Alberts Aya, Kjaer Susanne K, Søegaard Signe H, Winther Jeanette F, Schmiegelow Kjeld, Sopina Liza, Erdmann Friederike, Hargreave Marie
Virus, Lifestyle and Genes, Danish Cancer Institute, Copenhagen, Denmark.
Department of Gynecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Int J Cancer. 2025 Jul 1;157(1):55-63. doi: 10.1002/ijc.35338. Epub 2025 Jan 16.
A protective effect of childhood vaccinations on leukemia risk, particularly acute lymphoblastic leukemia (ALL), has been hypothesized, though findings are inconsistent. We used a nationwide cohort of Danish children born 1997-2018 (n = 1,360,230), to examine associations between childhood vaccinations and leukemia (<20 years) using registry data (follow-up: December 31, 2018). Cox proportional hazard models with age as the underlying time estimated hazard ratios (HRs) for leukemia (any, ALL, acute myeloid [AML], and other), comparing vaccinated with unvaccinated children. We also accessed the effect of each additional vaccine dose. During 14,536,819 person-years, 771 children were diagnosed with leukemia (74% ALL, 16% AML, and 10% other). Any vaccination was associated with an increased HR for ALL (HR: 2.76; 95% CI: 0.66-11.58), compared to unvaccinated children, with a change in HR of 1.01 (95% CI: 0.96-1.05) per dose. The corresponding HRs for any leukemia, AML, and other leukemia were 1.04 (95% CI: 0.50-2.17), 0.67 (95% CI: 0.18-2.59) and 0.29 (95% CI: 0.09-0.99), with a change in HR of 0.97 (95% CI: 0.94-1.02), 0.92 (95% CI: 0.84-1.00, p = .062) and 0.88 (95% CI: 0.78-1.00, p = .044) per dose. No significant associations were found for vaccination types, except for the pneumococcal vaccine which was associated with a decreased risk of other leukemia (HR: 0.32; 95% CI: 0.14-0.74). In six-months lag analyses, no significant associations were observed, and decreased risks were attenuated. The results provide no strong evidence that childhood vaccinations reduce leukemia risk. The limited number of unvaccinated cases and wide confidence intervals suggest cautious interpretation of some findings.
尽管研究结果并不一致，但有假设认为儿童疫苗接种对白血病风险，尤其是急性淋巴细胞白血病（ALL）具有保护作用。我们使用了一个丹麦全国性队列，该队列包括1997年至2018年出生的儿童（n = 1,360,230），利用登记数据（随访至2018年12月31日）来研究儿童疫苗接种与白血病（<20岁）之间的关联。以年龄为基础时间的Cox比例风险模型估计白血病（任何类型、ALL、急性髓系白血病[AML]和其他类型）的风险比（HRs），比较接种疫苗和未接种疫苗的儿童。我们还评估了每增加一剂疫苗的效果。在14,536,819人年的随访期间，771名儿童被诊断为白血病（74%为ALL，16%为AML，10%为其他类型）。与未接种疫苗的儿童相比，任何疫苗接种都与ALL的HR增加相关（HR：2.76；95%CI：0.66 - 11.58），每剂疫苗接种的HR变化为1.01（95%CI：0.96 - 1.05）。任何白血病、AML和其他白血病的相应HR分别为1.04（95%CI：0.50 - 2.17）、0.67（95%CI：0.18 - 2.59）和0.29（95%CI：0.09 - 0.99），每剂疫苗接种的HR变化分别为0.97（95%CI：0.94 - 1.02）、0.92（95%CI：0.84 - 1.00，p = 0.062）和0.88（95%CI：0.78 - 1.00，p = 0.044）。除肺炎球菌疫苗与其他白血病风险降低相关（HR：0.32；95%CI：0.14 - 0.74）外，未发现疫苗类型与白血病之间存在显著关联。在滞后六个月的分析中，未观察到显著关联，且降低的风险有所减弱。结果没有提供有力证据表明儿童疫苗接种可降低白血病风险。未接种疫苗的病例数量有限且置信区间较宽，这表明对一些研究结果的解释需谨慎。
