Age- and Sex-Specific Incidence of Childhood Leukemia by Immunophenotype in the Nordic Countries

Hjalgrim, Lisa Lyngsie; Rostgaard, Klaus; Schmiegelow, Kjeld; Söderhäll, Stefan; Kolmannskog, S; Vettenranta, Kim; Kristinsson, Jakob; Clausen, Niels; Melbye, Mads; Hjalgrim, Henrik; Gustafsson, Göran

doi:10.1093/jnci/djg064

Cited by 105 publications

(80 citation statements)

References 19 publications

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“…Incidence has increased significantly in Europe and in the United States since the 1970s, which is essentially attributable to ALL (Coleman et al, 1993;Smith et al, 1999;Xie et al, 2003;Steliarova-Foucher et al, 2004). However, the incidence of ALL and AML has been stable in the Nordic countries between 1982 and 2001 (Hjalgrim et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Increasing incidence of childhood leukaemia: a controversy re-examined

Shah

Coleman

2007

Br J Cancer

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Section: Discussionmentioning

confidence: 99%

Increasing incidence of childhood leukaemia: a controversy re-examined

Shah

Coleman

2007

Br J Cancer

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“…1 The diagnosis of ALL is currently based on morphological, immunophenotypic, and cytogenetic analyses of a bone marrow sample, as well as clinical examinations. Based on biological and clinical features, the patients are assigned to risk group adapted therapy, and the 5-year eventfree survival (EFS) rate has increased to more than 75% within the last decade.…”

Section: Introductionmentioning

confidence: 99%

Prediction of immunophenotype, treatment response, and relapse in childhood acute lymphoblastic leukemia using DNA microarrays

et al. 2004

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Gene expression profiling is a promising tool for classification of pediatric acute lymphoblastic leukemia (ALL). We analyzed the gene expression at the time of diagnosis for 45 Danish children with ALL. The prediction of 5-year event-free survival or relapse after treatment by NOPHO-ALL92 or 2000 protocols resulted in a classification accuracy of 78% and a Matthew's correlation coefficient of 0.59 independently of immunophenotypes. The sensitivity and specificity for prediction of relapse were 87% and 69% respectively. Prediction of high vs low levels of the minimal residual disease (MRD) on day 29 (X0.1% or p0.01%) resulted in an accuracy of 100% for precursor-B samples. The classification accuracy of precursor-B-vs Tlineage immunophenotypes was 100% even in samples with as little as 10% leukemic blast cells, and the immunophenotype classifier constructed in this study was able to classify 131 of 132 samples from a previous study correctly. Our study indicates that the Affymetrix Focus Array GeneChip may be used without loss of classification performance compared to previous studies using the far more extensive U133A þ B GeneChip set. Further studies should focus on prediction of MRD, as this prediction would relate strongly to long-term outcome and could thus determine the intensity of induction therapy.

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“…This group lacks a prominent age incidence peak, and the relapse rate is generally high with GC-/vincristine-/antimetabolite-based chemotherapy. 1,7 No study clearly supports that underreporting and misdiagnosis explain the lower registered incidence of childhood ALL in developing countries, compared to that in Europe and the United States. 3 In contrast, the available register-based data on ALL incidences by country and age group support that the incidence of ALL among children below 5 years of age is truly reduced with lower standards of living.…”

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confidence: 99%

“…1 Only a small proportion of cases can be attributed to genetic predisposition such as Down syndrome or ataxia telangiectasia, and siblings of children with ALL do not seem to have a significantly increased risk of ALL. 2 In contrast, considerable temporal and geographical variation in childhood ALL incidence is believed to reflect a correlation with the level of socioeconomic development suggesting a significant role for environmental factors in the pathogenesis of ALL.…”

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confidence: 99%

Etiology of common childhood acute lymphoblastic leukemia: the adrenal hypothesis

et al. 2008

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The pattern of infections in the first years of life modulates our immune system, and a low incidence of infections has been linked to an increased risk of common childhood acute lymphoblastic leukemia (ALL). We here present a new interpretation of these observations -the adrenal hypothesis -that proposes that the risk of childhood ALL is reduced when early childhood infections induce qualitative and quantitative changes in the hypothalamus-pituitary-adrenal axis that increase plasma cortisol levels. This may directly eliminate leukemic cells as well as preleukemic cells for the ALL subsets that dominate in the first 5-7 years of life and may furthermore suppress the Th1-dominated proinflammatory response to infections, and thus lower the proliferative stress on preexisting preleukemic cells.

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Age- and Sex-Specific Incidence of Childhood Leukemia by Immunophenotype in the Nordic Countries

Abstract: Incidences of acute myeloid leukemia overall, acute lymphoblastic leukemia overall, and specific acute lymphoblastic leukemia immunophenotypes have been stable in the Nordic countries over the past two decades.

Cited by 105 publications

References 19 publications

Increasing incidence of childhood leukaemia: a controversy re-examined

Increasing incidence of childhood leukaemia: a controversy re-examined

Prediction of immunophenotype, treatment response, and relapse in childhood acute lymphoblastic leukemia using DNA microarrays

Etiology of common childhood acute lymphoblastic leukemia: the adrenal hypothesis

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