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Breast-feeding and risk of childhood acute leukemia
X O Shu1, M S Linet, M Steinbuch
1Division of Pediatric Epidemiology and Clinical Research, University of Minnesota, Minneapolis, USA.
Insights
Breast-feeding is associated with a reduced risk of childhood acute leukemia. This finding suggests potential immune-modulating benefits of breastfeeding in preventing pediatric cancers.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Immunology
Background:
- Breast-feeding is recognized for its protective effects against infant infections.
- Limited research exists on the long-term impact of breastfeeding on childhood cancer risk.
- Previous studies suggested a protective role against Hodgkin's disease and lymphoma.
Purpose of the Study:
- To investigate the hypothesis that breastfeeding decreases the risk of childhood acute leukemia.
- To analyze the association between breastfeeding and the risk of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).
Main Methods:
- A case-control study involving 1744 children with ALL and 1879 controls (aged 1-14).
- Included 456 children with AML and 539 controls (aged 1-17).
- Breastfeeding data collected via maternal telephone interviews; analyses stratified by leukemia type, ALL immunophenotype, and AML morphology.
Main Results:
- Ever breastfeeding was linked to a 21% reduction in childhood acute leukemia risk (OR=0.79).
- Risk reduction observed for both AML (OR=0.77) and ALL (OR=0.80).
- Longer breastfeeding duration showed stronger inverse associations for ALL, AML, specific AML subtypes, and early pre-B-cell ALL.
Conclusions:
- Breastfeeding is associated with a reduced risk of childhood acute leukemia.
- Findings suggest potential anti-infective, immune-stimulatory, or immune-modulating effects of breastfeeding.
- Further research is warranted to explore these mechanisms in leukemogenesis.
Background:
Breast-feeding is well known to have a protective effect against infection in infants. Although the long-term effects of breast-feeding on childhood cancer have not been studied extensively, a protective effect against childhood Hodgkin's disease and lymphoma has been suggested previously from small investigations. In this study, we tested the hypothesis that breast-feeding decreases the risk of childhood acute leukemia.
Methods:
A total of 1744 children with acute lymphoblastic leukemia (ALL) and 1879 matched control subjects, aged 1-14 years, and 456 children with acute myeloid leukemia (AML) and 539 matched control subjects, aged 1-17 years, were included in the analysis. Information regarding breast-feeding was obtained through telephone interviews with mothers. All leukemias combined, histologic type of leukemia (ALL versus AML), immunophenotype of ALL (early pre-B cell, pre-B cell, or T cell), and morphology of AML were assessed separately in the data analysis.
Results:
Ever having breast-fed was found to be associated with a 21% reduction in risk of childhood acute leukemias (odds ratio [OR] for all types combined = 0.79; 95% confidence interval [CI] = 0.70-0.91). A reduction in risk was seen separately for AML (OR = 0.77; 95% CI = 0.57-1.03) and ALL (OR = 0.80; 95% CI = 0.69-0.93). The inverse associations were stronger with longer duration of breast-feeding for total ALL and AML; for M0, M1, and M2 morphologic subtypes of AML; and for early pre-B-cell ALL.
Conclusion:
In this study, breast-feeding was associated with a reduced risk of childhood acute leukemia. If confirmed in additional epidemiologic studies, our findings suggest that future epidemiologic and experimental efforts should be directed at investigating the anti-infective and/or immune-stimulatory or immune-modulating effects of breast-feeding on leukemogenesis in children.