Logo of brjcancerBJC HomepageBJC Advance online publicationBJC Current IssueSubmitting an article to BJCWeb feeds
Br J Cancer. May 2000; 82(9): 1571–1576.
Published online Apr 3, 2000. doi:  10.1054/bjoc.1999.1072
PMCID: PMC2363399

Space–time clustering patterns in childhood leukaemia support a role for infection

Abstract

Previous studies of space–time clustering in childhood leukaemia have produced equivocal and inconsistent results. To address this issue we have used Manchester Children's Tumour Registry leukaemia data in space–time clustering analyses. Knox tests for space–time interactions between cases were applied with fixed thresholds of close in space, < 5 km and close in time < 1 year apart. Addresses at birth as well as diagnosis were utilized. Tests were repeated replacing geographical distance with distance to the Nth nearest neighbour. N was chosen such that the mean distance was 5 km. Data were also examined by a second order procedure based on K-functions. All methods showed highly significant evidence of space–time clustering based on place of birth and time of diagnosis, particularly for all leukaemias aged 0–14 and 0–4 years, and acute lymphoblastic leukaemia (ALL) 0–4 years. Some results based on location at diagnosis were significant but mainly gave larger P -values. The results are consistent with an infectious hypothesis. Furthermore, we found an excess of male cases over females involved in space–time pairs. We suggest this may be related to genetic differences in susceptibility to infection between males and females. These findings provide the basis for future studies to identify possible infectious agents. © 2000 Cancer Research Campaign

Keywords: clustering, childhood leukaemia, infections

Full Text

The Full Text of this article is available as a PDF (89K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Alexander FE, Boyle P, Carli PM, Coebergh JW, Draper GJ, Ekbom A, Levi F, McKinney PA, McWhirter W, Magnani C, et al. Spatial temporal patterns in childhood leukaemia: further evidence for an infectious origin. EUROCLUS project. Br J Cancer. 1998 Mar;77(5):812–817. [PMC free article] [PubMed]
  • Alexander FE, Boyle P, Carli PM, Coebergh JW, Draper GJ, Ekbom A, Levi F, McKinney PA, McWhirter W, Michaelis J, et al. Spatial clustering of childhood leukaemia: summary results from the EUROCLUS project. Br J Cancer. 1998 Mar;77(5):818–824. [PMC free article] [PubMed]
  • Diggle PJ, Chetwynd AG, Häggkvist R, Morris SE. Second-order analysis of space-time clustering. Stat Methods Med Res. 1995 Jun;4(2):124–136. [PubMed]
  • Greaves MF. Speculations on the cause of childhood acute lymphoblastic leukemia. Leukemia. 1988 Feb;2(2):120–125. [PubMed]
  • Jacquez GM. A k nearest neighbour test for space-time interaction. Stat Med. 1996 Sep 15;15(17-18):1935–1949. [PubMed]
  • Kinlen L. Evidence for an infective cause of childhood leukaemia: comparison of a Scottish new town with nuclear reprocessing sites in Britain. Lancet. 1988 Dec 10;2(8624):1323–1327. [PubMed]
  • Kinlen LJ. Epidemiological evidence for an infective basis in childhood leukaemia. Br J Cancer. 1995 Jan;71(1):1–5. [PMC free article] [PubMed]
  • Mantel N. The detection of disease clustering and a generalized regression approach. Cancer Res. 1967 Feb;27(2):209–220. [PubMed]
  • Smith M. Considerations on a possible viral etiology for B-precursor acute lymphoblastic leukemia of childhood. J Immunother. 1997 Mar;20(2):89–100. [PubMed]
  • Taylor GM, Dearden S, Payne N, Ayres M, Gokhale DA, Birch JM, Blair V, Stevens RF, Will AM, Eden OB. Evidence that an HLA-DQA1-DQB1 haplotype influences susceptibility to childhood common acute lymphoblastic leukaemia in boys provides further support for an infection-related aetiology. Br J Cancer. 1998 Sep;78(5):561–565. [PMC free article] [PubMed]
  • Wiemels JL, Cazzaniga G, Daniotti M, Eden OB, Addison GM, Masera G, Saha V, Biondi A, Greaves MF. Prenatal origin of acute lymphoblastic leukaemia in children. Lancet. 1999 Oct 30;354(9189):1499–1503. [PubMed]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...