Related Experiment Video
Updated: Apr 20, 2026
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Perinatal and familial risk factors for acute lymphoblastic leukemia in a Swedish national cohort
Casey Crump1, Jan Sundquist, Weiva Sieh
1Department of Medicine, Stanford University, Stanford, California.
Insights
High fetal growth is linked to increased childhood acute lymphoblastic leukemia (ALL) risk, independent of gestational age. This suggests growth factors may influence ALL development.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Genetics
Background:
- Previous case-control studies suggest a link between perinatal factors, like high birth weight, and acute lymphoblastic leukemia (ALL).
- However, large population-based cohort studies examining these associations, particularly the roles of gestational age and fetal growth, are limited.
- The specific contributions of fetal growth and gestational age to ALL risk remain largely unknown.
Purpose of the Study:
- To investigate the association between perinatal and familial factors and the incidence of acute lymphoblastic leukemia (ALL).
- To examine the independent contributions of fetal growth and gestational age to ALL risk in a large population-based cohort.
Main Methods:
- A national cohort study was conducted in Sweden, including 3,569,333 individuals born between 1973 and 2008 without Down syndrome.
- Individuals were followed for ALL incidence through 2010, with a maximum follow-up age of 38 years.
- Perinatal and familial risk factors were analyzed using incidence rate ratios (IRRs) and confidence intervals (CIs).
Main Results:
- The study identified 1960 ALL cases over 69.7 million person-years.
- High fetal growth (IRR per SD: 1.07; large vs. appropriate for gestational age: 1.22) and a first-degree family history of ALL (IRR: 7.41) were significantly associated with increased ALL risk.
- Male sex (IRR: 1.20) and parental country of birth (IRR: 1.13) were also associated with higher ALL incidence. Gestational age, birth season, birth order, multiple birth, parental age, and education were not significant risk factors.
Conclusions:
- High fetal growth is independently associated with an increased risk of acute lymphoblastic leukemia (ALL) from childhood through young adulthood.
- These findings suggest that growth factor pathways may play a significant role in the etiology of ALL.
- The association between high fetal growth and ALL risk is independent of gestational age at birth.
Background:
Perinatal factors including high birth weight have been found to be associated with acute lymphoblastic leukemia (ALL) in case-control studies. However, to the best of our knowledge, these findings have seldom been examined in large population-based cohort studies, and the specific contributions of gestational age and fetal growth remain unknown.
Methods:
The authors conducted a national cohort study of 3,569,333 individuals without Down syndrome who were born in Sweden between 1973 and 2008 and followed for the incidence of ALL through 2010 (maximum age, 38 years) to examine perinatal and familial risk factors.
Results:
There were 1960 ALL cases with 69.7 million person-years of follow-up. After adjusting for potential confounders, risk factors for ALL included high fetal growth (incidence rate ratio [IRR] per additional 1 standard deviation, 1.07; 95% confidence interval [95% CI], 1.02-1.11 [P =.002]; and IRR for large vs appropriate for gestational age, 1.22; 95% CI, 1.06-1.40 [P =.005]), first-degree family history of ALL (IRR, 7.41; 95% CI, 4.60-11.95 [P<.001]), male sex (IRR, 1.20; 95% CI, 1.10-1.31 [P<.001]), and parental country of birth (IRR for both parents born in Sweden vs other countries, 1.13; 95% CI, 1.00-1.27 [P =.045]). These risk factors did not appear to vary by patient age at the time of diagnosis of ALL. Gestational age at birth, season of birth, birth order, multiple birth, parental age, and parental education level were not found to be associated with ALL.
Conclusions:
In this large cohort study, high fetal growth was found to be associated with an increased risk of ALL in childhood through young adulthood, independent of gestational age at birth, suggesting that growth factor pathways may play an important long-term role in the etiology of ALL.
More Related Videos
09:02Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
13:21Comprehensive DNA Methylation Analysis Using a Methyl-CpG-binding Domain Capture-based Method in Chronic Lymphocytic Leukemia Patients
Published on: June 16, 2017
