title: Infectious diseases in the first year of life, perinatal characteristics and childhood acute leukaemia.
abstract: The objective of the present study was to investigate the role of early common infections and perinatal characteristics in the aetiology of childhood common leukaemia. A case-control study was conducted from 1995 to 1998 in France, and included 473 incident cases of acute leukaemia (AL) (408 acute lymphoblastic leukaemia (ALL), 65 acute myeloid leukaemia (AML) age-, sex- and region-matched with 567 population-based controls. Data on the medical history of the child and his/her environment were collected using self-administered questionnaires. Analyses were conducted using nonconditional logistic regression. A slight negative association with early infections was observed (OR=0.8; 95% CI (0.6-1.0)). The association was stronger for early gastrointestinal infections. Early day-care was found to be associated with a decreased risk of AL (OR=0.6; 95% CI (0.4-0.8) and OR=0.8; 95% CI (0.5-1.2) for day-care starting before age 3 months and between 3 and 6 months, respectively). No association with breast-feeding was observed, irrespective of its duration. A birth order of 4 or more was associated with a significantly increased risk of AL (OR=2.0; 95% CI (1.1-3.7) with ALL). A history of asthma was associated with a decreased risk of ALL (OR 0.5; 95% CI (0.3-0.90). Although the results regarding birth order and breast-feeding do not fit with Greaves' hypothesis, the study supports the hypothesis that early common infections may play a protective role in the aetiology of childhood leukaemia, although this effect was not more marked for common ALL.
authors.affiliation: 1Institut National de la Santé et de la Recherche Médicale, INSERM U170-IFR69, 94807 Villejuif, France.
authors.forename: N
authors.initials: N
authors.lastname: Jourdan-Da Silva
authors.forename: Y
authors.initials: Y
authors.lastname: Perel
authors.forename: F
authors.initials: F
authors.lastname: Méchinaud
authors.forename: E
authors.initials: E
authors.lastname: Plouvier
authors.forename: V
authors.initials: V
authors.lastname: Gandemer
authors.forename: P
authors.initials: P
authors.lastname: Lutz
authors.forename: J P
authors.initials: JP
authors.lastname: Vannier
authors.forename: J L
authors.initials: JL
authors.lastname: Lamagnére
authors.forename: G
authors.initials: G
authors.lastname: Margueritte
authors.forename: P
authors.initials: P
authors.lastname: Boutard
authors.forename: A
authors.initials: A
authors.lastname: Robert
authors.forename: C
authors.initials: C
authors.lastname: Armari
authors.forename: M
authors.initials: M
authors.lastname: Munzer
authors.forename: F
authors.initials: F
authors.lastname: Millot
authors.forename: L
authors.initials: L
authors.lastname: De Lumley
authors.forename: C
authors.initials: C
authors.lastname: Berthou
authors.forename: X
authors.initials: X
authors.lastname: Rialland
authors.forename: B
authors.initials: B
authors.lastname: Pautard
authors.forename: D
authors.initials: D
authors.lastname: Hémon
authors.forename: J
authors.initials: J
authors.lastname: Clavel
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D001249:Asthma / Q000150:complications; D001722:Birth Order; D001942:Breast Feeding; D016022:Case-Control Studies; D002656:Child Day Care Centers; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D007239:Infections / Q000150:complications*; D007951:Leukemia, Myeloid / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008487:Medical History Taking; D016017:Odds Ratio; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology* / Q000209:etiology*; D012044:Regression Analysis; D012307:Risk Factors