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Prenatal and Perinatal Factors Associated with Infant Acute Lymphoblastic Leukaemia: A Scoping Review
Arantza Sanvisens1,2, Clara Bueno3,4,5, Oriol Calvete6
1Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Catalan Cancer Plan, Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI-CERCA), 17004 Girona, Spain.
Insights
This review explored prenatal and perinatal risk factors for infant acute lymphoblastic leukaemia (ALL). Findings suggest links between infant ALL and maternal pesticide exposure, high birth weight, parental smoking, certain medications, and air pollution.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Environmental Health
Background:
- Infant acute lymphoblastic leukaemia (ALL) (<1 year) has a poor prognosis, particularly with KMT2A rearrangements.
- Identifying prenatal and perinatal risk factors for infant ALL is challenging due to limited sample sizes in epidemiological studies.
Purpose of the Study:
- To conduct a scoping review to identify prenatal or perinatal factors associated with infant ALL.
- To elucidate potential risk factors contributing to the development of ALL in infants.
Main Methods:
- A comprehensive scoping review of original articles, letters, and conference abstracts.
- Literature search conducted across PubMed, Web of Science, and Embase databases up to June 2022.
- Selection of 33 observational studies for analysis.
Main Results:
- Established associations include maternal pesticide exposure and high birth weight.
- Suggestive associations identified: parental heavy smoking, parental use of medications (e.g., dipyrone), and maternal exposure to air pollution during pregnancy.
Conclusions:
- This review summarizes observational studies on prenatal/perinatal risk factors for infant ALL.
- Highlights a significant gap in research for this specific pediatric age group.
- Emphasizes the need for further investigation into infant ALL risk factors.
Objective:
Acute lymphoblastic leukaemia (ALL) is the most frequent childhood cancer. Infant ALL (<1 year) is rare, but it captures a lot of interest due to its poor prognosis, especially in patients harbouring KMT2A rearrangements, which have been demonstrated to arise prenatally. However, epidemiological studies aimed at identifying specific risk factors in such cases are scarce, mainly due to sample-size limitations. We conducted a scoping review to elucidate the prenatal or perinatal factors associated with infant ALL.
Methods:
Original articles, letters, or conference abstracts published up to June 2022 were identified using the PubMed, Web of Science, and Embase databases, and 33 observational studies were selected.
Results:
The study reveals several well-established associations across the literature, such as maternal exposure to pesticides and high birth weight, and outlines suggestive associations, such as parental heavy smoking, parental use of several medications (e.g., dipyrone), and maternal exposure to air pollution during pregnancy.
Conclusions:
This scoping review summarizes the few observational studies that have analysed the prenatal and perinatal risk factors for ALL in infants diagnosed before the age of 1 year. The results of this review highlight the lack of research into this specific age group, which merits further research.
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