CESP Centre for Research in Epidemiology and Population Health, INSERM, Villejuif, France.
Am J Epidemiol. 2010 Nov 1;172(9):1015-27. doi: 10.1093/aje/kwq233. Epub 2010 Aug 31.
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.
本研究调查了被认为与免疫系统早期刺激有关的因素在儿童急性白血病发病机制中的作用。该研究是 2003-2004 年在法国进行的基于国家登记的病例对照研究 ESCALE。人群对照按年龄和性别与病例相匹配。数据来自于对母亲进行的结构化电话问卷调查。使用非条件回归模型估计比值比,并调整了潜在混杂因素。共纳入了 634 例急性淋巴细胞白血病病例、86 例急性髓细胞性白血病病例和 1494 例年龄≥1 岁的对照。研究观察到,急性淋巴细胞白血病与出生顺序呈负相关(趋势 P<0.0001),1 岁前上日托中心(比值比(OR)=0.8,95%置信区间(CI):0.6,1.1),延长母乳喂养(OR=0.7,95% CI:0.5,1.0),反复早期常见感染(OR=0.7,95% CI:0.6,0.9),与农场动物有规律接触(OR=0.6,95% CI:0.5,0.8),在生命早期频繁去农场(OR=0.4,95% CI:0.3,0.6),以及哮喘(OR=0.7,95% CI:0.4,1.0)或湿疹(OR=0.7,95% CI:0.6,0.9)的病史。结果支持了这样一种假说,即反复的早期感染和哮喘可能在儿童急性白血病中起到一定的保护作用。