Allergies, atopy, immune-related factors and childhood rhabdomyosarcoma

A report from the children's oncology group

Philip J. Lupo, Renke Zhou, Stephen X. Skapek, Douglas S. Hawkins, Logan G. Spector, Michael E. Scheurer, M. Fatih Okcu, Beatrice Melin, Karin Papworth, Erik B. Erhardt, Seymour Grufferman

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Rhabdomyosarcoma (RMS) is a highly malignant tumor of developing muscle that can occur anywhere in the body. Due to its rarity, relatively little is known about the epidemiology of RMS. Atopic disease is hypothesized to be protective against several malignancies; however, to our knowledge, there have been no assessments of atopy and childhood RMS. Therefore, we explored this association in a case-control study of 322 childhood RMS cases and 322 pair-matched controls. Cases were enrolled in a trial run by the Intergroup Rhabdomyosarcoma Study Group. Controls were matched to cases on race, sex and age. The following atopic conditions were assessed: allergies, asthma, eczema and hives; in addition, we examined other immune-related factors: birth order, day-care attendance and breastfeeding. Conditional logistic-regression models were used to calculate an odds ratio (OR) and 95% confidence interval (CI) for each exposure, adjusted for age, race, sex, household income and parental education. As the two most common histologic types of RMS are embryonal (n = 215) and alveolar (n = 66), we evaluated effect heterogeneity of these exposures. Allergies (OR = 0.60, 95% CI: 0.41-0.87), hives (OR = 0.61, 95% CI: 0.38-0.97), day-care attendance (OR = 0.48, 95% CI: 0.32-0.71) and breastfeeding for > 12 months (OR = 0.36, 95% CI: 0.18-0.70) were inversely associated with childhood RMS. These exposures did not display significant effect heterogeneity between histologic types (p > 0.52 for all exposures). This is the first study indicating that atopic exposures may be protective against childhood RMS, suggesting additional studies are needed to evaluate the immune system's role in the development of this tumor.

Original languageEnglish (US)
Pages (from-to)431-436
Number of pages6
JournalInternational Journal of Cancer
Volume134
Issue number2
DOIs
StatePublished - Jan 15 2014

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Rhabdomyosarcoma
Immunologic Factors
Hypersensitivity
Odds Ratio
Confidence Intervals
Urticaria
Breast Feeding
Logistic Models
Embryonal Rhabdomyosarcoma
Neoplasms
Birth Order
Eczema
Case-Control Studies
Immune System
Epidemiology
Asthma
Education
Muscles

Keywords

  • allergies
  • atopy
  • epidemiology
  • rhabdomyosarcoma
  • soft tissue sarcoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Allergies, atopy, immune-related factors and childhood rhabdomyosarcoma : A report from the children's oncology group. / Lupo, Philip J.; Zhou, Renke; Skapek, Stephen X.; Hawkins, Douglas S.; Spector, Logan G.; Scheurer, Michael E.; Fatih Okcu, M.; Melin, Beatrice; Papworth, Karin; Erhardt, Erik B.; Grufferman, Seymour.

In: International Journal of Cancer, Vol. 134, No. 2, 15.01.2014, p. 431-436.

Research output: Contribution to journalArticle

Lupo, PJ, Zhou, R, Skapek, SX, Hawkins, DS, Spector, LG, Scheurer, ME, Fatih Okcu, M, Melin, B, Papworth, K, Erhardt, EB & Grufferman, S 2014, 'Allergies, atopy, immune-related factors and childhood rhabdomyosarcoma: A report from the children's oncology group', International Journal of Cancer, vol. 134, no. 2, pp. 431-436. https://doi.org/10.1002/ijc.28363
Lupo, Philip J. ; Zhou, Renke ; Skapek, Stephen X. ; Hawkins, Douglas S. ; Spector, Logan G. ; Scheurer, Michael E. ; Fatih Okcu, M. ; Melin, Beatrice ; Papworth, Karin ; Erhardt, Erik B. ; Grufferman, Seymour. / Allergies, atopy, immune-related factors and childhood rhabdomyosarcoma : A report from the children's oncology group. In: International Journal of Cancer. 2014 ; Vol. 134, No. 2. pp. 431-436.
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abstract = "Rhabdomyosarcoma (RMS) is a highly malignant tumor of developing muscle that can occur anywhere in the body. Due to its rarity, relatively little is known about the epidemiology of RMS. Atopic disease is hypothesized to be protective against several malignancies; however, to our knowledge, there have been no assessments of atopy and childhood RMS. Therefore, we explored this association in a case-control study of 322 childhood RMS cases and 322 pair-matched controls. Cases were enrolled in a trial run by the Intergroup Rhabdomyosarcoma Study Group. Controls were matched to cases on race, sex and age. The following atopic conditions were assessed: allergies, asthma, eczema and hives; in addition, we examined other immune-related factors: birth order, day-care attendance and breastfeeding. Conditional logistic-regression models were used to calculate an odds ratio (OR) and 95{\%} confidence interval (CI) for each exposure, adjusted for age, race, sex, household income and parental education. As the two most common histologic types of RMS are embryonal (n = 215) and alveolar (n = 66), we evaluated effect heterogeneity of these exposures. Allergies (OR = 0.60, 95{\%} CI: 0.41-0.87), hives (OR = 0.61, 95{\%} CI: 0.38-0.97), day-care attendance (OR = 0.48, 95{\%} CI: 0.32-0.71) and breastfeeding for > 12 months (OR = 0.36, 95{\%} CI: 0.18-0.70) were inversely associated with childhood RMS. These exposures did not display significant effect heterogeneity between histologic types (p > 0.52 for all exposures). This is the first study indicating that atopic exposures may be protective against childhood RMS, suggesting additional studies are needed to evaluate the immune system's role in the development of this tumor.",
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