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Wallace AD, Francis SS, Ma X, McKean-Cowdin R, Selvin S, Whitehead TP, Barcellos LF, Kang AY, Morimoto L, Moore TB, Wiemels JL, Metayer C. Allergies and Childhood Acute Lymphoblastic Leukemia: A Case-Control Study and Meta-analysis. Cancer Epidemiol Biomarkers Prev 2018; 27:1142-1150. [PMID: 30068517 PMCID: PMC6628274 DOI: 10.1158/1055-9965.epi-17-0584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/30/2017] [Accepted: 07/25/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Allergic disease is suspected to play a role in the development of childhood acute lymphoblastic leukemia (ALL). Studies conducted over the last several decades have yielded mixed results.Methods: We examined the association between allergy, a common immune-mediated disorder, and ALL in the California Childhood Leukemia Study (CCLS), a case-control study of 977 children diagnosed with ALL and 1,037 matched controls (1995-2015). History of allergies in the first year of life was obtained from interviews, mainly reported by mothers. Logistic regression analyses were conducted to estimate ORs and 95% confidence intervals (CIs), controlling for birth order, daycare attendance, and mode of delivery. In addition, we conducted meta-analyses with data from the CCLS and 12 published studies and employed a new method to estimate between-study heterogeneity (R_b).Results: Overall, no associations were observed between childhood ALL risk and specific allergy phenotypes or any allergy, as a group. However, having any allergy was associated with an increased risk of ALL among the youngest study participants. In the meta-analysis random-effects models, reduced odds of ALL were associated with hay fever (metaOR = 0.65; 95% CI, 0.47-0.90); however, restricting the analysis to studies that used medical records for assessment of allergy or recently published studies led to null or attenuated results.Conclusions: Overall, our findings do not support a clear association between allergy and childhood ALL.Impact: The degree to which epidemiologic studies can inform the relationship between allergies and risk of childhood ALL is limited by R_b. Cancer Epidemiol Biomarkers Prev; 27(10); 1142-50. ©2018 AACR.
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Affiliation(s)
- Amelia D Wallace
- School of Public Health, University of California, Berkeley, Berkeley, California.
| | - Stephen S Francis
- School of Community Health Sciences, University of Nevada, Reno, Nevada
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Xiomei Ma
- Department of Epidemiology and Public Health, Yale University, New Haven, Connecticut
| | - Roberta McKean-Cowdin
- Preventive Medicine, University of Southern California, Los Angeles, Los Angeles, California
| | - Steve Selvin
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Todd P Whitehead
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Lisa F Barcellos
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Alice Y Kang
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Libby Morimoto
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Theodore B Moore
- School of Medicine, Pediatrics, University of California, Los Angeles, Los Angeles, California
| | - Joseph L Wiemels
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, Berkeley, California
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Orsi L, Magnani C, Petridou ET, Dockerty JD, Metayer C, Milne E, Bailey HD, Dessypris N, Kang AY, Wesseling C, Infante-Rivard C, Wünsch-Filho V, Mora AM, Spector LG, Clavel J. Living on a farm, contact with farm animals and pets, and childhood acute lymphoblastic leukemia: pooled and meta-analyses from the Childhood Leukemia International Consortium. Cancer Med 2018; 7:2665-2681. [PMID: 29663688 PMCID: PMC6010788 DOI: 10.1002/cam4.1466] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/27/2017] [Accepted: 02/20/2018] [Indexed: 12/11/2022] Open
Abstract
The associations between childhood acute lymphoblastic leukemia (ALL) and several factors related to early stimulation of the immune system, that is, farm residence and regular contacts with farm animals (livestock, poultry) or pets in early childhood, were investigated using data from 13 case-control studies participating in the Childhood Leukemia International Consortium. The sample included 7847 ALL cases and 11,667 controls aged 1-14 years. In all studies, the data were obtained from case and control parents using standardized questionnaires. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by unconditional logistic regression adjusted for age, sex, study, maternal education, and maternal age. Contact with livestock in the first year of life was inversely associated with ALL (OR = 0.65, 95% CI: 0.50, 0.85). Inverse associations were also observed for contact with dogs (OR = 0.92, 95% CI: 0.86, 0.99) and cats (OR = 0.87, 95% CI: 0.80, 0.94) in the first year of life. There was no evidence of a significant association with farm residence in the first year of life. The findings of these large pooled and meta-analyses add additional evidence to the hypothesis that regular contact with animals in early childhood is inversely associated with childhood ALL occurrence which is consistent with Greaves' delayed infection hypothesis.
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Affiliation(s)
- Laurent Orsi
- INSERM U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris-Descartes University, Villejuif, France
| | - Corrado Magnani
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, AOUMaggiore della Carità & CPO, Piemonte, Novara, Italy
| | - Eleni T Petridou
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, University of Athens, Athens, Greece.,Department of Medicine, Clinical Epidemiology Unit, Karolinska Institute, Stockholm, Sweden
| | - John D Dockerty
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Catherine Metayer
- School of Public Health, University of California, Berkeley, California
| | - Elizabeth Milne
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Helen D Bailey
- INSERM U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris-Descartes University, Villejuif, France
| | - Nick Dessypris
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Alice Y Kang
- School of Public Health, University of California, Berkeley, California
| | - Catharina Wesseling
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Claire Infante-Rivard
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montréal, Quebec, Canada
| | | | - Ana M Mora
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | - Logan G Spector
- Division of Epidemiology and Clinical Research, Department of Pediatrics and Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Jacqueline Clavel
- INSERM U1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris-Descartes University, Villejuif, France
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3
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Barrington-Trimis JL, Cockburn M, Metayer C, Gauderman WJ, Wiemels J, McKean-Cowdin R. Trends in childhood leukemia incidence over two decades from 1992 to 2013. Int J Cancer 2017; 140:1000-1008. [PMID: 27778348 PMCID: PMC5550103 DOI: 10.1002/ijc.30487] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/28/2016] [Accepted: 10/07/2016] [Indexed: 12/24/2022]
Abstract
Incidence rates of childhood leukemia in the United States have steadily increased over the last several decades, but only recently have disparities in the increase in incidence been recognized. In the current analysis, Surveillance, Epidemiology and End Results (SEER) data were used to evaluate recent trends in the incidence of childhood leukemia diagnosed at age 0-19 years from 1992 to 2013, overall and by age, race/ethnicity, gender and histologic subtype. Hispanic White children were more likely than non-Hispanic White, non-Hispanic Black or non-Hispanic Asian children to be diagnosed with acute lymphocytic leukemia (ALL) from 2009 to 2013. From 1992 to 2013, a significant increase in ALL incidence was observed for Hispanic White children [annual percent change (APC)Hispanic = 1.08, 95% CI: 0.59, 1.58]; no significant increase was observed for non-Hispanic White, Black or Asian children. ALL incidence increased by about 3% per year from 1992 to 2013 for Hispanic White children diagnosed from 15 to 19 years (APC = 2.67; 95% CI: 0.88, 4.49) and by 2% for those 10-14 years (APC = 2.09; 95% CI: 0.57, 3.63), while no significant increases in incidence were observed in non-Hispanic White, Black, or Asian children of the same age. Acute myeloid leukemia (AML) incidence increased among non-Hispanic White children under 1 year at diagnosis, and among Hispanic White children diagnosed at age 1-4. The increase in incidence rates of childhood ALL appears to be driven by rising rates in older Hispanic children (10-14, and 15-19 years). Future studies are needed to evaluate reasons for the increase in ALL among older Hispanic children.
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Affiliation(s)
- Jessica L Barrington-Trimis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Myles Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Catherine Metayer
- School of Public Health, University of California Berkeley (UCB), Berkeley, CA
| | - W James Gauderman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Joseph Wiemels
- Department of Epidemiology and Biostatistics, University of California San Francisco (UCSF), San Francisco, CA
| | - Roberta McKean-Cowdin
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Fox M, Knapp LA, Andrews PW, Fincher CL. Hygiene and the world distribution of Alzheimer's disease: Epidemiological evidence for a relationship between microbial environment and age-adjusted disease burden. EVOLUTION MEDICINE AND PUBLIC HEALTH 2013; 2013:173-86. [PMID: 24481197 PMCID: PMC3868447 DOI: 10.1093/emph/eot015] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
People living in sanitized environments may be at greater Alzheimer's risk. We compare Alzheimer's rates in different countries in light of countries' historical and contemporary pathogen prevalence, sanitation, and urbanization. We find that countries that are less urbanized, with more pathogens and lower degree of sanitation have lower Alzheimer's rates. Background and objectives: Alzheimer’s disease (AD) shares certain etiological features with autoimmunity. Prevalence of autoimmunity varies between populations in accordance with variation in environmental microbial diversity. Exposure to microorganisms may improve individuals’ immunoregulation in ways that protect against autoimmunity, and we suggest that this may also be the case for AD. Here, we investigate whether differences in microbial diversity can explain patterns of age-adjusted AD rates between countries. Methodology: We use regression models to test whether pathogen prevalence, as a proxy for microbial diversity, across 192 countries can explain a significant amount of the variation in age-standardized AD disability-adjusted life-year (DALY) rates. We also review and assess the relationship between pathogen prevalence and AD rates in different world populations. Results: Based on our analyses, it appears that hygiene is positively associated with AD risk. Countries with greater degree of sanitation and lower degree of pathogen prevalence have higher age-adjusted AD DALY rates. Countries with greater degree of urbanization and wealth exhibit higher age-adjusted AD DALY rates. Conclusions and implications: Variation in hygiene may partly explain global patterns in AD rates. Microorganism exposure may be inversely related to AD risk. These results may help predict AD burden in developing countries where microbial diversity is rapidly diminishing. Epidemiological forecasting is important for preparing for future healthcare needs and research prioritization.
