Groves F D, Gridley G, Wacholder S, Shu X O, Robison L L, Neglia J P, Linet M S
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892-7244, USA.
Br J Cancer. 1999 Sep;81(1):175-8. doi: 10.1038/sj.bjc.6690668.
Previous studies have suggested that infant vaccinations may reduce the risk of subsequent childhood leukaemia. Vaccination histories were compared in 439 children (ages 0-14) diagnosed with acute lymphoblastic leukaemia (ALL) in nine Midwestern and Mid-Atlantic states (USA) between 1 January 1989 and 30 June 1993 and 439 controls selected by random-digit dialing and individually matched to cases on age, race and telephone exchange. Among matched pairs, similar proportions of cases and controls had received at least one dose of oral poliovirus (98%), diphtheria-tetanus-pertussis (97%), and measles-mumps-rubella (90%) vaccines. Only 47% of cases and 53% of controls had received any Haemophilus influenzae type b (Hib) vaccine (relative risk (RR) = 0.73; 95% confidence interval (CI) 0.50-1.06). Although similar proportions of cases (12%) and controls (11%) received the polysaccharide Hib vaccine (RR = 1.13; 95% CI 0.64-1.98), more controls (41%) than cases (35%) received the conjugate Hib vaccine (RR = 0.57; 95% CI 0.36-0.89). Although we found no relationship between most infant vaccinations and subsequent risk of childhood ALL, our findings suggest that infants receiving the conjugate Hib vaccine may be at reduced risk of subsequent childhood acute lymphoblastic leukemia. Further studies are needed to confirm this association and, if confirmed, to elucidate the underlying mechanism.
以往的研究表明，婴儿接种疫苗可能会降低后续儿童期患白血病的风险。对1989年1月1日至1993年6月30日期间在美国中西部和大西洋中部九个州诊断为急性淋巴细胞白血病（ALL）的439名儿童（0至14岁）的疫苗接种史进行了比较，并与通过随机数字拨号选择且在年龄、种族和电话局方面与病例个体匹配的439名对照进行了比较。在匹配对中，病例和对照中接受过至少一剂口服脊髓灰质炎病毒疫苗（98%）、白喉-破伤风-百日咳疫苗（97%）和麻疹-腮腺炎-风疹疫苗（90%）的比例相似。只有47%的病例和53%的对照接种过任何b型流感嗜血杆菌（Hib）疫苗（相对风险（RR）=0.73；95%置信区间（CI）0.50 - 1.06）。虽然病例（12%）和对照（11%）中接受多糖Hib疫苗的比例相似（RR = 1.13；95% CI 0.64 - 1.98），但接受结合型Hib疫苗的对照（41%）比病例（35%）多（RR = 0.57；95% CI 0.36 - 0.89）。虽然我们发现大多数婴儿疫苗接种与后续儿童期ALL风险之间没有关系，但我们的研究结果表明，接种结合型Hib疫苗的婴儿后续患儿童期急性淋巴细胞白血病的风险可能会降低。需要进一步研究来证实这种关联，如果得到证实，则需阐明其潜在机制。
