Childhood acute lymphoblastic leukemia and indicators of early immune stimulation: A childhood leukemia international consortium study
Authors
Jeremie Rudant
Tracy Lightfoot
Kevin Y. Urayama
Eleni Petridou
John D. Dockerty
Corrado Magnani
Elizabeth Milne
Logan G. Spector
Lesley J. Ashton
Nikolaos Dessypris
Alice Y. Kang
Margaret Miller, Edith Cowan UniversityFollow
Roberto Rondelli
Jill Simpson
Eftichia Stiakaki
Laurent Orsi
Eve Roman
Catherine Metayer
Claire Infante-Rivard
Jaqueline Clavel
Document Type
Journal Article
Publisher
Oxford University Press
School
School of Exercise and Health Sciences / Child Health Promotion Research Centre
RAS ID
21485
Abstract
The associations between childhood acute lymphoblastic leukemia (ALL) and several proxies of early stimulation of the immune system, that is, day-care center attendance, birth order, maternally reported common infections in infancy, and breastfeeding, were investigated by using data from 11 case-control studies participating in the Childhood Leukemia International Consortium (enrollment period: 1980-2010). The sample included 7,399 ALL cases and 11,181 controls aged 2-14 years. The data were collected by questionnaires administered to the parents. Pooled odds ratios and 95% confidence intervals were estimated by unconditional logistic regression adjusted for age, sex, study, maternal education, and maternal age. Day-care center attendance in the first year of life was associated with a reduced risk of ALL (odds ratio = 0.77, 95% confidence interval: 0.71, 0.84), with a marked inverse trend with earlier age at start (P < 0.0001). An inverse association was also observed with breastfeeding duration of 6 months or more (odds ratio = 0.86, 95% confidence interval: 0.79, 0.94). No significant relationship with a history of common infections in infancy was observed even though the odds ratio was less than 1 for more than 3 infections. The findings of this large pooled analysis reinforce the hypothesis that day-care center attendance in infancy and prolonged breastfeeding are associated with a decreased risk of ALL.
DOI
10.1093/aje/kwu298
Access Rights
free_to_read
Comments
Rudant, J., Lightfoot, T., Urayama, K.Y., Petridou, E., Dockerty, J.D., Magnani, C., ... & Clavel, J. (2015). Childhood acute lymphoblastic leukemia and indicators of early immune stimulation: A childhood leukemia international consortium study in American Journal of Epidemiology, 181(8), 549-562. Available here.