Seasonality in the diagnosis of childhood acute lymphoblastic leukaemia

Thorne, R; Hunt, LP; Mg, Mott

doi:10.1038/bjc.1998.110

Cited by 8 publications

(6 citation statements)

References 1 publication

(3 reference statements)

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“…Several have found no seasonality (Bjelke, 1964;Mainwaring, 1996;Till, et al 1967;Gunz and Spears, 1968;Walker and Van Noord, 1982;Gilman et al, 1998;Thorne et al, 1998;Douglas et al, 1999) while others have found a winter peak (Hayes, 1961;Fraumeni, 1963;Lanzkoswky, 1964), summer peak (Lee, 1962;Knox, 1964;Fekety and Carey, 1969;Badrinath et al, 1997;Gilman et al, 1998, Westerbeek et al, 1998Ross et al, 1999) or a more complex pattern (Harris and Al-Rashid, 1984;Harris et al, 1987). Most of the cases analysed by Lee (1962), and all of the cases in the other UK studies (Knox, 1964;Mainwaring, 1996;Till et al, 1967;Badrinath et al, 1997;Thorne et al, 1998;Gilman et al, 1998;Douglas et al, 1999) have been included in the present analyses, and are therefore effectively small subsets (less than 20% in size) of the present data. Some of the contrasting results may be due to the different statistical approaches that have been used, the failure to take account of temporal changes, but in particular the arbitrary cut-points that have been used to define the different seasons of the year.…”

Section: Discussionmentioning

confidence: 99%

Season of birth and diagnosis of children with leukaemia: an analysis of over 15 000 UK cases occurring from 1953–95

et al. 2001

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Summary If infections are involved in the aetiology of childhood leukaemia then seasonal variation in the birth or onset dates of the malignancy may be apparent. Previous studies that have examined seasonality of these dates have produced conflicting results. Using population-based data from the National Registry of Childhood Tumours we conducted a larger study than any to date of 15 835 cases of childhood leukaemia born and diagnosed in the UK between 1953-95. We found no evidence of seasonality in either month of birth or month of diagnosis overall or in any subgroups by age, sex, histology or immunophenotype. We did however find a significant (P = 0.01) February peak in month of birth for cases born before 1960 and a significant (P = 0.02) August peak in month of diagnosis for those diagnosed before 1962. Whilst these findings may be due to chance they are also consistent with changes over time in the seasonality of exposure, or immunological response, to a relevant infection. Changes in the seasonal variation in the fatality rate of a pre-leukaemic illness, such as pneumonia, could be another explanation.

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Section: Discussionmentioning

confidence: 99%

Season of birth and diagnosis of children with leukaemia: an analysis of over 15 000 UK cases occurring from 1953–95

et al. 2001

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“…If seasonal variation in the onset of disease could be shown in any of the diagnostic subgroups of leukaemia or lymphoma, this could be interpreted as supportive evidence of an aetiology linked to exposure to infection [4,5].…”

Section: Introductionmentioning

confidence: 98%

Seasonal Variation of Childhood Acute Lymphoblastic Leukaemia is Different Between Girls and Boys

Nyári

Kajtár

Bartyik

et al. 2008

Pathol. Oncol. Res.

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The aim of this study was to investigate seasonal trends in the incidence of acute lymphoblastic leukaemia (ALL) around the times of birth and diagnosis in children aged 0-4 years and also to examine gender specific effects. Children born in South Hungary during 1981-1997 were analysed. Registrations of first malignancies for children, diagnosed under age 5 years before the end of 2002 were obtained from the Hungarian Paediatric Oncology Group providing a representative sample of Hungarian children over a 17 year period of time. Data were available on the corresponding numbers of births for each month of the study period were obtained. Statistical analyses were performed using logistic regression with harmonic components. The study analysed 121 cases of children, aged under 5 years, who were diagnosed with ALL. We found no seasonal effect related to date of diagnosis. However, there was seasonal variability for ALL related to date of birth. Maximal rates were seen in children born in February and August in the simple harmonic regression model for all children diagnosed with ALL. Analysis by gender found evidence of seasonality related to month of birth with peaks in February and August in boys, but different seasonal effects were seen for girls (peak in November, nadir in May). Our study provides some evidence that male specific immune responses to infections around the time of birth could explain the male predominance in the incidence of ALL.

