ABSTRACT
BACKGROUND: A hormonal aetiology is one explanation for the lower incidence of myeloid leukaemia in women compared with men. METHODS: In this population-based case-control study, we evaluated associations between exogenous hormone use and reproductive history and myeloid leukaemia, overall and by disease subtype. RESULTS: We observed a suggestive association between oral contraceptive use and acute myeloid leukaemia (odds ratio=0.55, 95% confidence interval=0.32-0.96). Hormone replacement therapy and reproductive factors were not associated with risk. CONCLUSION: Despite the biological plausibility for a role of oestrogen in leukaemogenesis, other aetiologic factors are likely to explain the differing incidence rates in males and females.
Subject(s)
Contraceptives, Oral/adverse effects , Estrogens/adverse effects , Hormone Replacement Therapy , Leukemia, Myeloid/etiology , Reproductive History , Adult , Aged , Case-Control Studies , Female , Humans , Male , Middle Aged , Risk , Risk Factors , Young AdultABSTRACT
In contrast to the positive association found in three studies between maternal anaemia during pregnancy and childhood leukaemia, no such association was found in infant leukaemia (odds ratio 0.85, 95% confidence interval 0.53-1.37).
Subject(s)
Anemia/complications , Hemoglobins/metabolism , Leukemia/etiology , Pregnancy Complications, Hematologic/blood , Adult , Anemia/blood , Case-Control Studies , Female , Humans , Infant, Newborn , Leukemia/blood , Leukemia/classification , Maternal Age , Odds Ratio , Pregnancy , Risk FactorsABSTRACT
BACKGROUND: Most longitudinal studies of nondemented persons have reported greater cognitive decline among APOE epsilon4 carriers vs noncarriers. However, most studies involved elderly samples (aged 65+) and were not large enough to examine the three APOE alleles separately. METHODS: Change in cognitive function was examined over a 6-year period using three neuropsychological tests among four APOE genotype groups (epsilon2/2 + epsilon2/3, epsilon3/3 (referent), epsilon4/2 + epsilon4/3, epsilon4/4). The population-based sample included 1,693 African Americans and 6,202 Caucasians initially ages 47 to 68. RESULTS: There was increasingly greater cognitive decline from the epsilon2 group to the epsilon4/4 group in Caucasians for two of the three tests. The combination of APOE epsilon4 with hypercholesterolemia or diabetes showed the greatest cognitive decline. Among African Americans, only the test measuring psychomotor speed showed associations with APOE genotype. CONCLUSIONS: APOE epsilon4 is associated with greater cognitive decline in middle-aged Caucasian individuals, with a reduced decline among epsilon2 carriers. This suggests that the processes by which APOE genotype mediates dementia risk are operative well in advance of overt dementia.
Subject(s)
Apolipoproteins E/genetics , Cognition Disorders/genetics , Black or African American , Aged , Alleles , Apolipoprotein E2 , Apolipoprotein E4 , Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/epidemiology , Carotid Artery Diseases/genetics , Cognition Disorders/epidemiology , Cohort Studies , Diabetes Mellitus/epidemiology , Diabetes Mellitus/genetics , Disease Progression , Female , Genetic Predisposition to Disease , Genotype , Humans , Hypercholesterolemia/epidemiology , Hypercholesterolemia/genetics , Male , Middle Aged , Neuropsychological Tests , Prospective Studies , Ultrasonography , White PeopleABSTRACT
Children with Down syndrome (DS) are highly susceptible to acute leukaemia. Given the potential role of infections in the aetiology of leukaemia in children without DS, we investigated whether there was an association between early-life infections and acute leukaemia in children with DS. Maternal infections during pregnancy were also examined. We enrolled 158 incident cases of acute leukaemia in children with DS (97 acute lymphoblastic leukaemia (ALL) and 61 acute myeloid leukaemia (AML)) diagnosed at Children's Oncology Group institutions between 1997 and 2002. DS controls (N=173) were selected from the cases' primary care clinics and frequency matched on age at leukaemia diagnosis. Data were collected on demographics, child's medical history, mother's medical history, and other factors by maternal interview. Analyses were conducted using unconditional logistic regression adjusted for potential confounders. A significant negative association was observed between acute leukaemia and any infection in the first 2 years of life (adjusted odds ratio (OR)=0.55, 95% confidence interval (CI) (0.33-0.92); OR=0.53, 95% CI (0.29-0.97); and OR=0.59, 95% CI (0.28-1.25) for acute leukaemia combined, ALL, and AML respectively). The association between acute leukaemia and maternal infections during pregnancy was in the same direction but not significant. This study offers support for the hypothesis that early-life infections may play a protective role in the aetiology of acute leukaemia in children with DS.
