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Evaluation of the Association Between Congenital Cytomegalovirus Infection and Pediatric Acute Lymphoblastic Leukemia
Journal article   Open access   Peer reviewed

Evaluation of the Association Between Congenital Cytomegalovirus Infection and Pediatric Acute Lymphoblastic Leukemia

Jennifer M Geris, Mark R Schleiss, Anthony J Hooten, Erica Langer, Nelmary Hernandez-Alvarado, Michelle A Roesler, Jeannette Sample, Lindsay A Williams, David S Dickens, Rajen J Mody, …
JAMA network open, Vol.6(1), e2250219
01/03/2023
DOI: 10.1001/jamanetworkopen.2022.50219
PMCID: PMC9856744
PMID: 36622672
url
https://doi.org/10.1001/jamanetworkopen.2022.50219View
Published (Version of record) Open Access

Abstract

Acute lymphoblastic leukemia (ALL) is the most common form of pediatric cancer, and a leading cause of death in children. Understanding the causes of pediatric ALL is necessary to enable early detection and prevention; congenital cytomegalovirus (cCMV) has recently been identified as a potential moderate-to-strong factor associated with risk for ALL. To compare the prevalence of cCMV infection between ALL cases and matched controls. In this population-based case-control study of ALL cases and matched controls, cases consisted of children aged 0 to 14 years between 1987 and 2014 with an ALL diagnosis identified through the Michigan Cancer Surveillance Program and born in Michigan on or after October 1, 1987. Cancer-free controls were identified by the Michigan BioTrust for Health and matched on age, sex, and mother's race and ethnicity. Data were analyzed from November to May 2022. cCMV infection measured by quantitative polymerase chain reaction in newborn dried blood spots. ALL diagnosed in children aged 0 to 14 years. A total of 1189 ALL cases and 4756 matched controls were included in the study. Bloodspots were collected from participants at birth, and 3425 (57.6%) participants were male. cCMV was detected in 6 ALL cases (0.5%) and 21 controls (0.4%). There was no difference in the odds of cCMV infection comparing ALL cases with controls (odds ratio, 1.30; 95% CI, 0.52-3.24). Immunophenotype was available for 536 cases (45.1%) and cytogenetic data for 127 (27%). When stratified by subtype characteristics, hyperdiploid ALL (74 cases) was associated with 6.26 times greater odds of cCMV infection compared with unmatched controls (95% CI, 1.44-27.19). In this case-control study of cCMV and pediatric ALL, cCMV was associated with increased risk of hyperdiploid ALL. These findings encourage continued research.
Case-Control Studies Child Cytomegalovirus Infections - complications Cytomegalovirus Infections - epidemiology Female Humans Infant, Newborn Male Michigan Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology Prevalence

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