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Affiliation(s)
- Molly Fox
- Division of Biological Anthropology, Department of Anthropology and Archaeology, University of Cambridge, Pembroke Street, Cambridge CB2 3QY, UK, Department of Anthropology, University of Utah, 270 S 1400 E, Salt Lake City, UT 84112, USA, Department of Psychology, Neuroscience & Behaviour, McMaster University, 1280 Main Street W, Hamilton, ON L8S 4K1, Canada and Institute of Neuroscience and Psychology, University of Glasgow, 58 Hillhead Street, Glasgow G12 8QB, UK
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5
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Núñez-Enríquez JC, Fajardo-Gutiérrez A, Buchán-Durán EP, Bernáldez-Ríos R, Medina-Sansón A, Jiménez-Hernández E, Amador-Sanchez R, Peñaloza-Gonzalez JG, Paredes-Aguilera R, Alvarez-Rodriguez FJ, Bolea-Murga V, de Diego Flores-Chapa J, Flores-Lujano J, Bekker-Mendez VC, Rivera-Luna R, Del Carmen Rodriguez-Zepeda M, Rangel-López A, Dorantes-Acosta EM, Núñez-Villegas N, Velazquez-Aviña MM, Torres-Nava JR, Reyes-Zepeda NC, Cárdenas-Cardos R, Flores-Villegas LV, Martinez-Avalos A, Salamanca-Gómez F, Gorodezky C, Arellano-Galindo J, Mejía-Aranguré JM. Allergy and acute leukaemia in children with Down syndrome: a population study. Report from the Mexican inter-institutional group for the identification of the causes of childhood leukaemia. Br J Cancer 2013; 108:2334-8. [PMID: 23695017 PMCID: PMC3681010 DOI: 10.1038/bjc.2013.237] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 04/17/2013] [Accepted: 04/22/2013] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Allergies have been described as protective factors against the development of childhood acute leukaemia (AL). Our objective was to investigate the associations between allergy history and the development of AL and acute lymphoblastic leukaemia (ALL) in children with Down syndrome (DS). METHODS A case-control study was performed in Mexico City. The cases (n=97) were diagnosed at nine public hospitals, and the controls (n=222) were recruited at institutions for children with DS. Odds ratios (OR) were calculated. RESULTS Asthma was positively associated with AL development (OR=4.18; 95% confidence interval (CI): 1.47-11.87), whereas skin allergies were negatively associated (OR=0.42; 95% CI: 0.20-0.91). CONCLUSION Our findings suggest that allergies and AL in children with DS share biological and immune mechanisms. To our knowledge, this is the first study reporting associations between allergies and AL in children with DS.
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Affiliation(s)
- J C Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiologia Clínica, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo XXI, Instituto Mexicano del Seguro Social, Avenida Cuauhtémoc 330, Delegación Cuauhtémoc, México D.F. 06720, México.
