Breastfeeding and early infection in the aetiology of childhood leukaemia in Down syndrome

• Published in: British journal of cancer Vol. 101; no. 5; pp. 860 - 864
• Main Authors: Flores-Lujano, J, Perez-Saldivar, M L, Fuentes-Pananá, E M, Gorodezky, C, Bernaldez-Rios, R, Del Campo-Martinez, M A, Martinez-Avalos, A, Medina-Sanson, A, Paredes-Aguilera, R, De Diego-Flores Chapa, J, Bolea-Murga, V, Rodriguez-Zepeda, M C, Rivera-Luna, R, Palomo-Colli, M A, Romero-Guzman, L, Perez-Vera, P, Alvarado-Ibarra, M, Salamanca-Gómez, F, Fajardo-Gutierrez, A, Mejía-Aranguré, J M
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-09-2009; Nature Publishing Group
• Subjects: Acute Disease; Adolescent; Age; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Breast Feeding - adverse effects; Breastfeeding & lactation; Cancer Research; Case-Control Studies; Child; Child, Preschool; Children & youth; Down syndrome; Down Syndrome - complications; Down Syndrome - diagnosis; Down Syndrome - epidemiology; Drug Resistance; Epidemiology; Female; Hematologic and hematopoietic diseases; Hospitalization; Humans; Infant; Infant, Newborn; Infection - complications; Infection - epidemiology; Infections; Leukemia; Leukemia, Myeloid - complications; Leukemia, Myeloid - diagnosis; Leukemia, Myeloid - epidemiology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical research; Medical sciences; Molecular Medicine; Odds Ratio; Oncology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology; Regression Analysis; Special education; Surveys and Questionnaires; Tumors; Mexico; infections; leukaemia; Down syndrome; breastfeeding; Chromosomal aberration; Human; Trisomy; Leukemia; Chromosome G21; Aneuploidy; Malignant hemopathy; Breast feeding; Infection; Cancerology; Etiology; Early; Child; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6605244

Background:
For a child to develop acute leukaemia (AL), environmental exposure may not be sufficient: interaction with a susceptibility factor to the disease, such as Down syndrome (DS), may also be necessary. We assessed whether breastfeeding and early infection were associated with the risk of developing AL in children with DS.
Methods:
Children with DS in Mexico City, and either with or without AL, were the cases (
N
=57) and controls (
N
=218), respectively. Population was divided in children with AL and with acute lymphoblastic leukaemia (ALL) and also in children ⩽6 and >6 years old.
Results:
Breastfeeding and early infections showed moderate (but not significant) association for AL, whereas hospitalisation by infection during the first year of life increased the risk: odds ratios (confidence interval 95%) were 0.84 (0.43–1.61), 1.70 (0.82–3.52); and 3.57 (1.59–8.05), respectively. A similar result was obtained when only ALL was analysed.
Conclusion:
We found that breastfeeding was a protective factor for developing AL and ALL, and during the first year of life, infections requiring hospitalisation were related to a risk for developing the disease in those children with DS >6 years of age. These data do not support the Greaves's hypothesis of early infection being protective for developing ALL.