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“…The test is implemented to histogram data transformation and answers the question whether there is likely higher relative frequency in one group than the other, the other group usually being the mean of all data. Exploratory analysis without statistical tests was used in 11 publications (stated as "single-factor analysis" in Table1) 1) [38,47,55,57,58,60,62,66,67,70,72] with seven papers reporting positive results for seasonal variation in ALL/childhood leukmeia. The most recent paper with descriptive statistics was published in 2011, marking a shift towards use of more strict hypothesis-driven methods.…”

Section: Discussionmentioning

confidence: 99%

“…In a literature search we identified 41 papers published from 1961 an onward, investigating seasonal variation in ALL (predominantly in childhood) by a variety of methods and with inconsistent results (Table 1). 20 publications reported significant seasonal variation of ALL incidence [35, 36, 38, 39, 41, 44, 45, 47, 49, 50, 52, 53, 55, 56, 58, 63, 69–72], while 21 papers reported no evidence of seasonality [37, 40, 42, 43, 46, 48, 49, 51, 54, 56, 57, 59–62, 64–68, 73].…”

Section: Introductionmentioning

confidence: 99%

Evidence of seasonal variation of childhood acute lymphoblastic leukemia in Sweden

Bychkov

Bang

Engsner

et al. 2023

Preprint

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Background Recent molecular studies of B-cell precursor acute lymphoblastic leukemia (BCP-ALL) have started to delineate the nature and timing of genetic variants and those responsible for subsequent progression to overt leukemia. However, the etiology behind both initiation and progression remains largely unknown. Nonetheless, theories, but also epidemiological evidence, of how exposure to common infections and other microbes in our environment modulates the risk of developing childhood BCP-ALL, have emerged. In light of these theories and the well-known phenomena of seasonality in infectious disease spread, childhood ALL has been analyzed for signs of seasonal variation, with differing results. Methods In this study we applied the Bayesian Generalized Auto Regressive Integrated Moving Average with external variables (GARIMAX) model, adapted for count data via a negative binomial distribution, to study seasonal variation of incidence in a Swedish population-based cohort of 1601 BCP-ALL cases. The studied cases were aged 0-18 years at diagnosis and identified from the Swedish Childhood Cancer Registry (SCCR). Also, two subgroups of BCP-ALL represented by the most abundant genetic subtypes, ETV6/RUNX1 and HeH respectively, were analyzed accordingly. All analyses were performed in two stages. The first stage identified the presence of the repeatable pattern using harmonic functions, and the second stage consisted of the identification of the peak months in the series. Results An informative seasonal variation in BCP-ALL incidence numbers, displaying a peak in August and September, was detected in the total cohort of 1601 individuals. No seasonality was detected analyzing the subtype groups HeH and ETV6/RUNX1 positive BCP-ALL, respectively. Conclusion The manifested seasonality in BCP-ALL with a peak in August-September may suggest that the prolonged period of minimal viral spread during Swedish summer vacation causes a temporary halt in the last step of progression to overt disease and consequently an accumulated number of cases presenting in August-September.

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Seasonality in the diagnosis of childhood acute lymphoblastic leukaemia

Cited by 8 publications

References 1 publication

Season of birth and diagnosis of children with leukaemia: an analysis of over 15 000 UK cases occurring from 1953–95

Season of birth and diagnosis of children with leukaemia: an analysis of over 15 000 UK cases occurring from 1953–95

Seasonal Variation of Childhood Acute Lymphoblastic Leukaemia is Different Between Girls and Boys

Evidence of seasonal variation of childhood acute lymphoblastic leukemia in Sweden

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