| 1. |
- Karalexi, M A, et al.
(författare)
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History of Maternal Fetal Loss and Childhood Leukaemia Risk in Subsequent Offspring : Differentials by Miscarriage or Stillbirth History and Disease Subtype.
- 2015
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Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 29:5, s. 453-61
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite the putative intrauterine origins of childhood (0-14 years) leukaemia, it is complex to assess the impact of perinatal factors on disease onset. Results on the association of maternal history of fetal loss (miscarriage/stillbirth) with specific disease subtypes in the subsequent offspring are in conflict. We sought to investigate whether miscarriage and stillbirth may have different impacts on the risk of acute lymphoblastic leukaemia (ALL) and of its main immunophenotypes (B-cell and T-cell ALL), as contrasted to acute myeloid leukaemia (AML).METHODS: One thousand ninety-nine ALL incidents (957 B-ALL) and 131 AML cases along with 1:1 age and gender-matched controls derived from the Nationwide Registry for Childhood Hematological Malignancies and Brain Tumors (1996-2013) were studied. Multivariable regression models were used to assess the roles of previous miscarriage(s) and stillbirth(s) on ALL (overall, B-, T-ALL) and AML, controlling for potential confounders.RESULTS: Statistically significant exposure and disease subtype-specific associations of previous miscarriage(s) exclusively with AML [odds ratio (OR) 1.67, 95% confidence interval (CI) 1.00, 2.81] and stillbirth(s) with ALL [OR 4.82, 95% CI 1.63, 14.24] and B-ALL particularly, emerged.CONCLUSION: Differential pathophysiological pathways pertaining to genetic polymorphisms or cytogenetic aberrations are likely to create hostile environments leading either to fetal loss or the development of specific leukaemia subtypes in subsequent offspring, notably distinct associations of maternal miscarriage history confined to AML and stillbirth history confined to ALL (specifically B-ALL). If confirmed and further supported by studies revealing underlying mechanisms, these results may shed light on the divergent leukemogenesis processes.
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| 2. |
- Karalexi, M. A., et al.
(författare)
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Maternal fetal loss history and increased acute leukemia subtype risk in subsequent offspring : a systematic review and meta-analysis
- 2017
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Ingår i: Cancer Causes and Control. - : SPRINGER. - 0957-5243 .- 1573-7225. ; 28:6, s. 599-624
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Forskningsöversikt (refereegranskat)abstract
- Purpose History of fetal loss including miscarriage and stillbirth has been inconsistently associated with childhood (0-14 years) leukemia in subsequent offspring. A quantitative synthesis of the inconclusive literature by leukemia subtype was therefore conducted. Methods Eligible studies (N = 32) were identified through the screening of over 3500 publications. Random-effects meta-analyses were conducted on the association of miscarriage/stillbirth history with overall (AL; 18,868 cases/35,685 controls), acute lymphoblastic (ALL; 16,150 cases/38,655 controls), and myeloid (AML; 3042 cases/32,997 controls) leukemia. Sensitivity and subgroup analyses by age and ALL subtype, as well as meta-regression were undertaken. Results Fetal loss history was associated with increased AL risk [Odds Ratio (OR) 1.10, 95% Confidence Intervals (CI) 1.04-1.18]. The positive association was seen for ALL (OR 1.12, 95%CI 1.05-1.19) and for AML (OR 1.13, 95%CI 0.91-1.41); for the latter the OR increased in sensitivity analyses. Notably, stillbirth history was significantly linked to ALL risk (OR 1.33, 95%CI 1.02-1.74), but not AML. By contrast, the association of ALL and AML with previous miscarriage reached marginal significance. The association of miscarriage history was strongest in infant ALL (OR 2.34, 95%CI 1.19-4.60). Conclusions In this meta-analysis involving > 50,000 children, we found noteworthy associations by indices of fetal loss, age at diagnosis, and leukemia type; namely, of stillbirth with ALL and miscarriage history with infant ALL. Elucidation of plausible underlying mechanisms may provide insight into leukemia pathogenesis and indicate monitoring interventions prior to and during pregnancy.
