Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia
Authors: Duarte-Rodríguez David Aldebarán , Flores-Lujano Janet , McNally Richard J. Q. , Pérez-Saldivar María Luisa , Jiménez-Hernández Elva , Martín-Trejo Jorge Alfonso , Espinoza-Hernández Laura Eugenia , Medina-Sanson Aurora , Paredes-Aguilera Rogelio , Merino-Pasaye Laura Elizabeth , Velázquez-Aviña Martha Margarita , Torres-Nava José Refugio , Espinosa-Elizondo Rosa Martha , Amador-Sánchez Raquel , Dosta-Herrera Juan José , Mondragón-García Javier Anastacio , González-Ulibarri Juana Esther , Martínez-Silva Sofía Irene , Espinoza-Anrubio Gilberto , Paz-Bribiesca María Minerva , Salcedo-Lozada Perla , Landa-García Rodolfo Ángel , Ramírez-Colorado Rosario , Hernández-Mora Luis , Santamaría-Ascencio Marlene , López-Loyola Anselmo , Godoy-Esquivel Arturo Hermilo , García-López Luis Ramiro , Anguiano-Ávalos Alison Ireri , Mora-Rico Karina , Castañeda-Echevarría Alejandro , Rodríguez-Jiménez Roberto , Cibrian-Cruz José Alberto , Solís-Labastida Karina Anastacia , Cárdenas-Cardos Rocío , López-Santiago Norma , Flores-Villegas Luz Victoria , Peñaloza-González José Gabriel , González-Ávila Ana Itamar , Sánchez-Ruiz Martin , Rivera-Luna Roberto , Rodríguez-Villalobos Luis Rodolfo , Hernández-Pérez Francisco , Olvera-Durán Jaime Ángel , García-Cortés Luis Rey , Mata-Rocha Minerva , Sepúlveda-Robles Omar Alejandro , Bekker-Méndez Vilma Carolina , Jiménez-Morales Silvia , Meléndez-Zajgla Jorge , Rosas-Vargas Haydée , Vega Elizabeth , Núñez-Enríquez Juan Carlos , Mejía-Aranguré Juan Manuel 
Published: February 2024

Background

A heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC).

Methods

A population-based case-control study was conducted. Children &lt;18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff’s spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained.

Results

A total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p&lt;0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed.

Conclusions

The identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL.