Per- and polyfluoroalkyl substance concentrations during pregnancy and at birth and risk of childhood acute lymphoblastic leukemia

Per- and polyfluoroalkyl substances (PFAS) comprise a class of persistent environmental pollutants with potential carcinogenic effects, but their impact on childhood cancer remains underexplored. A child's exposure to PFAS can occur through various pathways postnatally, including contaminated food, water, and consumer products; and in utero, as PFAS can cross the placenta.

To investigate the association between early-life PFAS exposure and the risk of childhood acute lymphoblastic leukemia (ALL), we analyzed archived blood samples from children diagnosed with ALL and matched cancer-free controls. Using novel untargeted liquid chromatography-high resolution mass spectrometry (LC-HRMS), we measured PFAS levels in paired maternal pregnancy and child newborn blood samples.

Our study identified an independent association between MeFOSAA levels at birth and increased ALL risk, particularly among children diagnosed at 2 years of age or younger. MeFOSAA measured in maternal second-trimester blood showed a weak association with ALL, although it was not statistically significant.

These results suggest that early-life exposure to MeFOSAA may play a critical role in the development of childhood ALL. Our findings corroborate previous reports linking MeFOSAA exposure during pregnancy to childhood ALL, highlighting its potential carcinogenicity during key developmental windows.