AIM Evidence for an association of foetal growth with acute myeloid leukaemia (AML) is inconclusive. AML is a rare childhood cancer, relatively more frequent in girls, with distinct features in infancy. In the context of the Childhood Leukemia International Consortium (CLIC), we examined the hypothesis that the association may vary by age, sex and disease subtype using data from 22 studies and a total of 3564 AML cases. METHODS Pooled estimates by age, sex and overall for harmonised foetal growth markers in association with AML were calculated using the International Fetal and Newborn Growth Consortium for the 21st Century Project for 17 studies contributing individual-level data; meta-analyses were, thereafter, conducted with estimates provided ad hoc by five more studies because of administrative constraints. Subanalyses by AML subtype were also performed. RESULTS A nearly 50% increased risk was observed among large-for-gestational-age infant boys (odds ratio [OR]: 1.49, 95% confidence interval [CI]: 1.03-2.14), reduced to 34% in boys aged <2 years (OR: 1.34, 95% CI: 1.05-1.71) and 25% in boys aged 0-14 years (OR: 1.25, 95% CI: 1.06-1.46). The association of large for gestational age became stronger in boys with M0/M1subtype (OR: 1.80, 95% CI: 1.15-2.83). Large birth length for gestational age was also positively associated with AML (OR: 1.38, 95% CI: 1.00-1.92) in boys. By contrast, there were null associations in girls, as well as with respect to associations of decelerated foetal growth markers. CONCLUSIONS Accelerated foetal growth was associated with AML, especially in infant boys and those with minimally differentiated leukaemia. Further cytogenetic research would shed light into the underlying mechanisms.

中文翻译：

---

儿童急性髓性白血病风险中与年龄、性别和疾病亚型相关的胎儿生长差异：儿童白血病国际联盟的分析。


目的 胎儿生长与急性髓系白血病 (AML) 之间关系的证据尚无定论。 AML 是一种罕见的儿童癌症，在女孩中相对较多见，在婴儿期具有明显的特征。在儿童白血病国际联盟 (CLIC) 的背景下，我们使用 22 项研究和总共 3564 例 AML 病例的数据检验了这种关联可能因年龄、性别和疾病亚型而异的假设。方法 使用国际胎儿和新生儿生长联盟 21 世纪项目对 17 项提供个人水平数据的研究，按年龄、性别和整体计算与 AML 相关的统一胎儿生长标志物的汇总估计值；此后，由于行政限制，根据另外五项研究临时提供的估计值进行了荟萃分析。还按 AML 亚型进行了亚组分析。结果 大于胎龄男婴的风险增加近 50%（比值比 [OR]：1.49，95% 置信区间 [CI]：1.03-2.14），<2 岁男婴的风险增加至 34%岁（OR：1.34，95% CI：1.05-1.71），0-14 岁男孩为 25%（OR：1.25，95% CI：1.06-1.46）。在 M0/M1 亚型男孩中，大胎龄的相关性更强（OR：1.80，95% CI：1.15-2.83）。男孩的出生身长相对胎龄也与 AML 呈正相关（OR：1.38，95% CI：1.00-1.92）。相比之下，女孩以及胎儿生长标志物减慢的关联均无效。结论 胎儿生长加速与 AML 相关，尤其是男婴和患有微分化白血病的婴儿。进一步的细胞遗传学研究将揭示其潜在机制。