Family studies in acute leukaemia in childhood: a possible association with autoimmune disease

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Abstract
Medical histories of themselves and first-degree relatives were obtained from parents of 82 leukemic children [54 acute lymphoblastic (ALL), 28 acute myeloblastic (AML)] and from control couples matched for age. The possibility of primary familial immunological abnormality as an etiological factor in childhood leukemia was suggested by finding some infections significantly more frequently reported in parents than controls, but more strongly supported by the finding of a significantly (P < 0.02) increased prevalence of disorders associated with autoimmunity (but not of other conditions such as peptic ulceration, infective hepatitis, tuberculosis or malignancy) among members of ALL families compared to those of controls. Analogy with Down''s syndrome and the strain of NZB mice, in which diminished T [thymus-derived] cell function relates to autoimmune disease and lymphoid neoplasia, was discussed. Varicella and herpes zoster occurred respectively in 2 ALL mothers during pregnancies involving the patients and in none of the other 388 pregnancies here reported. This supports previous evidence that antenatal varicella infections may be of etiological importance in some cases of ALL.