Epidemiology of childhood acute leukemias in marginalized populations of the central-south region of Mexico: results from a population-based registry
Authors: Flores-Lujano Janet , Allende-López Aldo , Duarte-Rodríguez David Aldebarán , Alarcón-Ruiz Erika , López-Carrillo Lizbeth , Shamah-Levy Teresa , Cebrián Mariano E. , Baños-Lara Ma. del Rocío , Casique-Aguirre Diana , Elizarrarás-Rivas Jesús , López-Aquino Javier Antonio , Garrido-Hernández Miguel Ángel , Olvera-Caraza Daniela , Terán-Cerqueda Vanessa , Martínez-José Karina Beatriz , Aristil-Chery Pierre Mitchel , Alvarez-Rodríguez Enoch , Herrera-Olivares Wilfrido , Ruíz-Arguelles Guillermo J. , Chavez-Aguilar Lénica Anahí , Márquez-Toledo Aquilino , Cano-Cuapio Lena Sarahi , Luna-Silva Nuria Citlalli , Martínez-Martell Maria Angélica , Ramirez-Ramirez Anabel Beatriz , Merino-Pasaye Laura Elizabeth , Galván-Díaz César Alejandro , Medina-Sanson Aurora , Gutiérrez-Rivera Maria de Lourdes , Martín-Trejo Jorge Alfonso , Rodriguez-Cedeño Emmanuel , Bekker-Méndez Vilma Carolina , Romero-Tlalolini María de los Ángeles , Cruz-Maza Astin , Juárez-Avendaño Gerardo , Pérez-Tapia Sonia Mayra , Rodríguez-Espinosa Juan Carlos , Suárez-Aguirre Miriam Carmina , Herrera-Quezada Fernando , Hernández-Díaz Anahí , Galván-González Lizbeth Alondra , Mata-Rocha Minerva , Olivares-Sosa Amanda Idaric , Rosas-Vargas Haydeé , Jiménez-Morales Silvia , Cárdenas-González Mariana , Álvarez-Buylla Roces María Elena , Duque-Molina Célida , Pelayo Rosana , Mejía-Aranguré Juan Manuel , Núñez-Enriquez Juan Carlos 
Published: February 2024

Introduction

Acute leukemias (AL) are the main types of cancer in children worldwide. In Mexico, they represent one of the main causes of death in children under 20 years of age. Most of the studies on the incidence of AL in Mexico have been developed in the urban context of Greater Mexico City and no previous studies have been conducted in the central-south of the country through a population-based study. The aim of the present work was to identify the general and specific incidence rates of pediatric AL in three states of the south-central region of Mexico considered as some of the marginalized populations of Mexico (Puebla, Tlaxcala, and Oaxaca).

Methods

A population-based study was conducted. Children aged less than 20 years, resident in these states, and newly diagnosed with AL in public/private hospitals during the period 2021-2022 were identified. Crude incidence rates (cIR), standardized incidence rates (ASIRw), and incidence rates by state subregions (ASIRsr) were calculated. Rates were calculated using the direct and indirect method and reported per million children under 20 years of age. In addition, specific rates were calculated by age group, sex, leukemia subtype, and immunophenotype.

Results

A total of 388 cases with AL were registered. In the three states, the ASIRw for AL was 51.5 cases per million (0-14 years); in Puebla, it was 53.2, Tlaxcala 54.7, and Oaxaca de 47.7. In the age group between 0-19 years, the ASIRw were 44.3, 46.4, 48.2, and 49.6, in Puebla, Tlaxcala, and Oaxaca, respectively. B-cell acute lymphoblastic leukemia was the most common subtype across the three states.

Conclusion

The incidence of childhood AL in the central-south region of Mexico is within the range of rates reported in other populations of Latin American origin. Two incidence peaks were identified for lymphoblastic and myeloid leukemias. In addition, differences in the incidence of the disease were observed among state subregions which could be attributed to social factors linked to the ethnic origin of the inhabitants. Nonetheless, this hypothesis requires further investigation.