Birth weight and risk of childhood solid tumors in Brazil: a record linkage between population-based data sets.

OBJECTIVE: To analyze the relationship between the development of childhood solid tumors and 1) birth weight and 2) fetal growth, using two Brazilian population-based data sets. METHODS: A case-cohort study was performed using two population-based data sets, and linkage between the Live Birth Information System (Sistema de Informação sobre Nascidos Vivos, SINASC) and 14 population-based cancer registries (PBCRs) was established. Four controls per case were chosen randomly from the SINASC data set. Tumors were classified as central nervous system (CNS), non-CNS embryonal, and other tumors ("miscellaneous"). Adjustments were made for potential confounders (maternal age, mode of delivery, maternal education, birth order, gestational age, sex, and geographic region). Odds ratios (ORs) with 95% confidence intervals (CIs) were computed using unconditional logistic regression analysis. RESULTS: In a trend analysis, for every 500 g of additional birth weight, the crude OR was 1.12 (CI: 1.00-1.24) and the adjusted OR was 1.02 (CI: 0.90-1.16) for all tumors. For every 1 000 g of additional birth weight, the crude OR was 1.25 (CI: 1.00-1.55) and the adjusted OR was 1.04 (CI: 0.82-1.34) for all tumors. Among children diagnosed after reaching the age of 3 years, in the miscellaneous tumor category, the OR was significantly increased for every additional 500 g and 1 000 g of birth weight. CONCLUSIONS: The study data suggested that increased birth weight was associated with childhood solid tumor development, especially among children more than 3 years old with "miscellaneous" tumors.

Distribution of human T cell lymphotropic virus type 1 (HTLV-1) subtypes in Brazil: genetic characterization of LTR and tax region.

We report the molecular and epidemiological characterization of 128 human T cell lymphotropic virus type 1 (HTLV-1) isolates from Brazilian patients with different clinical manifestations of the infection. Thirty-two percent of the patients were asymptomatic, 44% had HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and 23% had adult T cell leukemia/lymphoma (ATLL). Phylogenetic analysis performed using part of the LTR region of the viral genome revealed that all Brazilian isolates belonged to the Cosmopolitan subtype, with the following distribution within the Transcontinental subgroup: 81.6% within the Latin American cluster and 15.8% outside the Latin American cluster. Two isolates belonged to the Japanese subgroup. Molecular analysis of the tax region showed a high nucleotide similarity ( approximately 99%) with 41 prototype sequences, including the ATK-1 isolate. The mean number of nucleotide substitutions ranged from 1 to 8. Five specific nucleotide substitutions, C7401T, T7914C, C7920T, C7982T, and G8231A, were highly conserved among the Brazilian isolates (79.6%), with a frequency ranging from 81.6% to 100% in the sample group and from 18.4% to 24.1% in the prototypes used, suggesting the existence of a molecular signature. These changes were not correlated with a specific clinical status of the patients and could be a molecular characteristic of the HTLV-1 strains that circulate in Brazil.

Translocation (11;11)(p13- p15;q23) in a child with therapy-related acute myeloid leukemia following chemotherapy with DNA-topoisomerase II inhibitors for Langerhans cell histiocytosis.

We report a new case of therapy-related acute myeloid leukemia in a child with Langerhans cell histiocytosis. This patient was previously treated with a protocol of multidrug chemotherapy, containing a relatively low dose of etoposide (total dose of 900/m(2)). Twenty-six months after the end of the therapy, the patient returned to the hospital with fever and anemia. The white blood cell count was 53 x 10(9)/L. The bone marrow examination showed massive infiltration with French-American-British acute myeloid leukemia classification M4 blast cells. The patient did not respond to an intensive treatment with high dose ARA-C and idarubicin. He died 6 months later. The cytogenetic abnormality of the blast cells was a t(11;11)(p13 -15;q23), that has not been described before in a secondary leukemia case.

