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Barahmani N.,Baylor College of Medicine | Barahmani N.,Childhood Cancer Prevention and Epidemiology Center | Dorak M.T.,Liverpool Hope University | Forman M.R.,University of Texas at Austin | And 9 more authors.
Pediatric Hematology and Oncology | Year: 2015

High birth weight is an established risk factor for childhood acute lymphoblastic leukemia (ALL), especially in children younger than 5 years of age at diagnosis. The goal of this study was to explore the association between being born large for gestational age and the risk for ALL by race/ethnicity to determine if the role of this risk factor differed by these characteristics. The authors compared birth certificate data of 575 children diagnosed with ALL who were younger than 5 years and included in the Texas Cancer Registry, Texas Department of Health, between the years 1995 and 2003 with 11,379 controls matched by birth year. Stratified odds ratios were calculated for risk of ALL by birth weight for gestational age, categorized in 3 groups, small, appropriate, and large for gestational age (SGA, AGA, and LGA, respectively), for each race/ethnicity group. The risk of developing ALL was higher among Hispanics who were LGA (odds ratio [OR] = 1.90, 95% confidence interval [CI]: 1.34-2.68) compared with LGA non-Hispanic whites (OR = 1.27, 95% CI: 0.87-1.86) after adjusting for infant gender, year of birth, maternal age, birth order, and presence of Down syndrome. However, the difference was not statistically significant. These results suggest that there may be differences in the association between higher growth in utero and risk of childhood ALL among Hispanics versus non-Hispanic whites. © 2015 Copyright © Taylor & Francis Group, LLC.


Sprehe M.R.,Baylor College of Medicine | Barahmani N.,Baylor College of Medicine | Barahmani N.,Childhood Cancer Prevention and Epidemiology Center | Cao Y.,University of Texas M. D. Anderson Cancer Center | And 7 more authors.
Pediatric Blood and Cancer | Year: 2010

Introduction. High birth weight (HBW) is an established risk factor for childhood acute lymphoblastic leukemia (ALL). The purpose of this study was to evaluate if birth weight (BW) corrected-for-gestational age is a better predictor than BW alone for occurrence of ALL and other malignancies in children. Materials and Methods. Birth certificate data of 2,254 children with cancer who were younger than 5 years old at diagnosis and registered at Texas Cancer Registry during 1995-2003 were compared to 11,734 age-matched controls. Multivariable logistic regression was used to compare models with BW corrected-for-gestational age and BW alone. Results. Compared to children who were appropriate for gestational age (AGA), children who were large for gestational age (LGA) at birth had a 1.66 times (95% CI 1.32-2.10) higher odds of ALL. Similarly, children with a BW≥4,000 g had a 1.5 times (95% CI 1.18-1.89) higher odds for ALL, compared to children who weighed >2,500 and <4,000 g at birth. Using model diagnostics, the model containing BW corrected-for-gestational age was a better predictor than the model with BW alone [Akaike's Information Criterion (AIC) 4,646 vs. 4,658, respectively]. Odds ratios (OR) were similar for LGA children who were <4,000 g and LGA children who were ≥4,000 g (OR=1.5, 95% CI 0.97-2.5 and OR=1.67, 95% CI 1.29-2.16, respectively). BW was not an independent risk factor for acute myeloid leukemia or brain tumors. Conclusion. BW corrected-forgestational age is a better predictor than BW alone of risk for ALL. Future studies using BW variable should incorporate gestational age in their analyses. © 2009 Wiley-Liss, Inc.


Kilburn L.,Baylor College of Medicine | Kilburn L.,Childhood Cancer Prevention and Epidemiology Center | Okcu M.F.,Baylor College of Medicine | Okcu M.F.,Childhood Cancer Prevention and Epidemiology Center | And 10 more authors.
Cancer | Year: 2010

BACKGROUND: Glutathione S-transferases (GSTs) are polymorphic enzymes that are responsible for glutathione conjugation of alkylators and scavenging of free radicals created by radiation. GST polymorphisms may result in altered or absent enzyme activity and have been associated with survival in patients with cancer. The authors of this report hypothesized that patients with anaplastic glioma (AG) who have GST genotypes that encode for lower activity enzymes will have longer survival than similar patients who have higher activity genotypes. The current study was performed to investigate the role of GST enzyme polymorphisms in predicting the survival of patients with AG. METHODS: The medical records of 207 patients with AG from a single cancer center were reviewed retrospectively. Polymorphisms for the GST μ1 (GSTM1), GST θ1 (GSTT1), and GST π1 (GSTP1) enzymes were identified. Overall survival was compared using the Kaplan-Meier method and Cox proportional hazards analyses adjusting for age, sex, histology, and therapy. RESULTS: Among the patients with oligodendroglial tumors (n = 94), patients who had the GSTT1 null genotype had a 2.9 times increased risk of death (95% confidence interval [CI], 1.3-6.3) compared with patients who had the GSTT1 non-null genotype. Adjustment for 1p/19q status did not change the finding. In the patients who had anaplastic astrocytoma (n = 113), the patients with all GSTP1 genotypes except GSTP1 *B/*B had a 3.8 times increased risk of death (95% CI, 0.5-29.6) compared with patients who had the GSTP1 *B/*B genotype. CONCLUSIONS: In patients with anaplastic oligodendroglial tumors, the GSTT1 null genotype may be associated with poor survival, possibly because of modifications in therapy secondary to increased toxicity. This hypothesis is under investigation. In patients with anaplastic astrocytoma, the GSTP1 *B/*B genotype may confer a survival advantage. © 2010 American Cancer Society.

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