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6
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Alonso A, Bahillo A, de la Rosa R, Carrera A, Durán RJ, Fernández P. Measurement procedure to assess exposure to extremely low-frequency fields: a primary school case study. RADIATION PROTECTION DOSIMETRY 2012; 151:426-436. [PMID: 22456991 DOI: 10.1093/rpd/ncs026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
How to correctly measure the exposure of general public to extremely low-frequency (ELF) radiation is a key issue for ELF epidemiological studies. This paper proposes a measurement procedure to accurately assess the exposure of people to electric and magnetic field in the frequency band from 5 Hz to 100 kHz in buildings and their premises. As ELF radiation could be particularly harmful to children, the measurement procedure is focused on exposure to ELF in schools. Thus, the students' exposure to ELF fields can be assessed by correlating the ELF measurements to the hours of school activity. In this paper, the measurement protocol was applied to study the ELF exposure on students from García Quintana primary school in Valladolid, Spain. The campaign of measurements for ELF exposure assessment in this primary school was of great interest for the Regional Council of Public Health because of the social alarm generated by the presence of a significant number cancer cases in children.
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Affiliation(s)
- A Alonso
- Department of Signal Theory and Communications and Telematic Engineering, University of Valladolid. Paseo de Belén 15, 47011, Valladolid, Spain
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Turner MC. Epidemiology: allergy history, IgE, and cancer. Cancer Immunol Immunother 2012; 61:1493-510. [PMID: 22183126 PMCID: PMC11028502 DOI: 10.1007/s00262-011-1180-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 12/01/2011] [Indexed: 01/10/2023]
Abstract
Numerous epidemiological studies have investigated potential associations between allergy history and cancer risk with strong inverse associations reported in studies of pancreatic cancer, glioma, and childhood leukemia. Recently, there has been a rapid expansion of the epidemiological literature both of studies evaluating self-reported allergy history in relation to cancer risk and of studies evaluating biological indicators of allergy history and immune function including levels of immunoglobulin (Ig) E. However, there are several potential methodological limitations associated with prior studies, and further research is required to clarify associations observed. This paper summarizes the recent epidemiological literature examining associations between allergy history and cancer risk. From 2008, a total of 55 epidemiological studies were identified that examined some aspect of the association between allergy and cancer. Although the majority of studies examined self-reported allergy history in relation to cancer risk, there were also studies examining allergy diagnoses or discharges as captured in existing administrative databases, levels of IgE, polymorphisms of allergy, inflammatory- or allergy-related cytokine genes, and concentrations of immune regulatory proteins. The most frequently studied cancer sites included brain and lymphatic and hematopoietic cancers. Potential methodological sources of bias are discussed as well as recommendations for future work.
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Affiliation(s)
- Michelle C Turner
- McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, One Stewart Street, Room 313, Ottawa, ON K1N 6N5, Canada.
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Rudant J, Orsi L, Monnereau A, Patte C, Pacquement H, Landman-Parker J, Bergeron C, Robert A, Michel G, Lambilliotte A, Aladjidi N, Gandemer V, Lutz P, Margueritte G, Plantaz D, Méchinaud F, Hémon D, Clavel J. Childhood Hodgkin's lymphoma, non-Hodgkin's lymphoma and factors related to the immune system: the Escale Study (SFCE). Int J Cancer 2011; 129:2236-47. [PMID: 21170962 DOI: 10.1002/ijc.25862] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 11/17/2010] [Indexed: 11/07/2022]
Abstract
The study investigated the role of factors considered related to the early stimulation of the immune system in the aetiology of childhood lymphoma. The national registry-based case-control study, Escale, was carried out in France over the period 2003-2004. Population controls were frequency matched with the cases on age and gender. Data were obtained from structured telephone questionnaires administered to mothers. Odds ratios (ORs) were estimated using unconditional regression models adjusted for potential confounders. Data from 128 cases of Hodgkin's lymphoma (HL) aged 5-14 years, 164 cases of non-Hodgkin's lymphoma (NHL) aged 2-14 years and 1,312 controls were analyzed. Negative associations were observed between HL and day care attendance [OR = 0.5 (0.2-1.2)] and between HL and repeated early common infections among non-breastfed children [OR = 0.3 (.2-0.7), p = 0.003] [OR for breastfed children: 1.0 (.5-2.1)], but not for the other factors investigated. Negative associations were observed between NHL and birth order 3 or more [OR = 0.7 (0.4-1.1)], prolonged breastfeeding [OR = 0.5 (0.3-1.0)], regular contact with farm animals [OR = 0.5 (0.3-1.0)], frequent farm visits in early life [OR = 0.6 (0.4-1.1)] and history of asthma [OR = 0.6 (0.3-1.1)]. In conclusion, the results partly support the hypothesis that an abnormal maturation of the immune system may play a role in childhood HL or NHL, and call for further investigations.
