0.008, respectively). When the treatment groups were compared with each other in terms of irradiance, no significant difference was found (p=0.08). Conclusions: Phototherapy causes an increase in the frequency of sister chromatid exchange regardless of the irradiance. Phototherapy could have some genotoxic adverse effects on chromosomes; however, further investigations are warranted to enlighten as to whether these effects are permanent or clinically important.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The effect of phototherapy on sister chromatid exchange with different light density in newborn hyperbilirubinemia

Kanmaz¹,

Okur²,

Díllí³

et al. 2018

Turk Pediatri Ars

Self Cite

View full text Add to dashboard Cite

show abstract

“…More recent studies have confirmed DNA damage in vivo from phototherapy. [11][12][13][14] Epidemiologic studies have focused on leukemia. Three studies from northern Europe found no association.…”

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confidence: 99%

Retrospective Cohort Study of Phototherapy and Childhood Cancer in Northern California

et al. 2016

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OBJECTIVE: To investigate the association between neonatal phototherapy use and childhood cancer.METHODS: This retrospective cohort study included 499 621 children born at ≥35 weeks' gestation from 1995 to 2011 in Kaiser Permanente Northern California hospitals, who survived to hospital discharge and were followed ≥60 days. We obtained data on home and inpatient phototherapy, covariates, and cancer incidence from electronic records. We used propensity-adjusted Cox and Poisson models to control for confounding and unequal follow-up times.RESULTS: There were 60 children with a diagnosis of cancer among 39 403 exposed to phototherapy (25 per 100 000 person-years), compared with 651 of 460 218 unexposed children (18 per 100 000 person-years; incidence rate ratio [IRR] 1.4; P = .01). Phototherapy was associated with increased rates of any leukemia (IRR 2.1; P = .0007), nonlymphocytic leukemia (IRR 4.0; P = .0004), and liver cancer (IRR 5.2; P = .04). With adjustment for a propensity score that incorporated bilirubin levels, chromosomal disorders, congenital anomalies, and other covariates, associations were no longer statistically significant: Adjusted hazard ratios (95% confidence intervals) were 1.0 (0.7-1.6) for any cancer, 1.6 (0.8-3.5) for any leukemia, 1.9 (0.6-6.9) for nonlymphocytic leukemia, and 1.4 (0.2-12) for liver cancer. Upper limits of 95% confidence intervals for adjusted 10-year excess risk were generally <0.1% but reached 4.4% for children with Down syndrome. CONCLUSIONS:Although phototherapy use was associated with increased cancer rates (particularly nonlymphocytic leukemia), control for confounding variables eliminated or attenuated the associations. Nonetheless, the possibility of even partial causality suggests that avoiding unnecessary phototherapy may be prudent.

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“…The potential for phototherapy to increase the incidence of cancer is supported by data from in vitro and in vivo studies. [11][12][13][14][15][16][17][18][19][20][21][22] It is important to determine whether phototherapy contributes to early childhood cancer to determine the optimal management of infants with neonatal hyperbilirubinemia. In this study, we used population-based data to investigate the association between phototherapy and cancer in the first year after birth.…”

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confidence: 99%

Neonatal Phototherapy and Infantile Cancer

et al. 2016

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OBJECTIVE: To determine whether neonatal phototherapy is associated with cancer in the first year after birth. METHODS:We analyzed a data set from the California Office of Statewide Health Planning and Development that was created by linking birth certificates, death certificates, and hospital discharge abstracts up to age 1 year. Subjects were 5 144 849 infants born in California hospitals at ≥35 weeks' gestation from 1998 to 2007. We used International Classification of Diseases, Ninth Revision codes to identify phototherapy at <15 days and discharge diagnoses of cancer at 61 to 365 days. We adjusted for potential confounding variables by using traditional and propensity-adjusted logistic regression models. RESULTS:Cancer was diagnosed in 58/178 017 infants with diagnosis codes for phototherapy and 1042/4 966 832 infants without such codes (32.6/100 000 vs 21.0/100 000; relative risk 1.6; 95% confidence interval [CI], 1.2-2.0, P = .002). In propensity-adjusted analyses, associations were seen between phototherapy and overall cancer (adjusted odds ratio [aOR] 1.4; 95% CI, 1.1-1.9), myeloid leukemia (aOR 2.6; 95% CI, 1.3-5.0), and kidney cancer (aOR 2.5; 95% CI, 1.2-5

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A chromosomal-effect study of intensive phototherapy versus conventional phototherapy in newborns with jaundice

Cited by 34 publications

References 23 publications

The effect of phototherapy on sister chromatid exchange with different light density in newborn hyperbilirubinemia

The effect of phototherapy on sister chromatid exchange with different light density in newborn hyperbilirubinemia

Retrospective Cohort Study of Phototherapy and Childhood Cancer in Northern California

Neonatal Phototherapy and Infantile Cancer

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