Birth weight and risk of childhood solid tumors in Brazil: a record linkage between population-based data sets / El peso al nacer y el riesgo de formación de tumores sólidos en la niñez en el Brasil: vinculación de registros entre conjuntos de datos poblacionales

Objective. To analyze the relationship between the development of childhood solid tumors and 1) birth weight and 2) fetal growth, using two Brazilian population-based data sets. Methods. A case–cohort study was performed using two population-based data sets, and linkage between the Live Birth Information System (Sistema de Informação sobre Nascidos Vivos, SINASC) and 14 population-based cancer registries (PBCRs) was established. Four controls per case were chosen randomly from the SINASC data set. Tumors were classified as central nervous system (CNS), non-CNS embryonal, and other tumors (“miscellaneous”). Adjustments were made for potential confounders (maternal age, mode of delivery, maternal education, birth order, gestational age, sex, and geographic region). Odds ratios (ORs) with 95% confidence intervals (CIs) were computed using unconditional logistic regression analysis. Results. In a trend analysis, for every 500 g of additional birth weight, the crude OR was 1.12 (CI: 1.00–1.24) and the adjusted OR was 1.02 (CI: 0.90–1.16) for all tumors. For every 1 000 g of additional birth weight, the crude OR was 1.25 (CI: 1.00–1.55) and the adjusted OR was 1.04 (CI: 0.82–1.34) for all tumors. Among children diagnosed after reaching the age of 3 years, in the miscellaneous tumor category, the OR was significantly increased for every additional 500 g and 1 000 g of birth weight. Conclusions. The study data suggested that increased birth weight was associated with childhood solid tumor development, especially among children more than 3 years old with “miscellaneous” tumors.

Objetivo. Analizar la relación entre la aparición de tumores sólidos en la niñez y 1) el peso al nacer y 2) el crecimiento fetal, a partir de dos conjuntos de datos poblacionales del Brasil. Métodos. Se efectuó un estudio de casos en una cohorte a partir de dos conjuntos de datos poblacionales y se vinculó el sistema de información de nacidos vivos (Sistema de Informação sobre Nascidos Vivos, SINASC) con 14 registros oncológicos poblacionales. Se eligieron al azar cuatro controles por caso del conjunto de datos del SINASC. Los tumores se clasificaron en tres tipos: del sistema nervioso central (SNC), embrionarios ajenos al SNC y otros (“misceláneos”). Se hicieron ajustes en función de los posibles factores de confusión (edad materna, modalidad de parto, educación materna, orden de nacimiento, edad gestacional, sexo y región geográfica) y se calcularon las razones de posibilidad (OR) con un intervalo de confianza (IC) del 95 % mediante análisis de la regresión logística incondicional. Resultados. En el análisis de las tendencias, se observó que, en todos los tumores, cada 500 g adicionales de peso al nacer la OR bruta fue de 1,12 (IC: 1,00-1,24) y la OR ajustada, de 1,02 (IC: 0,90-1,16), mientras que, cada 1 000 g adicionales, la OR bruta fue de 1,25 (IC: 1,00-1,55) y la OR ajustada, de 1,04 (IC: 0,82-1,34). En cuanto a los niños diagnosticados después de los 3 años de edad, en la categoría de tumores misceláneos, la OR fue significativamente más alta con cada 500 g y 1 000 g adicionales de peso al nacer. Conclusiones. Los datos del estudio indican que el peso alto al nacer está asociado a la aparición de tumores sólidos en la niñez, especialmente de la categoría “misceláneos” y en los niños mayores de 3 años de edad.

Birth weight and risk of childhood solid tumors in Brazil: a record linkage between population-based data sets / El peso al nacer y el riesgo de formación de tumores sólidos en la niñez en el Brasil: vinculación de registros entre conjuntos de datos poblacionales

