Excess of mild errors of morphogenesis in childhood lymphoblastic leukemia

Abstract

The prevalence of 55 well-defined mild errors of morphogenesis (MEMs) was determined in 100 children with acute lymphoblastic leukemia (ALL), their 80 sibs, 91 mothers, and 76 fathers. Seventy-four patients were treated in Pécs (Hungary) and 26 in Tübingen (Germany). Only white Caucasian index cases were included in the study. Two-hundred children examined for acute infections served as controls. In addition, we analyzed the family history for birth defects and malignancies, associated major malformations, birth weight, birth order, and pretreatment height of the patients. The results of the Pécs and Tübingen patients were at first evaluated separately but since no differences were found only the cumulative data were analyzed further. A significantly increased prevalence of MEMs was found in the ALL patients and their sibs of both sexes: their MEM/subject ratios were 1.59 and 1.51, respectively, whereas the same parameter was 0.74 in the mothers, 0.67 in the fathers and 0.69 in the controls. The same tendency was observed when familial cases and/or age-dependent MEMs were excluded and when malformation-type and variant-type MEMs were evaluated separately. No association of ALL with specific MEMs or combinations was recorded. Family history, associated major malformations, parity and birth weight of the patients did not differ significantly from the local reference values, whereas the pretreatment height of the male probands proved to be greater than expected.

Phenotypic abnormalities: Terminology and classification

“…Until now, seven earlier studies were performed describing the prevalence of minor physical anomalies in pediatric cancer patients [Kobayashi et al, 1968; Stojimirovic, 1981; Méhes et al, 1985, 1994, 1998; Fekete et al, 1987; Roganovic et al, 2002]. Méhes et al [1985] was able to examine 106 pediatric cancer patients.…”

Supernumerary digital flexion creases

“…We had no special control group in this study. However, when investigating the prevalence of mild errors of morphogenesis in childhood malignancies in earlier studies [Méhes et al, 1985, 1998], no supernumerary digital creases were found in 204 children with leukemia or soft tissue tumors, in their 408 first‐degree relatives, and in 204 healthy control subjects.…”

High incidence of malformation syndromes in a series of 1,073 children with cancer

“…The reliance on major malformations ignores the fact that many syndromes primarily manifest minor anomalies, which can be true even for Down syndrome [Preus, 1977]. There are a limited number of studies of the prevalence of minor physical anomalies in childhood cancer patients [Kobayashi et al, 1968; Stojimirovic, 1981; Méhes et al, 1985, 1998; Fekete et al, 1987; Roganovic et al, 2002]. In all of these studies, the prevalence of minor anomalies was increased.…”