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| 3. |
- Petridou, E, et al.
(författare)
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Are traffic injuries disproportionally more common among tourists in Greece? Struggling with incomplete data
- 1999
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Ingår i: Accident Analysis and Prevention. - 0001-4575 .- 1879-2057. ; 31:6, s. 611-615
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Tidskriftsartikel (refereegranskat)abstract
- Data concerning injury hazards among tourists are difficult to obtain because estimates of person-time denominators are rarely available. Existing sources are limited to enumeration of injured or killed persons by nationality and type of injury and the analysis can only rely on proportional indicators. Since 1995, the Regional Hospital in the tourist island of Kerkyra (Corfu) has been covering all types of accidents including road traffic injuries, in the context of the Emergency Department Injury Surveillance System (EDISS). The catchment area of this hospital practically coincides with the island population. About 15% of all accidents are traffic-related among either permanent residents or Greek tourists, but they represent 40% among tourists of foreign nationalities. This is suggestive, but far from conclusive evidence, that traffic injuries may be more common among foreign tourists. There are indications that accidents among foreign tourists overall are slightly more serious. Among Greek tourists, the ratio between peak and non-peak period is similar for non-traffic injuries (7.4) and traffic injuries (6.8), whereas among foreign tourists the corresponding ratio is 9.2 for non traffic injuries and 15.0 for traffic injuries. This pattern is difficult to explain in terms other than an excess risk of traffic injuries among foreign tourists.
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| 4. |
- Petridou, E, et al.
(författare)
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Car restraints and seating position for prevention of motor vehicle injuries in Greece
- 1998
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Ingår i: Archives of Disease in Childhood. - 0003-9888 .- 1468-2044. ; 78:4, s. 335-339
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Tidskriftsartikel (refereegranskat)abstract
- The protective effect of child restraint and the relative safety of front and rear seating in a population where children often travel unrestrained was assessed in a population based case-control study. The cases were all 129 children aged 0-11 years injured as car passengers in a motor vehicle accident who contacted, during 1996, one of the two major children's hospitals in Athens; emergency cases are accepted by the two hospitals on alternate days throughout the year, thus generating a random sample of children injured as car passengers. The prevalence of the studied exposures in the study base was estimated from an inspection survey comprising a random sample of 191 children of the same age who travelled in passenger cars. The survey was conducted by medical staff from our centre in collaboration with the road traffic police. Odds ratios (ORs) were calculated after adjustment for confounding factors through the Mantel-Haenszel procedure. The OR for injury was 3.3 among unrestrained children compared with restrained children (comparison essentially limited to children aged 0-4 years) and 5.0 for children seated in the front compared with those seated in the rear (comparison essentially limited among unrestrained children). Protective effect estimates derived from this analytical study suggest that in Greece about two thirds of all childhood injuries from car crashes could have been avoided through the regular use of a proper child restraint. The data also indicate that, in the absence of a child restraint system, a rear seating position conveys substantial protection and could explain the low mortality of children as car passengers in Greece, a country which is characterised by a high overall road traffic mortality as well as a high childhood accident mortality.
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| 5. |
- Petridou, E, et al.
(författare)
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Effectiveness of a comprehensive multisector campaign to increase seat belt use in the greater Athens area, Greece. Hellenic Road Traffic Police Department.
- 1999
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Ingår i: American Journal of Public Health. - 0090-0036 .- 1541-0048. ; 89:12, s. 1861-1863
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:This study assessed the effectiveness of a comprehensive campaign to increase seat belt use in Athens.METHODS:In 1996 a survey focusing on seat belt use was undertaken among occupants of 1400 passenger cars. From October 1997 to June 1998 the campaign was implemented; during the campaign, seat belt law enforcement was not intensified. In 1998 another inspection survey of 2250 cars was undertaken.RESULTS:The program brought only a 6% increase in compliance, but there was an estimated gain of about 50 averted deaths and 1500 averted injuries.CONCLUSIONS:An intensive campaign to increase seat belt use, conducted in the absence of increased law enforcement, resulted in moderate gains.
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| 6. |
- Petridou, E, et al.
