Infections, vaccinations, and the risk of childhood leukaemia

Dockerty, John D.; Skegg, D. C. G.; Elwood, J. Mark; Herbison, Peter; Becroft, D. M. O.; Lewis, Margaret E.

doi:10.1038/sj.bjc.6690548

Cited by 119 publications

(172 citation statements)

References 12 publications

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“…The positive relationship with social class is further supported by the strong inverse association we demonstrated between household density and risk of childhood ALL. This finding is in keeping with the inverse (although not statistically significant), relationship between household density and childhood ALL which was observed in a case control study from New Zealand (Dockerty et al, 1999). However, as far was we are aware, this is the first time the association has been demonstrated in a cohort study and our findings are likely to reflect the true relationship between socioeconomic position, household density and risk of childhood ALL.…”

Section: Socioeconomic Status and Household Densitysupporting

confidence: 90%

“…Although higher maternal age has generally been associated with higher risk of ALL (Kaye et al, 1991;Dockerty et al, 1999;Hemminki et al, 1999;Mogren et al, 1999), not all studies have observed this relationship (Shaw et al, 1984 , 2000) and one has demonstrated higher risk at younger maternal age (Schuz et al, 1999). We did find any association with maternal age.…”

Section: Parental Agecontrasting

confidence: 51%

“…Most previous reports failed to find an association between ALL and length of gestation (Kaye et al, 1991;Kaatsch et al, 1996;McKinney et al, 1999), although one study has shown a similar, but not statistically significant, relationship (Dockerty et al, 1999). Some studies have reported positive associations between history of previous foetal loss and childhood leukaemia (van Steensel-Moll et al, 1985;Kaye et al, 1991), others found no association (Schuz et al, 1999) while in the current study, as in a Chinese case -control study (Shu et al, 1988) an inverse association was found.…”

Section: Gestational Age and Previous History Of Miscarriagecontrasting

confidence: 49%

“…As in this study, some investigators have shown that higher socioeconomic position, is associated with higher risk of ALL (McWhirter, 1982;Kaye et al, 1991;Dockerty et al, 1999) but others have failed to observe this association (Shaw et al, 1984;van SteenselMoll et al, 1985van SteenselMoll et al, , 1986Shu et al, 1988;Kaatsch et al, 1996;McKinney et al, 1999;Rosenbaum et al, 2000) and some have found the opposite pattern, both for childhood ALL (Brondum et al, 1999;Dockerty et al, 1999) and infant leukaemia . In some of these studies subjects from higher socio-economic and better educational backgrounds are overrepresented among controls, reducing the ability to detect a positive association between socio-economic position and childhood ALL.…”

Section: Socioeconomic Status and Household Densitymentioning

confidence: 51%

“…To date, the findings on birth weight and risk of childhood leukaemia have been inconsistent. Several studies have reported positive relationships with ALL (Robison et al, 1987;Kaye et al, 1991;Westergaard et al, 1997) while others (McKinney et al, 1987(McKinney et al, , 1999Roman et al, 1997;Dockerty et al, 1999), found no association or a relationship with both high and low birth weight (Schuz et al, 1999). It is possible that selection bias, particularly among controls, may have resulted in the failure of some investigators to observe a positive association as controls are likely to be of higher socio-economic position and thus have infants of higher average birth weight, than the general population (Kogan, 1995).…”

Section: Birth Weightmentioning

confidence: 99%

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Association of early life factors and acute lymphoblastic leukaemia in childhood: historical cohort study

et al. 2002

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In a historical cohort study of all singleton live births in Northern Ireland from 1971 -86 (n=434 933) associations between early life factors and childhood acute lymphoblastic leukaemia were investigated. Multivariable analyses showed a positive association between high paternal age (535 years) and acute lymphoblastic leukaemia (relative risk=1.49; 95% confidence interval (CI)=0.96 -2.31) but no association with maternal age. High birth weight (53500 g) was positively associated with acute lymphoblastic leukaemia (relative risk=1.66; 95% CI=1.18 -2.33). Children of mothers with a previous miscarriage or increased gestation (540 weeks) had reduced risks of ALL (respective relative risks=0.49; 95% CI=0.29 -0.80, and 0.67; 95% CI=0.48 -0.94). Children born into more crowded households (51 person per room) had substantially lower risks than children born into less crowded homes with also some evidence of a lower risk for children born into homes with three adults (relative risks=0.56; 95% CI=0.35 -0.91 and 0.58; 95% CI=0.21 -1.61 respectively). These findings indicate that several early life factors, including living conditions in childhood and maternal miscarriage history, influence risk of acute lymphoblastic leukaemia in childhood.

