Childhood leukemia incidence in California: High and rising in the Hispanic population

Abstract

Background High rates of childhood leukemia incidence have been reported in Latin America and among Hispanic children in the United States. California’s large Hispanic population affords an important opportunity to perform a detailed analysis of the leukemia burden among Hispanic children. Methods Leukemias diagnosed among non-Hispanic white (NHW), Hispanic, African American (AA), and Asian/Pacific Islander (API) children, aged 0 to 19 years, between January 1, 1990 and December 31, 2012 were obtained from the California Cancer Registry (n=11,084). Age-adjusted incidence rates (AAIR), standardized rate ratios (SRR), and secular trends in incidence (annual percent change [APC]) were analyzed by subtype, race/ethnicity, sex, and age. Results Compared to NHWs, acute lymphoblastic leukemia (ALL) incidence was higher among Hispanics (SRR=1.32) and lower among AAs (SRR=0.55) and APIs (SRR=0.91). From 1990 to 2012, ALL incidence increased overall (APC=1.1%), among males (APC=1.0%), females (APC=1.3%), Hispanics (APC=1.1%), AAs (APC=1.9%), AA males (APC=2.8%), API males (APC=1.9%), and Hispanic females (APC=1.5%). ALL increased among Hispanic males aged 15 to 19 years (APC=2.5%) and Hispanic females aged 0 to 4 and 15 to 19 years (APC=2.2% and 1.9%, respectively). Acute myeloid leukemia (AML) incidence did not differ among racial/ethnic groups. From 1990 to 2012, overall AML incidence remained stable but increased among Hispanics (APC=1.2%), females (APC=1.0%), Hispanic females (APC=2.3%), and Hispanic females aged 15 to 19 years (APC=3.4%). Conclusions Notable differences in childhood leukemia incidence among four racial/ethnic groups in California were observed. Factors which may contribute to these differences include differential exposure to carcinogens and/or genetic susceptibility.

Survival analysis of adult patients with ALL in Mexico City: first report from the Acute Leukemia Workgroup (ALWG) (GTLA)

“…The negative impact of the Ph‐like signature has been recently described, as well as its prevalence in the Latino population . We do not know the frequency of this feature in our study population but a high prevalence is to be expected in the light of previous reports and it tends to negatively affect survival.…”

Hospitalization rate and costs in acute lymphoblastic leukemia of childhood in a low‐income group: Financial impact in Northeast Mexico

“…Ultimately, these data have greater importance in a high‐risk population, where the relapse rate is higher and financial resources are scarce. Specific genetic polymorphisms in Hispanics have been associated with a higher incidence of ALL and a greater risk or relapse, thus representing worse prognosis in this population, as recently reviewed …”

“…Specific genetic polymorphisms in Hispanics have been associated with a higher incidence of ALL and a greater risk or relapse, thus representing worse prognosis in this population, as recently reviewed. 20,21 For admissions that involved PICU utilization, mean cost increased to $19,000 per stay, in contrast with $61,800 in the United States. 22 Faraci et al 23 reported a median LOS in the PICU of 4 days and a mortality of 38.9% for patients with malignant and nonmalignant diseases, comparable to 5 days and 30% mortality in our group.…”

Home remodeling and risk of childhood leukemia

“…The increasing gap in ALL incidence between Hispanic and non-Hispanic children in California suggests the presence of distinct etiologic risk factors by ethnicity; as such we evaluated ALL risk associated with home remodeling while stratifying by Hispanic ethnicity (28). The routes by which children are exposed to indoor chemicals vary by age, so we also stratified our ALL risk analysis by age at diagnosis.…”