Early vaccination protects against childhood leukemia: A systematic review and meta-analysis

Mostafa Ebraheem Morra, Nguyen Dang Kien, Ahmed Elmaraezy, Omar Ayman M. Abdelaziz, Ahmed Lotfy Elsayed, Oday Halhouli, Ahmed Mosaad Montasr, Tran Le Huy Vu, Chau Ho, Amr Sayed Foly, Anh Phan Phi, Wessam Magdy Abdullah, Marina Mikhail, Elizabeth Milne, Kenji Hirayama, Nguyen Tien Huy

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Leukemia is the most commonly diagnosed childhood cancer, although its etiology is still largely unknown. Growing evidence supports a role for infection in the etiology of acute lymphocytic leukemia (ALL), and the involvement of the immune system suggests that vaccination may also play a role. However, the findings presented in the published literature are inconsistent. Therefore, we conducted a PRISMA systematic review and meta-analysis. 14 studies were identified and meta-analyzed. Vaccinations studied comprised Bacillus Calmette-Guérin (BCG) vaccine, Triple vaccine, Hepatitis B vaccine (HBV), Polio, Measles, Rubella, Mumps, trivalent MMR vaccine and Haemophilus influenza type B (HiB) vaccine. We observed a protective association between any vaccination in the first year of life and risk of childhood leukemia (summary odds ratio (OR) 0.58 [95% confidence interval (CI) 0.36-0.91]). When individual vaccines were analysed, some evidence of an association was seen only for BCG (summary OR 0.73 [95% CI 0.50-1.08]). In conclusion, early vaccination appears to be associated with a reduced risk of childhood leukemia. This finding may be underpinned by the association observed for BCG. Given the relatively imprecise nature of the results of this meta-analysis, our findings should be interpreted cautiously and replicated in future studies.

Original languageEnglish
Article number15986
JournalScientific Reports
Volume7
Issue number1
DOIs
Publication statusPublished - 1 Dec 2017

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Meta-Analysis
Leukemia
Vaccination
Bacillus
Haemophilus Vaccines
Vaccines
Odds Ratio
Measles-Mumps-Rubella Vaccine
Confidence Intervals
BCG Vaccine
Hepatitis B Vaccines
Mumps
Rubella
Measles
Poliomyelitis
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Immune System
Infection
Neoplasms

Cite this

Morra, M. E., Kien, N. D., Elmaraezy, A., Abdelaziz, O. A. M., Elsayed, A. L., Halhouli, O., ... Huy, N. T. (2017). Early vaccination protects against childhood leukemia: A systematic review and meta-analysis. Scientific Reports, 7(1), [15986]. https://doi.org/10.1038/s41598-017-16067-0
Morra, Mostafa Ebraheem ; Kien, Nguyen Dang ; Elmaraezy, Ahmed ; Abdelaziz, Omar Ayman M. ; Elsayed, Ahmed Lotfy ; Halhouli, Oday ; Montasr, Ahmed Mosaad ; Vu, Tran Le Huy ; Ho, Chau ; Foly, Amr Sayed ; Phi, Anh Phan ; Abdullah, Wessam Magdy ; Mikhail, Marina ; Milne, Elizabeth ; Hirayama, Kenji ; Huy, Nguyen Tien. / Early vaccination protects against childhood leukemia : A systematic review and meta-analysis. In: Scientific Reports. 2017 ; Vol. 7, No. 1.
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title = "Early vaccination protects against childhood leukemia: A systematic review and meta-analysis",
abstract = "Leukemia is the most commonly diagnosed childhood cancer, although its etiology is still largely unknown. Growing evidence supports a role for infection in the etiology of acute lymphocytic leukemia (ALL), and the involvement of the immune system suggests that vaccination may also play a role. However, the findings presented in the published literature are inconsistent. Therefore, we conducted a PRISMA systematic review and meta-analysis. 14 studies were identified and meta-analyzed. Vaccinations studied comprised Bacillus Calmette-Gu{\'e}rin (BCG) vaccine, Triple vaccine, Hepatitis B vaccine (HBV), Polio, Measles, Rubella, Mumps, trivalent MMR vaccine and Haemophilus influenza type B (HiB) vaccine. We observed a protective association between any vaccination in the first year of life and risk of childhood leukemia (summary odds ratio (OR) 0.58 [95{\%} confidence interval (CI) 0.36-0.91]). When individual vaccines were analysed, some evidence of an association was seen only for BCG (summary OR 0.73 [95{\%} CI 0.50-1.08]). In conclusion, early vaccination appears to be associated with a reduced risk of childhood leukemia. This finding may be underpinned by the association observed for BCG. Given the relatively imprecise nature of the results of this meta-analysis, our findings should be interpreted cautiously and replicated in future studies.",
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Morra, ME, Kien, ND, Elmaraezy, A, Abdelaziz, OAM, Elsayed, AL, Halhouli, O, Montasr, AM, Vu, TLH, Ho, C, Foly, AS, Phi, AP, Abdullah, WM, Mikhail, M, Milne, E, Hirayama, K & Huy, NT 2017, 'Early vaccination protects against childhood leukemia: A systematic review and meta-analysis' Scientific Reports, vol. 7, no. 1, 15986. https://doi.org/10.1038/s41598-017-16067-0

