2020 Fiscal Year Annual Research Report
Epidemiological investigation of risk factors for childhood leukemia onset and adverse effects among survivors
| Project/Area Number |
18H03044
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| Research Institution | National Center for Child Health and Development |
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Principal Investigator |
浦山 ケビン 国立研究開発法人国立成育医療研究センター, 社会医学研究部, 部長 (60726850)
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| Co-Investigator(Kenkyū-buntansha) |
高木 正稔 東京医科歯科大学, 大学院医歯学総合研究科, 准教授 (10406267)
真部 淳 北海道大学, 医学研究院, 教授 (20292849)
清河 信敬 国立研究開発法人国立成育医療研究センター, 小児血液・腫瘍研究部, 部長 (60195401)
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| Project Period (FY) |
2018-04-01 – 2022-03-31
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| Keywords | 小児がん / 疫学 |
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| Outline of Annual Research Achievements |
Working with our clinical collaborators (7 hospitals), we have accumulated a total of about 230 cases and have recruited 140 matched controls. We have pursued descriptive analysis on this interim dataset, and our current study call, Epidemiological Study of Hematologic Cancers in Children (Epi-HCC) has been presented at the Japanese Society of Hematology Annual Meeting (October 2020) in the Presidential Symposium. Facilitated by our activities with the Epi-HCC, we are members of the Childhood Cancer and Leukemia International Consortium, and are leading a pooled analysis including nearly 15 studies to examine the association between infections during pregnancy and risk of childhood leukemia in the offspring. In addition, in order to help us identify genetic targets for analysis in the Epi-HCC population, we have performed genome-wide association analyses on a SNP dataset of Japanese childhood leukemia cases and controls. We have identified five genetic loci which are associated with risk in Japanese, and these targets will be considered in the analysis of Epi-HCC data.
Regarding the follow-up childhood cancer survivors, we have recruited about 30 patients from a single center who are also part of Epi-HCC. An extensive baseline questionnaire and annual follow-up has been conducted, and through this effort, we hope to examine factors related to various hardships and adverse health outcomes that cancer survivors are known to experience. This work is being pursued within a larger long-term follow-up cohort study effort within the Tokyo Children’s Study Cancer Group.
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| Current Status of Research Progress |
Current Status of Research Progress
2: Research has progressed on the whole more than it was originally planned.
Reason
While case and control recruitment has been slower then expected influenced by challenges in 2020 with COVID-19, we plan to compensate for this with more recruitment during 2021. We expect that we will still be able to assemble an adequate sample size that will allow for meaningful data analysis and valid results.
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| Strategy for Future Research Activity |
Since childhood cancer is a rare disease, we expected that effort would be needed to reach our target sample size, particularly now due to the COVID-19 circumstance. We plan to continue our efforts in recruitment this year in order to reach our goal of about 300-400 cases and matched controls. We will try to use enhanced strategies for study advertisement and recruitment. Participation rates in controls was lower than expected, which was likely influenced by the need to collect saliva samples. In order to increase participation rates in controls, we will consider removing sample collection, but we will still collect the large amounts of questionnaire-based data. This will allow us to maintain a high level of study validity in results, but will reduce our control sample size for genetic analysis. However, we do not view this as a major issue since it is standard practice to utilize existing genomic data available through other studies as comparison. Laboratory collaborators involved in this study can provided these data.
As the final year of this funding, we expect to achieve a sample size that is adequate for generating valid epidemiological evidence, pursue final analyses and journal submissions specific to a series of etiological hypotheses in childhood hematologic cancers, complete complementary analyses being pursuing with the consortium and genetics collaborators, consider genetic targets specifically within the Epi-HCC, and strengthen the infrastructure for follow-up of cancer survivors and seek opportunities for resources to continue follow-up into the future.
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