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Section: Socioeconomic Status and Household Densitysupporting

confidence: 90%

Section: Parental Agecontrasting

confidence: 51%

Section: Gestational Age and Previous History Of Miscarriagecontrasting

confidence: 49%

Section: Socioeconomic Status and Household Densitymentioning

confidence: 51%

Section: Birth Weightmentioning

confidence: 99%

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Association of early life factors and acute lymphoblastic leukaemia in childhood: historical cohort study

et al. 2002

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Evaluation of Maternal Infection During Pregnancy and Childhood Leukemia Among Offspring in Denmark

Fang

et al. 2023

JAMA Netw Open

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ImportanceMaternal infection is common during pregnancy and is an important potential cause of fetal genetic and immunological abnormalities. Maternal infection has been reported to be associated with childhood leukemia in previous case-control or small cohort studies.ObjectiveTo evaluate the association of maternal infection during pregnancy with childhood leukemia among offspring in a large study.Design, Setting, and ParticipantsThis population-based cohort study used data from 7 Danish national registries (including the Danish Medical Birth Register, the Danish National Patient Registry, the Danish National Cancer Registry, and others) for all live births in Denmark between 1978 and 2015. Swedish registry data for all live births between 1988 and 2014 were used to validate the findings for the Danish cohort. Data were analyzed from December 2019 to December 2021.ExposuresMaternal infection during pregnancy categorized by anatomic locations identified from the Danish National Patient Registry.Main Outcomes and MeasuresThe primary outcome was any leukemia; secondary outcomes were acute lymphoid leukemia (ALL) and acute myeloid leukemia (AML). Offspring childhood leukemia was identified in the Danish National Cancer Registry. Associations were first assessed in the whole cohort using Cox proportional hazards regression models, adjusted for potential confounders. A sibling analysis was performed to account for unmeasured familial confounding.ResultsThis study included 2 222 797 children, 51.3% of whom were boys. During the approximately 27 million person-years of follow-up (mean [SD], 12.0 [4.6] years per person), 1307 children were diagnosed with leukemia (ALL, 1050; AML, 165; or other, 92). Children born to mothers with infection during pregnancy had a 35% increased risk of leukemia (adjusted hazard ratio [HR], 1.35 [95% CI, 1.04-1.77]) compared with offspring of mothers without infection. Maternal genital and urinary tract infections were associated with a 142% and 65% increased risk of childhood leukemia, with HRs of 2.42 (95% CI, 1.50-3.92) and 1.65 (95% CI, 1.15-2.36), respectively. No association was observed for respiratory tract, digestive, or other infections. The sibling analysis showed comparable estimates to the whole-cohort analysis. The association patterns for ALL and AML were similar to that for any leukemia. No association was observed for maternal infection and brain tumors, lymphoma, or other childhood cancers.Conclusions and RelevanceIn this cohort study of approximately 2.2 million children, maternal genitourinary tract infection during pregnancy was associated with childhood leukemia among offspring. If confirmed in future studies, our findings may have implications for understanding the etiology and developing preventive measures for childhood leukemia.

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Breastfeeding and Childhood Leukemia Incidence

2015

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IMPORTANCE Childhood cancer is a leading cause of mortality among children and adolescents in the developed world and the incidence increases by 0.9% each year. Leukemia accounts for about 30% of all childhood cancer but its etiology is still mostly unknown.OBJECTIVE To conduct a meta-analysis of available scientific evidence on the association between breastfeeding and childhood leukemia.DATA SOURCES A thorough search for articles published between January 1960 and December 2014 researching the association between breastfeeding and childhood leukemia was conducted on PubMed, the Cochrane Library, and Scopus (performed in July and December 2014), supplemented by manual searches of reference lists.STUDY SELECTION To be included in the meta-analyses, studies had to be case control; include breastfeeding as a measured exposure and leukemia as a measured outcome; include data on breastfeeding duration in months; and be published in a peer-reviewed journal with full text available in English. DATA EXTRACTION AND SYNTHESISThe search identified 24 relevant studies, 17 of which met all inclusion criteria. No publication bias or significant heterogeneity among these 17 studies were detected. The quality of each study that met the inclusion criteria was assessed using the Newcastle-Ottawa Scale. Multiple meta-analyses were conducted using the random effect model on raw data in the StatsDirect statistical program. MAIN OUTCOMES AND MEASURESNo or short duration of breastfeeding and the incidence of childhood leukemia. RESULTSThe meta-analysis of all 17 studies indicated that compared with no or shorter breastfeeding, any breastfeeding for 6 months or longer was associated with a 20% lower risk for childhood leukemia (odds ratio, 0.80; 95% CI, 0.72-0.90). A separate meta-analysis of 15 studies indicated that ever breastfed compared with never breastfed was associated with a 9% lower risk for childhood leukemia (odds ratio, 0.91; 95% CI, 0.80-1.04), although the definition of never breastfed differed between studies. All meta-analyses of subgroups of the 17 studies showed similar associations. Based on current meta-analyses results, 14% to 20% of all childhood leukemia cases may be prevented by breastfeeding for 6 months or more.CONCLUSIONS AND RELEVANCE Breastfeeding is a highly accessible, low-cost public health measure. This meta-analysis that included studies not featured in previous meta-analyses on the subject indicates that promoting breastfeeding for 6 months or more may help lower childhood leukemia incidence, in addition to its other health benefits for children and mothers.

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Infections, vaccinations, and the risk of childhood leukaemia

Cited by 119 publications

References 12 publications

Association of early life factors and acute lymphoblastic leukaemia in childhood: historical cohort study

Association of early life factors and acute lymphoblastic leukaemia in childhood: historical cohort study

Evaluation of Maternal Infection During Pregnancy and Childhood Leukemia Among Offspring in Denmark

Breastfeeding and Childhood Leukemia Incidence

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