title: Childhood acute lymphoblastic leukemia and infections in the first year of life: a report from the United Kingdom Childhood Cancer Study.
abstract: The United Kingdom Childhood Cancer Study was designed to examine the relation between childhood cancer and preceding exposure to infectious diseases. The authors analyzed the relation between diagnosis (1991-1996) of acute lymphoblastic leukemia (ALL) at ages 2-5 years and clinically diagnosed infections in infancy. Almost all study children (96% of both cases and controls) were taken to a general practitioner for a non-immunization-associated visit at least once before their first birthday. Children diagnosed with ALL had significantly more clinically diagnosed infectious episodes in infancy than did controls; the average number of episodes was 3.6 (95% confidence interval (CI): 3.3, 3.9) versus 3.1 (95% CI: 2.9, 3.2). This case-control difference was most apparent in the neonatal period (< or =1 month); 18% of controls and 24% of ALL cases were diagnosed with at least one infection (odds ratio = 1.4, 95% CI: 1.1, 1.9; p < 0.05). Cases who had more than one neonatal infectious episode tended to be diagnosed with ALL at a comparatively young age; the mean age at ALL diagnosis was 37.7 months for cases with two or more episodes versus 45.3 months for cases with only one episode or none (p < 0.01). These findings support the hypothesis that a dysregulated immune response to infection in the first few months of life promotes transition to overt ALL later in childhood.
authors.affiliation: Epidemiology and Genetics Unit, Department of Health Sciences, University of York, York, United Kingdom. eve.roman@egu.york.ac.uk
authors.forename: E
authors.initials: E
authors.lastname: Roman
authors.forename: J
authors.initials: J
authors.lastname: Simpson
authors.forename: P
authors.initials: P
authors.lastname: Ansell
authors.forename: S
authors.initials: S
authors.lastname: Kinsey
authors.forename: C D
authors.initials: CD
authors.lastname: Mitchell
authors.forename: P A
authors.initials: PA
authors.lastname: McKinney
authors.forename: J M
authors.initials: JM
authors.lastname: Birch
authors.forename: M
authors.initials: M
authors.lastname: Greaves
authors.forename: T
authors.initials: T
authors.lastname: Eden
mesh_terms: D017668:Age of Onset; D016022:Case-Control Studies; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000453:epidemiology*; D008297:Male; D016017:Odds Ratio; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology*; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology