A case-control study of non-T cell acute lymphoblastic leukaemia of children in Hokkaido, Japan.

Nishi, Motoi; Miyake, Hirotsugu

doi:10.1136/jech.43.4.352

Cited by 58 publications

(59 citation statements)

References 9 publications

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“…In contrast with four previous studies (Kneale et al, 1986;McKinney et al, 1987;Nishi and Miyake, 1989;Kaatsch et al, 1996), our data provide no evidence of a reduced ALL risk following vaccination with DTP, MMR, or OPV. Our failure to detect such inverse associations may be due to a lack of statistical power, because DTP, MMR and OPV were nearly universal among both cases and controls.…”

Section: Discussioncontrasting

confidence: 56%

“…Our study differed in several methodologic aspects from previous investigations. Only one previous study (Innis, 1965) obtained vaccine data from written records, only one (Kneale et al, 1986) included more cases, and only two (Nishi and Miyake, 1989;Kaatsch et al, 1996) focused specifically on ALL. While four of the previous studies (Kneale et al, 1986;McKinney et al, 1987;Nishi and Miyake, 1989;Kaatsch et al, 1996) utilized age-matched controls, only one (Kaatsch et al, 1996) adjusted for socioeconomic status.…”

Section: Discussionmentioning

confidence: 99%

“…Only one previous study (Innis, 1965) obtained vaccine data from written records, only one (Kneale et al, 1986) included more cases, and only two (Nishi and Miyake, 1989;Kaatsch et al, 1996) focused specifically on ALL. While four of the previous studies (Kneale et al, 1986;McKinney et al, 1987;Nishi and Miyake, 1989;Kaatsch et al, 1996) utilized age-matched controls, only one (Kaatsch et al, 1996) adjusted for socioeconomic status. Only one previous study (Nishi and Miyake, 1989) separately reported the relative risks and 95% confidence intervals for childhood leukaemia following specific vaccinations; other studies reported the effect of specific vaccines on all malignancies combined (Kneale et al, 1986), and/or the effect of vaccines in general on childhood leukaemia in particular (Innis, 1965;Kneale et al, 1986;McKinney et al, 1987;Kaatsch et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

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Infant vaccinations and risk of childhood acute lymphoblastic leukaemia in the USA

et al. 1999

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Previous studies have suggested that infant vaccinations may reduce the risk of subsequent childhood leukaemia. Vaccination histories were compared in 439 children (ages 0–14) diagnosed with acute lymphoblastic leukaemia (ALL) in nine Midwestern and Mid-Atlantic states (USA) between 1 January 1989 and 30 June 1993 and 439 controls selected by random-digit dialing and individually matched to cases on age, race and telephone exchange. Among matched pairs, similar proportions of cases and controls had received at least one dose of oral poliovirus (98%), diphtheria–tetanus–pertussis (97%), and measles–mumps–rubella (90%) vaccines. Only 47% of cases and 53% of controls had received any Haemophilus influenzae type b (Hib) vaccine (relative risk (RR) = 0.73; 95% confidence interval (CI) 0.50–1.06). Although similar proportions of cases (12%) and controls (11%) received the polysaccharide Hib vaccine (RR = 1.13; 95% CI 0.64–1.98), more controls (41%) than cases (35%) received the conjugate Hib vaccine (RR = 0.57; 95% CI 0.36–0.89). Although we found no relationship between most infant vaccinations and subsequent risk of childhood ALL, our findings suggest that infants receiving the conjugate Hib vaccine may be at reduced risk of subsequent childhood acute lymphoblastic leukemia. Further studies are needed to confirm this association and, if confirmed, to elucidate the underlying mechanism. © 1999 Cancer Research Campaign

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Infant vaccinations and risk of childhood acute lymphoblastic leukaemia in the USA

et al. 1999

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“…Part of the association between fewer routine immunizations and leukaemia can be explained by reporting bias as mentioned above and by prodromal manifestations of the malignancy preventing the conduct of regular immunization schemes. Previous studies have been inconsistent on this topic, while some found evidence that immunizations convey protection (Kneale et al, 1986;Hartley et al, 1988;Nishi and Miyake, 1989), this was not confirmed by recent studies (Buckley et al, 1994;Petridou et al, 1997). Hence, if a negative association between routine immunizations and the occurrence of childhood acute leukaemia exists, we assume it to be weak as implied by the risk estimates for older children.…”

Section: Discussionmentioning

confidence: 60%

“…Zheng et al (1993) reported an association between appendectomy, tonsillectomy and adult leukaemia. If the inverse association between allergies of the child and acute leukaemia, also observed by Nishi and Miyake (1989) and Petridou et al (1997), is not due to reporting bias, the protective effect of allergies could be interpreted as a proxy for a well-functioning, even overreacting immune system. Since for allergies there seems to exist a genetic predisposition and children of parents with allergies tend to develop an allergy (Daniels et al, 1996), the result, for maternal allergies especially, is not surprising and might be less influenced by recall bias than that for allergies of the child.…”

Section: Discussionmentioning

confidence: 99%

Association of childhood leukaemia with factors related to the immune system

et al. 1999

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SummaryThe childhood peak of common acute lymphoblastic leukaemia has been proposed as being a rare response to delayed exposure to a common infection. In this context, factors related to the child's immune system are of special interest. Information on such factors was obtained in a recent German case-control study comprising more than 1000 children with acute leukaemia. Neither being the first-born child, nor a short duration of breastfeeding, indicators of a deficit in viral contacts during infancy or the number of infectious diseases, were significant risk factors. We observed a strong association with fewer routine immunizations with a 3.2-fold increase for those children getting less than four immunizations, but this association could partly be explained by reporting bias. While tonsillectomy or appendectomy increased the risk of leukaemia in our studies, a protective effect of allergies could be seen. In summary, we found only weak support for the delayed exposure hypothesis. To some extent this may be due to the chosen surrogate markers which reflect, rather indirectly, immunological isolation in infancy and delayed exposure to common viruses. However, the significant findings for routine immunizations, tonsillectomy and allergies of the child or its parents merit further investigation.

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