Increased prevalence of minor anomalies in children with hematologic malignancies

Minor Anomalies in Childhood Lymphomas and Solid Tumors

“…The association between childhood malignancy and major genetic anomalies (eg, Down syndrome, Beckwith-Wiedemann syndrome, WAGR syndrome) has been well described. [7][8][9][10][11] The aim of this study was to investigate the frequency of minor anomalies in childhood solid tumors and compare them with a group of age-matched and sexmatched healthy children. Possible correlations between childhood malignancies and nonsyndrome congenital anomalies also have been investigated in several studies.…”

Infant leukemia and congenital abnormalities: A Children's Oncology Group study

“…Our finding of a twofold increase risk of infant leukemia in association with large or multiple birthmarks in females is intriguing in light of reports by four previous studies (two of childhood cancer and two of childhood leukemia) that have reported significant positive associations for birthmarks [12,31-33]. Mertens et al [12] reported significant increased risks for large or multiple birthmarks overall in the index child but not their siblings for both ALL (OR=1.3; 95% CI 1.1-1.7) and AML (OR=1.9; 95% CI 1.2-3.1).…”

“…However, not all previous studies have excluded individuals with Down syndrome from their analyses [11,21]. In studies that have excluded these individuals, non-significant associations have generally been reported between leukemia (AML, ALL, or total) and any congenital anomaly [13,22-29], major congenital anomalies [30], and heart defects [13,22], while significant associations have been reported for birthmarks (ALL and AML) [12,31], heart abnormalities (ALL) [12], and pancreas or digestive tract abnormalities (ALL) [12]. Our finding of no overall association between CAs and infant leukemia is consistent with that of most previous studies that have excluded Down syndrome.…”

“…Mertens et al [12] reported significant increased risks for large or multiple birthmarks overall in the index child but not their siblings for both ALL (OR=1.3; 95% CI 1.1-1.7) and AML (OR=1.9; 95% CI 1.2-3.1). Roganovic et al [31] reported significant excesses of pigmented nevi and café-au-lait spots in children with hematological malignancies, while Johnson et al [32] and Merks et al [33] reported increased frequencies of birthmarks and port-wine stains respectively in childhood cancer cases compared to non-cases. Similar to the results of our study, Johnson et al [32] also reported a female excess in cases with birthmarks.…”

Unexpected medical coincidences require systematic and careful strategies: an example

“…12 Even minor anomalies are associated with a higher frequency of malignancies. 13 A study from the Children's Cancer group reported AML more often among children with congenital heart defects (odds ratio 2.07) than among children without malformations; children with Down's syndrome were at a particularly high risk (odds ratio 76.8). 14 There are convincing indications of an increased susceptibility to cancer for children with congenital defects, and, at the moment, no substantial evidence of an association between cancer and bovine xenografts.…”