Day-care, early common infections and childhood acute leukaemia: a multicentre French case–control study

We conducted a case–control study to investigate the role of early infections in the aetiology of childhood acute leukaemias. The study included 280 incident cases (240 acute lymphoblastic leukaemia and 40 acute non-lymphoblastic leukaemia) and 288 hospital controls, frequency matched by age, gender...

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Veröffentlicht in:Breast cancer research and treatment 2002-04, Vol.86 (7), p.1064-1069
Hauptverfasser: Perrillat, F, Clavel, J, Auclerc, M F, Baruchel, A, Leverger, G, Nelken, B, Philippe, N, Schaison, G, Sommelet, D, Vilmer, E, Hémon, D
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container_end_page 1069
container_issue 7
container_start_page 1064
container_title Breast cancer research and treatment
container_volume 86
creator Perrillat, F
Clavel, J
Auclerc, M F
Baruchel, A
Leverger, G
Nelken, B
Philippe, N
Schaison, G
Sommelet, D
Vilmer, E
Hémon, D
description We conducted a case–control study to investigate the role of early infections in the aetiology of childhood acute leukaemias. The study included 280 incident cases (240 acute lymphoblastic leukaemia and 40 acute non-lymphoblastic leukaemia) and 288 hospital controls, frequency matched by age, gender, hospital, catchment area of the hospital and ethnic origin. Data were obtained from standardised face-to-face interviews of the mothers. The interviews included questions on early common infections, day-care attendance, breast-feeding, birth order and infantile diseases. Odds ratios were estimated using an unconditional regression model including the stratification variables, parental socio-economic status and perinatal characteristics. Birth order was not associated with childhood leukaemia (acute lymphoblastic or acute non-lymphoblastic). A statistically-significant inverse association was observed between childhood leukaemia and day-care attendance (odds ratio=0.6, 95% Confidence Interval=(0.4–1.0)), repeated early common infections (⩾4 per year before age two, odds ratio=0.6 (0.4–1.0)), surgical procedures for ear–nose–throat infections before age two (odds ratio=0.5 (0.2–1.0)) and prolonged breast-feeding (⩾6 months, odds ratio=0.5 (0.2–1.0)). In the multivariate model including day-care attendance, early common infections and breast-feeding, results concerning breast-feeding remained unchanged. A statistically significant interaction between day-care attendance and repeated early common infections was observed. When the interaction was taken into account, the simple effects of day-care and early common infections disappeared (odds ratio=1.1 (0.5–2.3) and odds ratio=0.8 (0.5–1.3), respectively) while the joint effect of day-care attendance and early common infections was negatively associated with childhood leukaemia (odds ratio=0.3 (0.1–0.8)). All the above associations were observed both for acute lymphoblastic leukaemia and acute non-lymphoblastic leukaemia. Our results support Greaves' hypothesis, even though they are not specific of common leukaemia.
doi_str_mv 10.1038/sj.bjc.6600091
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The study included 280 incident cases (240 acute lymphoblastic leukaemia and 40 acute non-lymphoblastic leukaemia) and 288 hospital controls, frequency matched by age, gender, hospital, catchment area of the hospital and ethnic origin. Data were obtained from standardised face-to-face interviews of the mothers. The interviews included questions on early common infections, day-care attendance, breast-feeding, birth order and infantile diseases. Odds ratios were estimated using an unconditional regression model including the stratification variables, parental socio-economic status and perinatal characteristics. Birth order was not associated with childhood leukaemia (acute lymphoblastic or acute non-lymphoblastic). A statistically-significant inverse association was observed between childhood leukaemia and day-care attendance (odds ratio=0.6, 95% Confidence Interval=(0.4–1.0)), repeated early common infections (⩾4 per year before age two, odds ratio=0.6 (0.4–1.0)), surgical procedures for ear–nose–throat infections before age two (odds ratio=0.5 (0.2–1.0)) and prolonged breast-feeding (⩾6 months, odds ratio=0.5 (0.2–1.0)). In the multivariate model including day-care attendance, early common infections and breast-feeding, results concerning breast-feeding remained unchanged. A statistically significant interaction between day-care attendance and repeated early common infections was observed. 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The study included 280 incident cases (240 acute lymphoblastic leukaemia and 40 acute non-lymphoblastic leukaemia) and 288 hospital controls, frequency matched by age, gender, hospital, catchment area of the hospital and ethnic origin. Data were obtained from standardised face-to-face interviews of the mothers. The interviews included questions on early common infections, day-care attendance, breast-feeding, birth order and infantile diseases. Odds ratios were estimated using an unconditional regression model including the stratification variables, parental socio-economic status and perinatal characteristics. Birth order was not associated with childhood leukaemia (acute lymphoblastic or acute non-lymphoblastic). A statistically-significant inverse association was observed between childhood leukaemia and day-care attendance (odds ratio=0.6, 95% Confidence