Allergies and Childhood Acute Lymphoblastic Leukemia: A Case-Control Study and Meta-analysis.
Allergies and Childhood Acute Lymphoblastic Leukemia: A Case-Control Study and Meta-analysis.
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DOI：
10.1158/1055-9965.epi-17-0584
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发表时间：
2018-10
期刊：
影响因子：
--
通讯作者：
Metayer C
中科院分区：
文献类型：
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作者：
Wallace AD;Francis SS;Ma X;McKean-Cowdin R;Selvin S;Whitehead TP;Barcellos LF;Kang AY;Morimoto L;Moore TB;Wiemels JL;Metayer C
过敏性疾病被怀疑在儿童急性淋巴细胞白血病 (ALL) 的发展中发挥着一定作用。过去几十年进行的研究取得了不同的结果。我们在加州儿童白血病研究 (CCLS) 中研究了过敏（一种常见的免疫介导疾病）与 ALL 之间的关联，该研究是一项病例对照研究，纳入了 977 名被诊断患有 ALL 的儿童和 1037 名匹配的对照儿童（1995 年至 2015 年）。出生后第一年的过敏史通过访谈获得，主要由母亲报告。进行逻辑回归分析以估计比值比 (OR) 和 95% 置信区间 (CI)，并控制出生顺序、日托出勤率和分娩方式。此外，我们对 CCLS 和 12 项已发表研究的数据进行了荟萃分析，并采用了一种新方法来估计研究间异质性 (R_b)。总体而言，作为一个群体，没有观察到儿童 ALL 风险与特定过敏表型或任何过敏之间存在关联。然而，在最年轻的研究参与者中，任何过敏都会增加患 ALL 的风险。在荟萃分析随机效应模型中，ALL 发生率降低与花粉症相关（metaOR=0.65，95% CI：0.47，0.90）；然而，将分析仅限于使用医疗记录评估过敏的研究或最近发表的研究，会导致结果无效或减弱。总体而言，我们的研究结果并不支持过敏与儿童 ALL 之间存在明确的关联。流行病学研究可以在多大程度上揭示过敏与儿童 ALL 风险之间的关系，但受到研究间异质性的限制。
Allergic disease is suspected to play a role in the development of childhood acute lymphoblastic leukemia (ALL). Studies conducted over the last several decades have yielded mixed results. We examined the association between allergy, a common immune-mediated disorder, and ALL in the California Childhood Leukemia Study (CCLS), a case-control study of 977 children diagnosed with ALL and 1037 matched controls (1995–2015). History of allergies in the first year of life was obtained from interviews, mainly reported by mothers. Logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs), controlling for birth order, day care attendance, and mode of delivery. In addition, we conducted meta-analyses with data from the CCLS and 12 published studies and employed a new method to estimate between-study heterogeneity (R_b). Overall, no associations were observed between childhood ALL risk and specific allergy phenotypes or any allergy, as a group. However, having any allergy was associated with an increased risk of ALL among the youngest study participants. In the meta-analysis random-effect models, a reduced odds of ALL was associated with hay fever (metaOR=0.65, 95% CI: 0.47, 0.90); however, restricting the analysis to studies that used medical records for assessment of allergy or recently published studies, led to null or attenuated results. Overall, our findings do not support a clear association between allergy and childhood ALL. The degree to which epidemiological studies can inform the relationship between allergies and risk of childhood ALL is limited by between-study heterogeneity.