History of Early Childhood Infections and Acute Lymphoblastic Leukemia Risk Among Children in a U.S. Integrated Health Care System
Menée aux Etats-Unis auprès de 2 170 témoins et 435 patients atteints d'une leucémie aiguë lymphoblastique diagnostiquée entre 1994 et 2014 (âge au diagnostic : 0-14 ans), cette étude analyse l'association entre des antécédents d'infections au cours de la première année de vie et le risque de développer la maladie
Surrogate measures of infectious exposures have been consistently associated with lower childhood acute lymphoblastic leukemia (ALL) risk. However, recent reports have suggested that physician-diagnosed early life infections increase ALL risk, thereby raising the possibility that stronger responses to infections may promote risk. We examined whether medically diagnosed infections were related to childhood ALL risk in an integrated health care system in the United States. Cases of ALL (n=435) diagnosed between 1994-2014 at age 0-14 years along with matched controls (n=2170) were identified at Kaiser Permanente Northern California. Conditional logistic regression was used to estimate risk of ALL associated with history of infections during first year of life and across the lifetime (up to diagnosis). History of infection during first year of life was not associated with ALL risk (odds ratio [OR]: 0.85, 95% confidence interval [CI]: 0.60, 1.21). However, infections with at least one medication prescribed (i.e., more “severe” infections) were inversely associated with risk (OR: 0.42, 95% CI: 0.20, 0.88). Similar associations were observed when the exposure window was expanded to include medication-prescribed infections throughout the subjects’ lifetime (OR=0.52, 95% CI: 0.32, 0.85).