(författare)
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Endogenous risk factors for childhood leukemia in relation to the IGF system (Greece)
- 2000
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Ingår i: Cancer Causes and Control. - 0957-5243 .- 1573-7225. ; 11:8, s. 765-771
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:Insulin-like growth factor-1 (IGF-1) and its principal binding protein-3 (IGFBP-3) are central in the mediation of the effect of growth hormone, and the IGF system has been reported to play a role in the pathogenesis of childhood leukemia.METHODS:To further evaluate the hypothesis connecting the IGF system to this disease, we have examined whether IGF-1 and IGFBP-3 are associated with the two main endogenous risk factors for childhood leukemia, namely gender and birth weight, since boys and heavier newborns are known to be at higher risk. IGF-1 and IGFBP-3 were measured under code in the serum of 118 apparently healthy children aged 0-14 years and the values of each of these components were regressed on age, gender and birth weight. Insulin-like growth factor-2 (IGF-2), as a dependent variable, and anemia during the corresponding pregnancy, as a predictor variable, were also evaluated for exploratory purposes.RESULTS:In the total data set, IGF-1 was positively associated with birth weight (p = 0.0001), whereas girls had higher levels of IGFBP-3 (p = 0.01).CONCLUSIONS:It appears that the associations of measured components of the IGF system with the examined risk factors for childhood leukemia are largely compatible with those that would have been expected, if this system played a role in the pathogenesis of childhood leukemia.
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| 7. |
- Petridou, E, et al.
(författare)
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Evidence on the infectious etiology of childhood leukemia : the role of low herd immunity (Greece)
- 2001
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Ingår i: Cancer Causes and Control. - 0957-5243 .- 1573-7225. ; 12:7, s. 645-652
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:Acute lymphoblastic leukemia (ALL) among children may be a rare outcome of a delayed non-specific infection in situations of overall low herd immunity. We evaluated the hypothesis as to whether newly diagnosed ALL cases, compared to their controls, are characterized by lower herd immunity, as reflected in a more seronegative spectrum to several agents, with the exception of a strongly positive response to a single infectious agent, assumed to trigger ALL.METHODS:The study included 94 incident cases of ALL, from all pediatric hematology-oncology units of Greece, and 94, matched for age and gender, controls hospitalized with minor non-infectious conditions. The past exposure to common infections was assessed using 10 serological markers.RESULTS:There was little evidence for an association of ALL with the serology of any of the studied infectious agents among the very young children. In contrast, among children aged 5 years or older, leukemia was inversely associated with seropositivity to Epstein-Barr virus, human herpes virus-6, Mycoplasma pneumoniae and parvovirus B19.CONCLUSIONS:Among children aged 5 years or older the risk of leukemia may be higher when the low herd immunity for several agents is challenged by late infection from an agent that, as a rule, would attack children at a younger age.
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| 8. |
- Petridou, E, et al.
(författare)
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Insulin-like growth factor binding protein-3 predicts survival from acute childhood leukemia
- 2001
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Ingår i: Oncology. - : S. Karger AG. - 0030-2414 .- 1423-0232. ; 60:3, s. 252-257
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To investigate whether the three principal components of the insulin-like growth factor (IGF) system, IGF-1, IGF-2 and IGF binding protein-3 (IGFBP-3), are associated with survival from childhood leukemia.PATIENTS AND METHODS:116 children, 0--14 years old, with newly diagnosed and bone-marrow-biopsy-confirmed acute childhood leukemia between 1993 and 1996 were followed up until death or March 31, 1998. IGF-1, IGF-2 and IGFBP-3 were measured at diagnosis and clinical data, including presence of hepatosplenomegaly and number of white blood cells, were available.RESULTS:After controlling for gender, age, indicators of clinical severity and the other measured components of the IGF system there was a statistically significant (p < 0.05) inverse association of IGFBP-3 with survival. An increment of one standard deviation in IGFBP-3 was associated with a 65% reduction of the death hazard among the children with leukemia. Neither IGF-1 nor IGF-2 was associated with survival in this data set.CONCLUSION:The presented empirical evidence in conjunction with the fact that IGFBP-3 modulates IGF-1 and IGF-2 bioavailability and is likely to have proapoptotic effects makes this compound a plausible independent predictor of survival from childhood leukemia.
