Evaluation of the Association Between Congenital Cytomegalovirus Infection and Pediatric Acute Lymphoblastic Leukemia.
JAMA Network Open
IMPORTANCE: Acute lymphoblastic leukemia (ALL) is the most common form of pediatric cancer, and a leading cause of death in children. Understanding the causes of pediatric ALL is necessary to enable early detection and prevention; congenital cytomegalovirus (cCMV) has recently been identified as a potential moderate-to-strong factor associated with risk for ALL.
OBJECTIVE: To compare the prevalence of cCMV infection between ALL cases and matched controls.
DESIGN, SETTING, AND PARTICIPANTS: In this population-based case-control study of ALL cases and matched controls, cases consisted of children aged 0 to 14 years between 1987 and 2014 with an ALL diagnosis identified through the Michigan Cancer Surveillance Program and born in Michigan on or after October 1, 1987. Cancer-free controls were identified by the Michigan BioTrust for Health and matched on age, sex, and mother's race and ethnicity. Data were analyzed from November to May 2022.
EXPOSURES: cCMV infection measured by quantitative polymerase chain reaction in newborn dried blood spots.
MAIN OUTCOMES AND MEASURES: ALL diagnosed in children aged 0 to 14 years.
RESULTS: A total of 1189 ALL cases and 4756 matched controls were included in the study. Bloodspots were collected from participants at birth, and 3425 (57.6%) participants were male. cCMV was detected in 6 ALL cases (0.5%) and 21 controls (0.4%). There was no difference in the odds of cCMV infection comparing ALL cases with controls (odds ratio, 1.30; 95% CI, 0.52-3.24). Immunophenotype was available for 536 cases (45.1%) and cytogenetic data for 127 (27%). When stratified by subtype characteristics, hyperdiploid ALL (74 cases) was associated with 6.26 times greater odds of cCMV infection compared with unmatched controls (95% CI, 1.44-27.19).
CONCLUSIONS AND RELEVANCE: In this case-control study of cCMV and pediatric ALL, cCMV was associated with increased risk of hyperdiploid ALL. These findings encourage continued research.
Geris JM, Schleiss MR, Hooten AJ, Langer E, Hernandez-Alvarado N, Roesler MA, et al. [Gowans KL] Evaluation of the association between congenital cytomegalovirus infection and pediatric acute lymphoblastic leukemia. JAMA Netw Open. 2023 Jan 3;6(1):e2250219. doi: 10.1001/jamanetworkopen.2022.50219. PMID: 36622672.