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Affiliation(s)
- Jérémie Rudant
- Inserm UMRS1018, CESP, Université Paris Sud, Villejuif, France
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9
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Rudant J, Orsi L, Menegaux F, Petit A, Baruchel A, Bertrand Y, Lambilliotte A, Robert A, Michel G, Margueritte G, Tandonnet J, Mechinaud F, Bordigoni P, Hémon D, Clavel J. Childhood acute leukemia, early common infections, and allergy: The ESCALE Study. Am J Epidemiol 2010; 172:1015-27. [PMID: 20807738 DOI: 10.1093/aje/kwq233] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study investigated the role of factors considered related to early stimulation of the immune system in the etiology of childhood acute leukemia. The national registry-based case-control study ESCALE was carried out in France in 2003-2004. Population controls were frequency matched to cases on age and gender. Data were obtained from structured telephone questionnaires administered to mothers. Odds ratios were estimated using unconditional regression models adjusted for potential confounders. Included were 634 acute lymphoblastic leukemia cases, 86 acute myeloblastic leukemia cases, and 1,494 controls aged ≥1 year. Negative associations were observed between acute lymphoblastic leukemia and birth order (P for trend < 0.0001), attendance at a day-care center before age 1 year (odds ratio (OR) = 0.8, 95% confidence interval (CI): 0.6, 1.1), prolonged breastfeeding (OR = 0.7, 95% CI: 0.5, 1.0), repeated early common infections (OR = 0.7, 95% CI: 0.6, 0.9), regular contact with farm animals (OR = 0.6, 95% CI: 0.5, 0.8), frequent farm visits in early life (OR = 0.4, 95% CI: 0.3, 0.6), and history of asthma (OR = 0.7, 95% CI: 0.4, 1.0) or eczema (OR = 0.7, 95% CI: 0.6, 0.9). Results support the hypothesis that repeated early infections and asthma may play a role against childhood acute leukemia.
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Affiliation(s)
- Jérémie Rudant
- CESP Centre for Research in Epidemiology and Population Health, INSERM, Villejuif, France
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Linabery AM, Jurek AM, Duval S, Ross JA. The association between atopy and childhood/adolescent leukemia: a meta-analysis. Am J Epidemiol 2010; 171:749-64. [PMID: 20228139 DOI: 10.1093/aje/kwq004] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Atopic disease is hypothesized to be protective against several malignancies, including childhood/adolescent leukemia. To summarize the available epidemiologic evidence, the authors performed a meta-analysis of associations between atopy/allergies, asthma, eczema, hay fever, and hives and childhood/adolescent leukemia, acute lymphoblastic leukemia (ALL), and acute myeloid leukemia (AML). They searched MEDLINE literature (1952-March 2009) and queried international experts to identify eligible studies. Ten case-control studies were included. Summary odds ratios and 95% confidence intervals were computed via random-effects models. Odds ratios for atopy/allergies were 1.42 (95% confidence interval (CI): 0.60, 3.35) for 3 studies of leukemia overall, 0.69 (95% CI: 0.54, 0.89) for 6 studies of ALL, and 0.87 (95% CI: 0.62, 1.22) for 2 studies of AML, with high levels of heterogeneity detected for leukemia overall and ALL. Inverse associations were observed for ALL and asthma (odds ratio (OR) = 0.79, 95% CI: 0.61, 1.02), eczema (OR = 0.74, 95% CI: 0.58, 0.96), and hay fever (OR = 0.55, 95% CI: 0.46, 0.66) examined separately. Odds ratios for ALL differed by study design, exposure data source, and latency period, indicating that these factors affect study results. These results should be interpreted cautiously given the modest number of studies, substantial heterogeneity, and potential exposure misclassification but are useful in designing future research.
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MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/immunology
- Case-Control Studies
- Child
- Child, Preschool
- Confidence Intervals
- Dermatitis, Atopic/epidemiology
- Dermatitis, Atopic/immunology
- Humans
- Hypersensitivity, Immediate/epidemiology
- Hypersensitivity, Immediate/immunology
- Incidence
- Infant
- Infant, Newborn
- Leukemia/epidemiology
- Leukemia/immunology
- Leukemia, Myeloid, Acute/epidemiology
- Leukemia, Myeloid, Acute/immunology
- Multivariate Analysis
- Odds Ratio
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology
- Prevalence
- Research Design
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/immunology
- Urticaria/epidemiology
- Urticaria/immunology
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Affiliation(s)
- Amy M Linabery
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota 55455, USA
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