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| 9. |
- Petridou, E, et al.
(författare)
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Insulin-like growth factor-I and binding protein-3 in relation to childhood leukaemia
- 1999
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Ingår i: International Journal of Cancer. - 0020-7136 .- 1097-0215. ; 80:4, s. 494-496
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Tidskriftsartikel (refereegranskat)abstract
- The aetiology of most cases of childhood leukaemia remains unknown, but several studies have indicated that increased birthweight and height are risk factors for the disease. Since insulin-like growth factor-I (IGF-I) mediates the effect of growth hormone and has been positively associated with prostate cancer, we have evaluated the role of this hormone and its principal binding protein, IGFBP-3, in the aetiology of childhood leukaemia. Incident cases of childhood leukaemia from those recorded by a national network of childhood oncologists were enrolled in our study. Controls were children hospitalised for acute conditions of no more than moderate severity with matching for gender, age and maternal place of residence. Blood measurements of IGF-I and IGFBP-3 were undertaken using commercially available radioimmunoassays. Serum IGF-I values decreased by about 1.7% per month, and the rate of decline was higher, though not significantly so, among cases (2.1% per month) than among controls (1.4%). There was no significant association between IGF-I and the likelihood of childhood leukaemia, but an increment of 1 microg/ml of IGFBP-3 was associated with a substantial and statistically significant reduction of childhood leukaemia by 28% (95% confidence interval 7% to 45%). Because IGFBP-3 is essentially a binding protein, we interpret our findings as indicating that bioavailable IGF-I may play an important role in the aetiology of childhood leukaemia. The much smaller quantities and the inherent instability of IGF-I in the blood in comparison to those of IGFBP-3 are likely to hinder documentation of an underlying positive association of IGF-I with the disease.
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| 10. |
- Petridou, E., et al.
(författare)
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PO-124 Childhood Leukemia International Consortium (CLIC) Studies Report Diffrential Associations of Advanced Parental Age with Childhood Acute Lymphoblastic Leukemia
- 2018
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Ingår i: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 65:52, s. S150-S151
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background/Objectives:Advanced parental age has beenassociated with adverse health effects in the offspring includ-ing childhood (0-14 years) acute lymphoblastic leukemia(ALL), as reported in our meta-analysis of published stud-ies. Primary data from 16 studies participating in theChildhood Leukemia International Consortium provide aunique methodological opportunity to further explore thisassociation.Design/Methods:Data from 11 case-control (CC) studies(7919 cases; 12942 interviewed controls) and five nested case-control (NCC) studies (8801 cases; 29690 controls recordlinked via population-based registries) with enrollment peri-ods ranging from 1968 to 2015 were used. Adjusted oddsratios (OR) were derived from each study using five-yearpaternal and maternal age increments and introduded in twometa-analyses by CC or NCC study design.Results:Advancement of paternal age was associated withstatistically significant higher risk for ALL in the off-spring (ORCC:1.05; ORNCC:1.04) and advanced mater-nal age only in the NCC (ORNCC:1.05). By contrast, theresults were heterogeneous in CC studies (ORCC:0.99, 95%CI:0.91-1.07, heterogeneityI2=58%,p=0.002). The positive association between parental age and risk of ALL was moreevident in the age group among 1-5 years and remainedunchanged after mutual adjustment for the collinear effect ofthe paternal and maternal age variables. We further performedanalyses of the relatively small numbers of discordant pater-nal and maternal age pairs to explore the collinear effect ofparental age but the results were not fully enlightening.Conclusions:The results of this larger ever dataset of primarydata allowing for separate analysis by study design and bettercontrol of selection bias in CC studies strengthen the evidencethat advanced parental age is associated with increased child-hood ALL risk. The observational study design and ollinear-ity of maternal with paternal age complicate causal interpre-tation. Employing datasets with cytogenetic information mayfurther elucidate involvement of each parental component andclarify underlying mechanisms.
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