ABSTRACT Objective To analyze the relationship between the development of childhood solid tumors and 1) birth weight and 2) fetal growth, using two Brazilian population-based data sets. Methods A case–cohort study was performed using two population-based data sets, and linkage between the Live Birth Information System (Sistema de Informação sobre Nascidos Vivos, SINASC) and 14 population-based cancer registries (PBCRs) was established. Four controls per case were chosen randomly from the SINASC data set. Tumors were classified as central nervous system (CNS), non-CNS embryonal, and other tumors (“miscellaneous”). Adjustments were made for potential confounders (maternal age, mode of delivery, maternal education, birth order, gestational age, sex, and geographic region). Odds ratios (ORs) with 95% confidence intervals (CIs) were computed using unconditional logistic regression analysis. Results In a trend analysis, for every 500 g of additional birth weight, the crude OR was 1.12 (CI: 1.00–1.24) and the adjusted OR was 1.02 (CI: 0.90–1.16) for all tumors. For every 1 000 g of additional birth weight, the crude OR was 1.25 (CI: 1.00–1.55) and the adjusted OR was 1.04 (CI: 0.82–1.34) for all tumors. Among children diagnosed after reaching the age of 3 years, in the miscellaneous tumor category, the OR was significantly increased for every additional 500 g and 1 000 g of birth weight. Conclusions The study data suggested that increased birth weight was associated with childhood solid tumor development, especially among children more than 3 years old with “miscellaneous” tumors.

RESUMEN Objetivo Analizar la relación entre la aparición de tumores sólidos en la niñez y 1) el peso al nacer y 2) el crecimiento fetal, a partir de dos conjuntos de datos poblacionales del Brasil. Métodos Se efectuó un estudio de casos en una cohorte a partir de dos conjuntos de datos poblacionales y se vinculó el sistema de información de nacidos vivos (Sistema de Informação sobre Nascidos Vivos, SINASC) con 14 registros oncológicos poblacionales. Se eligieron al azar cuatro controles por caso del conjunto de datos del SINASC. Los tumores se clasificaron en tres tipos: del sistema nervioso central (SNC), embrionarios ajenos al SNC y otros (“misceláneos”). Se hicieron ajustes en función de los posibles factores de confusión (edad materna, modalidad de parto, educación materna, orden de nacimiento, edad gestacional, sexo y región geográfica) y se calcularon las razones de posibilidad (OR) con un intervalo de confianza (IC) del 95 % mediante análisis de la regresión logística incondicional. Resultados En el análisis de las tendencias, se observó que, en todos los tumores, cada 500 g adicionales de peso al nacer la OR bruta fue de 1,12 (IC: 1,00-1,24) y la OR ajustada, de 1,02 (IC: 0,90-1,16), mientras que, cada 1 000 g adicionales, la OR bruta fue de 1,25 (IC: 1,00-1,55) y la OR ajustada, de 1,04 (IC: 0,82-1,34). En cuanto a los niños diagnosticados después de los 3 años de edad, en la categoría de tumores misceláneos, la OR fue significativamente más alta con cada 500 g y 1 000 g adicionales de peso al nacer. Conclusiones Los datos del estudio indican que el peso alto al nacer está asociado a la aparición de tumores sólidos en la niñez, especialmente de la categoría “misceláneos” y en los niños mayores de 3 años de edad.

Trends in childhood leukemia mortality over a 25-year period.

OBJECTIVE: To analyze trends in childhood leukemia mortality in the state of Rio de Janeiro, Brazil, between 1980 and 2006. METHOD: Gender-stratified leukemia mortality data for children aged < 15 years from 1980 to 2006 were retrieved from the Brazilian Mortality Information System for the state of Rio de Janeiro. Data were stratified by place of death (city of Rio de Janeiro proper, the state capital; Rio de Janeiro Metropolitan Region, excluding the capital; and rest of the state). Leukemia deaths were defined according to death certificate ICD-9 and ICD-10 coding (for deaths occurring in 1980-1995 and 1996-2006, respectively). Leukemia mortality rates were calculated by age and calendar year and age-adjusted to a standard world population. Polynomial linear regression with a 5% significance level was used to evaluate mortality trends in the study regions. RESULTS: The three studied regions revealed similar trends, with a continuous downward pattern; the most substantial decline was detected in the municipality of Rio de Janeiro (city proper). In all studied areas, leukemia mortality was highest among males. CONCLUSION: A downward trend in childhood leukemia mortality was detected throughout the state of Rio de Janeiro. The most pronounced reduction occurred in the state capital.