In utero cytomegalovirus infection and development of childhood acute lymphoblastic leukemia.

Journal Article (Journal Article)

It is widely suspected, yet controversial, that infection plays an etiologic role in the development of acute lymphoblastic leukemia (ALL), the most common childhood cancer and a disease with a confirmed prenatal origin in most cases. We investigated infections at diagnosis and then assessed the timing of infection at birth in children with ALL and age, gender, and ethnicity matched controls to identify potential causal initiating infections. Comprehensive untargeted virome and bacterial analyses of pretreatment bone marrow specimens (n = 127 ALL in comparison with 38 acute myeloid leukemia cases in a comparison group) revealed prevalent cytomegalovirus (CMV) infection at diagnosis in childhood ALL, demonstrating active viral transcription in leukemia blasts as well as intact virions in serum. Screening of newborn blood samples revealed a significantly higher prevalence of in utero CMV infection in ALL cases (n = 268) than healthy controls (n = 270) (odds ratio [OR], 3.71, confidence interval [CI], 1.56-7.92, P = .0016). Risk was more pronounced in Hispanics (OR=5.90, CI=1.89-25.96) than in non-Hispanic whites (OR=2.10 CI= 0.69-7.13). This is the first study to suggest that congenital CMV infection is a risk factor for childhood ALL and is more prominent in Hispanic children. Further investigation of CMV as an etiologic agent for ALL is warranted.

Full Text

Duke Authors

Cited Authors

  • Francis, SS; Wallace, AD; Wendt, GA; Li, L; Liu, F; Riley, LW; Kogan, S; Walsh, KM; de Smith, AJ; Dahl, GV; Ma, X; Delwart, E; Metayer, C; Wiemels, JL

Published Date

  • March 23, 2017

Published In

Volume / Issue

  • 129 / 12

Start / End Page

  • 1680 - 1684

PubMed ID

  • 27979823

Pubmed Central ID

  • PMC5364339

Electronic International Standard Serial Number (EISSN)

  • 1528-0020

Digital Object Identifier (DOI)

  • 10.1182/blood-2016-07-723148


  • eng

Conference Location

  • United States