ArticleAmerican journal of epidemiology2015
Childhood acute lymphoblastic leukemia and indicators of early immune stimulation: a Childhood Leukemia International Consortium study.
Article in American journal of epidemiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
62 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Microbiome and pediatric leukemia, diabetes, and allergies: Systematic review and meta-analysis.PloS one · 2025Pooled it
- Breastfeeding and the risk of childhood cancer: a systematic review and dose-response meta-analysis.BMC medicine · 2021Pooled it
- Vaccination and the Risk of Childhood Cancer-A Systematic Review and Meta-Analysis.Frontiers in oncology · 2020Pooled it
- Living on a farm, contact with farm animals and pets, and childhood acute lymphoblastic leukemia: pooled and meta-analyses from the Childhood Leukemia International Consortium.Cancer medicine · 2018Pooled it
- A systematic review and meta-analysis of the association between childhood infections and the risk of childhood acute lymphoblastic leukaemia.British journal of cancer · 2018Pooled it
- Radiation exposure from computerized tomography and risk of childhood leukemia: Finnish register-based case-control study of childhood leukemia (FRECCLE).Haematologica · 2018Trial
- The Childhood Cancer and Leukemia International Consortium (CLIC): Expanding global collaboration in pediatric cancer etiology research.Cancer epidemiology · 2026Review
- What is in the Dust? Species-Level Profiling Reveals Pathogenic and Protective Potential of Microbial Communities in Daycare and Home Environments.Environmental microbiology reports · 2026Article
- Early-life infections and childhood cancer risk: a nationwide cohort study of 2 million children.BMC cancer · 2026Article
- The potential role of environmentally associated DNA methylation in childhood acute lymphoblastic leukaemia subtypes.International journal of cancer · 2025Article
- Early Infection Incidence and Risk of Acute Leukemia Development Among Mexican Children.Cancers · 2025Article
- Microbiome Modulation in Pediatric Leukemia: Impact on Graft-Versus-Host Disease and Treatment Outcomes: A Narrative Review.Children (Basel, Switzerland) · 2025Review
- Unlocking the Heterogeneity in Acute Leukaemia: Dissection of Clonal Architecture and Metabolic Properties for Clinical Interventions.International journal of molecular sciences · 2024Review
- Childhood B cell leukemia: Intercepting the paths to progression.BioEssays : news and reviews in molecular, cellular and developmental biology · 2024Review
- Exclusive Breastfeeding Duration and Risk of Childhood Cancers.JAMA network open · 2024Article
- Environmental microbiome in the home and daycare settings during the COVID-19 pandemic, and potential risk of non-communicable disease in children.Environmental microbiology reports · 2024Article
- The pros and cons of probiotic use in pediatric oncology patients following treatment for acute lymphoblastic leukemia.Frontiers in pediatrics · 2024Review
- Immune stress suppresses innate immune signaling in preleukemic precursor B-cells to provoke leukemia in predisposed mice.Nature communications · 2023Article
- Gut microbiome immaturity and childhood acute lymphoblastic leukaemia.Nature reviews. Cancer · 2023Review
- Associations between early-life and in utero infections and cytomegalovirus-positive acute lymphoblastic leukemia in children.International journal of cancer · 2023Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
Abstract
The associations between childhood acute lymphoblastic leukemia (ALL) and several proxies of early stimulation of the immune system, that is, day-care center attendance, birth order, maternally reported common infections in infancy, and breastfeeding, were investigated by using data from 11 case-control studies participating in the Childhood Leukemia International Consortium (enrollment period: 1980-2010). The sample included 7,399 ALL cases and 11,181 controls aged 2-14 years. The data were collected by questionnaires administered to the parents. Pooled odds ratios and 95% confidence intervals were estimated by unconditional logistic regression adjusted for age, sex, study, maternal education, and maternal age. Day-care center attendance in the first year of life was associated with a reduced risk of ALL (odds ratio = 0.77, 95% confidence interval: 0.71, 0.84), with a marked inverse trend with earlier age at start (P < 0.0001). An inverse association was also observed with breastfeeding duration of 6 months or more (odds ratio = 0.86, 95% confidence interval: 0.79, 0.94). No significant relationship with a history of common infections in infancy was observed even though the odds ratio was less than 1 for more than 3 infections. The findings of this large pooled analysis reinforce the hypothesis that day-care center attendance in infancy and prolonged breastfeeding are associated with a decreased risk of ALL.
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