Association Between Sickle Cell Trait and Patients With Leukemia Observed in National Inpatient Sample Study

In a nationwide, case-controlled, cohort study, researchers found statistically significantly higher odds of sickle cell trait (SCT) among patients with leukemia, specifically myeloid and monocytic leukemias, compared with those who do not have leukemia.

Sickle cell disease (SCD) has been previously associated with an increased risk of leukemia. In their study, Sostin and colleagues utilized the National Inpatient Sample (NIS) 2016-2019 database to examine the association between leukemia and those with SCT (those who inherited one sickle cell gene).

Patients with leukemia-related ICD-10-CM codes were considered cases, while those without such codes served as controls. Exclusion criteria included conditions like Down syndrome and Fanconi anemia, which have been linked to an increased risk for leukemia independent from the presence of SCT.  Researchers used propensity score matching based on sex, race, and age groups, and used multivariate logistic regression models to analyze the relationship between leukemia subtypes and SCT while controlling for these patient characteristics. Researchers calculated odds ratios (ORs) for “any leukemia” diagnosis, as well as for each subtype of leukemia.

The study identified 181,676 cases and 726,704 controls, with a mean subject age of 59 years, the majority of which were men (56%). A higher proportion of SCT was found among the cases cohort (0.12%) compared with controls (0.08%; p < 0.0001). The OR for a leukemia of any type was 1.48 (95% CI, 1.27-1.73; p < 0.0001), which indicated a statistically significant association. Additionally, researchers found a significant association between SCT and myeloid (OR = 1.74; 95% CI, 1.40-2.17; p < 0.0001) and monocytic leukemias (OR = 2.20; 95% CI 1.09 - 4.42; p = 0.02).

“Our results suggest that, similarly to SCD, SCT, although a benign condition, can increase the risk for leukemia,” the researchers concluded. “To better understand this association, future prospective studies are needed for the mapping of individual risk factors and examining the HbS% levels in SCT carriers who go on to develop leukemia.”

Reference
Sostin S, Pai R, Dandwani M, Espana-Schmidt C. Sickle cell trait as a risk factor for leukemia: a nationwide study. Talk presented at ASH Annual Meeting; December 9-12, 2023; San Diego, CA.  Accessed November 17, 2023. https://ash.confex.com/ash/2023/webprogram/Paper178275.html.