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Congenital Abnormalities and Acute Leukemia among Children with Down Syndrome: A Children's Oncology Group Study

¹ Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota and ² University of Minnesota Cancer Center, Minneapolis, Minnesota; ³ Department of Hematology-Oncology, The Children's Mercy Hospital, Kansas City, Missouri; ⁴ Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina; and ⁵ Department of Pathology, The Ohio State University, Columbus, Ohio

Requests for reprints: Julie A. Ross, Department of Pediatrics, University of Minnesota, 420 Delaware Street Southeast, MMC 422, Minneapolis, MN 55455. Phone: 612-626-2902; Fax: 612-626-4842. E-mail: rossx014{at}umn.edu

Children with Down syndrome, due to their heightened risk of leukemia and increased prevalence of congenital abnormalities, comprise a valuable population in which to study etiology. A Children's Oncology Group study investigated the causes of childhood leukemia in children with Down syndrome diagnosed at ages 0 to 19 years during the period 1997-2002. Telephone interviews were completed with mothers of 158 cases [n = 97 acute lymphoblastic leukemia (ALL) and n = 61 acute myeloid leukemia (AML)] and 173 controls. Odds ratios (OR) and 95% confidence intervals (95% CI) were computed via unconditional logistic regression to evaluate the association between congenital abnormalities and acute leukemia overall, and ALL and AML analyzed separately. The results do not provide evidence for an association among the index children (OR_Combined, 0.74; 95% CI, 0.45-1.23; OR_ALL, 0.67; 95% CI, 0.38-1.20; OR_AML,1.03; 95% CI, 0.49-2.16) or their siblings (OR_Combined, 1.23; 95% CI, 0.71-2.13; OR_ALL, 1.12; 95% CI, 0.60-2.09; OR_AML, 1.60; 95% CI, 0.66-3.86), suggesting congenital malformations do not confer additional risk of leukemia beyond the risk attributable to trisomy 21 in this population. (Cancer Epidemiol Biomarkers Prev 2008;17(10):2572–7)