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Exploring Occupational and Familial Risks for Chronic Myeloid Leukaemia



Author(s)

Nicholas Anthony Othieno-Abinya, Walter Otieno Mwanda, Joseph David Macharia Maina, Andrew Odhiambo, Peter Oyiro, Sitna Ali Mwanzi, Esther Musyoka Dindi and Anne Waweru

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DOI:10.17265/1548-6648/2017.01.006

BACKGROUND: The malignant process in chronic myeloid leukaemia (CML) is driven by the BCR-ABL fusion gene encoding the p210 kd tyrosine kinase involved in downstream signaling activities resulting in leukaemia. The finding of BCR-ABL fusion in some normal, healthy individuals however confounds the picture, though activation of other downstream signaling pathways is required for proliferation of BCR-ABL-positive cells. Apart perhaps from exposure to atomic weapon or nuclear accident radiation, causes of BCR-ABL fusion are not well understood, making a case for more research. In this study, we intended to show association between patients’ occupations, and also personal and family history of cancer, with occurrence of CML. METHODS: Patients with CML followed up at the Glivec International Patient Assistance Program (GIPAP) Clinic at the Nairobi Hospital had details of their occupations, personal and family histories of cancer taken. The latter included details of degree of relationship, and cancer type. RESULTS: Three hundred and ninety-eight patients were included. Males were 222 (55.8%) and females 176 (44.2%). Age range was 8-80 years, with a median of median of 44 years. Three hundred and fifty occupations were recorded. Farmers were the leading group, with 69 (19.7%), followed by carpenters/builders/painters/masons/drivers 55 (15.7%). Of note was a 32 year old man whose two female work mates in a telecommunications firm in the same building in Nairobi had acute myeloid leukaemia. Two hundred and sixty-seven (267) patients had personal or family history of cancer verifiable. Of these, 41 (15.4%) gave positive history. Eight (3%) were oesophageal cancer (5 among first degree relatives, 1 second degree, 2 third-degree). Eight (3%) were prostate cancer (4 first-degree, 1 second degree, 3 third degree). Five (1.9%) were breast cancer (1 self, 1 first degree, 3 second degree). CONCLUSION: Occupational profiles shown mirror the frequencies of cancers as seen in the general population. The three workmates who developed myeloid leukaemias cannot be ignored as they raise serious occupational concerns. Familial associations with other cancers could be epidemiological, implying, purely by chance.

 

Chronic myeloid leukaemia, BCR-ABL fusion, predispositions, ionizing radiation, occupational history, family history.