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Childhood Acute Lymphoblastic Leukemia and Infections in the First Year of Life: a Report From the United Kingdom Childhood Cancer Study

Roman, E., Simpson, J., Ansell, P., Kinsey, S., Mitchell, C.D., McKinney, P.A., Birch, J.M., Greaves, M. and Eden, T. (2007) Childhood Acute Lymphoblastic Leukemia and Infections in the First Year of Life: a Report From the United Kingdom Childhood Cancer Study. American Journal of Epidemiology, 165 (5). pp. 496-504. ISSN 0002-9262

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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 (≤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.

Item Type: Article
Academic Units: The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 12 Aug 2009 16:38
Last Modified: 12 Aug 2009 16:38
Published Version: http://dx.doi.org/10.1093/aje/kwk039
Status: Published
Publisher: Oxford University Press
Identification Number: 10.1093/aje/kwk039
URI: http://eprints.whiterose.ac.uk/id/eprint/5482

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