Tobacco Smoke Exposure and the Risk of Childhood Acute Lymphoblastic and Myeloid Leukemias by Cytogenetic Subtype
A partir des données 1996-2008 portant sur 902 patients pédiatriques atteints d'une leucémie aiguë lymphoblastique ou d'une leucémie myéloïde et sur 1 139 témoins, cette étude évalue l'association entre le tabagisme passif prénatal ou postnatal et le risque de développer ces maladies durant l'enfance en fonction de la présence d'anomalies cytogénétiques (translocation t(12;21) ou hyperdiploïdie élevée : 51-67 chromosomes)
Background : Tobacco smoke contains carcinogens known to damage somatic and germ cells. We investigated the effect tobacco smoke on the risk of childhood acute lymphoblastic leukemia (ALL) and myeloid leukemia (AML), especially subtypes of pre-natal origin like ALL with translocation t(12;21) or high-hyperdiploidy (51-67 chromosomes).
Methods : We collected information on exposures to tobacco smoking before conception, during pregnancy, and after birth in 767 ALL cases, 135 AML cases, and 1,139 controls (1996-2008). Among cases, chromosome translocations, deletions, or aneuploidy were identified by conventional karyotype and fluorescence in-situ hybridization.
Results : Multivariable regression analyses for ALL and AML overall showed no definite evidence of associations with self-reported (yes/no) parental prenatal active smoking and child's passive smoking. However, children with history of paternal prenatal smoking combined with postnatal passive smoking had a 1.5-fold increased risk of ALL (95% CI: 1.01-2.23), compared to those without smoking history (ORs for pre- or postnatal smoking only were close to one). This joint effect was seen for B-cell precursor ALL with t(12;21) (OR=2.08; 95% CI: 1.04-4.16), but not high hyperdiploid B-cell ALL. Similarly, child's passive smoking was associated with an elevated risk of AML with chromosome structural changes (OR=2.76; 95% CI: 1.01-7.58), but not aneuploidy.
Conclusions : our data suggest that exposure to tobacco smoking before were associated with increased risks of childhood ALL and AML ; and risks varied by timing of exposure (before and/or after birth) and cytogenetic subtype, based on imprecise estimates.
Impact : Parents should limit exposures to tobacco smoke before and after the child's birth.
http://cebp.aacrjournals.org/content/early/2013/07/12/1055-9965.EPI-13-0350.abstract 2013