Interval=(0.4–1.0)), repeated early common infections (⩾4 per year before age two, odds ratio=0.6 (0.4–1.0)), surgical procedures for ear–nose–throat infections before age two (odds ratio=0.5 (0.2–1.0)) and prolonged breast-feeding (⩾6 months, odds ratio=0.5 (0.2–1.0)). In the multivariate model including day-care attendance, early common infections and breast-feeding, results concerning breast-feeding remained unchanged. A statistically significant interaction between day-care attendance and repeated early common infections was observed. When the interaction was taken into account, the simple effects of day-care and early common infections disappeared (odds ratio=1.1 (0.5–2.3) and odds ratio=0.8 (0.5–1.3), respectively) while the joint effect of day-care attendance and early common infections was negatively associated with childhood leukaemia (odds ratio=0.3 (0.1–0.8)). All the above associations were observed both for acute lymphoblastic leukaemia and acute non-lymphoblastic leukaemia. Our results support Greaves' hypothesis, even though they are not specific of common leukaemia.</description><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Birth order</subject><subject>Breast Feeding</subject><subject>Breastfeeding &amp; lactation</subject><subject>Cancer Research</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child Day Care Centers</subject><subject>Child, Preschool</subject><subject>Drug Resistance</subject><subject>Epidemiology</subject><subject>Etiology</subject><subject>Female</subject><subject>France</subject><subject>France - epidemiology</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infection</subject><subject>Infections</subject><subject>Leukemia</subject><subject>Leukemia, Lymphocytic, Acute</subject><subject>Leukemia, Myeloid, Acute - epidemiology</subject><subject>Leukemia, Myeloid, Acute - etiology</subject><subject>Leukemia, Myeloid, Acute - prevention &amp; control</subject><subject>Leukemia, Nonlymphocytic, Acute</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. 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The study included 280 incident cases (240 acute lymphoblastic leukaemia and 40 acute non-lymphoblastic leukaemia) and 288 hospital controls, frequency matched by age, gender, hospital, catchment area of the hospital and ethnic origin. Data were obtained from standardised face-to-face interviews of the mothers. The interviews included questions on early common infections, day-care attendance, breast-feeding, birth order and infantile diseases. Odds ratios were estimated using an unconditional regression model including the stratification variables, parental socio-economic status and perinatal characteristics. Birth order was not associated with childhood leukaemia (acute lymphoblastic or acute non-lymphoblastic). A statistically-significant inverse association was observed between childhood leukaemia and day-care attendance (odds ratio=0.6, 95% Confidence Interval=(0.4–1.0)), repeated early common infections (⩾4 per year before age two, odds ratio=0.6 (0.4–1.0)), surgical procedures for ear–nose–throat infections before age two (odds ratio=0.5 (0.2–1.0)) and prolonged breast-feeding (⩾6 months, odds ratio=0.5 (0.2–1.0)). In the multivariate model including day-care attendance, early common infections and breast-feeding, results concerning breast-feeding remained unchanged. A statistically significant interaction between day-care attendance and repeated early common infections was observed. When the interaction was taken into account, the simple effects of day-care and early common infections disappeared (odds ratio=1.1 (0.5–2.3) and odds ratio=0.8 (0.5–1.3), respectively) while the joint effect of day-care attendance and early common infections was negatively associated with childhood leukaemia (odds ratio=0.3 (0.1–0.8)). All the above associations were observed both for acute lymphoblastic leukaemia and acute non-lymphoblastic leukaemia. Our results support Greaves' hypothesis, even though they are not specific of common leukaemia.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>11953850</pmid><doi>10.1038/sj.bjc.6600091</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-1048-1517</orcidid><oa>free_for_read</oa></addata></record>
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source MEDLINE; Nature Journals Online; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings
subjects Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Birth order
Breast Feeding
Breastfeeding & lactation
Cancer Research
Case-Control Studies
Child
Child Day Care Centers
Child, Preschool
Drug Resistance
Epidemiology
Etiology
Female
France
France - epidemiology
Hematologic and hematopoietic diseases
Hematology
Hospitals
Humans
Hypotheses
Infant
Infant, Newborn
Infection
Infections
Leukemia
Leukemia, Lymphocytic, Acute
Leukemia, Myeloid, Acute - epidemiology
Leukemia, Myeloid, Acute - etiology
Leukemia, Myeloid, Acute - prevention & control
Leukemia, Nonlymphocytic, Acute
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Life Sciences
Male
Medical research
Medical sciences
Molecular Medicine
Odds Ratio
Oncology
Pediatrics
Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology
Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology
Precursor Cell Lymphoblastic Leukemia-Lymphoma - prevention & control
Risk Factors
Santé publique et épidémiologie
title Day-care, early common infections and childhood acute leukaemia: a multicentre French case–control study
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