Early vaccination protects against childhood leukemia : A systematic review and meta-analysis. / Morra, Mostafa Ebraheem; Kien, Nguyen Dang; Elmaraezy, Ahmed; Abdelaziz, Omar Ayman M.; Elsayed, Ahmed Lotfy; Halhouli, Oday; Montasr, Ahmed Mosaad; Vu, Tran Le Huy; Ho, Chau; Foly, Amr Sayed; Phi, Anh Phan; Abdullah, Wessam Magdy; Mikhail, Marina; Milne, Elizabeth; Hirayama, Kenji; Huy, Nguyen Tien.

In: Scientific Reports, Vol. 7, No. 1, 15986, 01.12.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Early vaccination protects against childhood leukemia

T2 - A systematic review and meta-analysis

AU - Morra, Mostafa Ebraheem

AU - Kien, Nguyen Dang

AU - Elmaraezy, Ahmed

AU - Abdelaziz, Omar Ayman M.

AU - Elsayed, Ahmed Lotfy

AU - Halhouli, Oday

AU - Montasr, Ahmed Mosaad

AU - Vu, Tran Le Huy

AU - Ho, Chau

AU - Foly, Amr Sayed

AU - Phi, Anh Phan

AU - Abdullah, Wessam Magdy

AU - Mikhail, Marina

AU - Milne, Elizabeth

AU - Hirayama, Kenji

AU - Huy, Nguyen Tien

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Leukemia is the most commonly diagnosed childhood cancer, although its etiology is still largely unknown. Growing evidence supports a role for infection in the etiology of acute lymphocytic leukemia (ALL), and the involvement of the immune system suggests that vaccination may also play a role. However, the findings presented in the published literature are inconsistent. Therefore, we conducted a PRISMA systematic review and meta-analysis. 14 studies were identified and meta-analyzed. Vaccinations studied comprised Bacillus Calmette-Guérin (BCG) vaccine, Triple vaccine, Hepatitis B vaccine (HBV), Polio, Measles, Rubella, Mumps, trivalent MMR vaccine and Haemophilus influenza type B (HiB) vaccine. We observed a protective association between any vaccination in the first year of life and risk of childhood leukemia (summary odds ratio (OR) 0.58 [95% confidence interval (CI) 0.36-0.91]). When individual vaccines were analysed, some evidence of an association was seen only for BCG (summary OR 0.73 [95% CI 0.50-1.08]). In conclusion, early vaccination appears to be associated with a reduced risk of childhood leukemia. This finding may be underpinned by the association observed for BCG. Given the relatively imprecise nature of the results of this meta-analysis, our findings should be interpreted cautiously and replicated in future studies.

AB - Leukemia is the most commonly diagnosed childhood cancer, although its etiology is still largely unknown. Growing evidence supports a role for infection in the etiology of acute lymphocytic leukemia (ALL), and the involvement of the immune system suggests that vaccination may also play a role. However, the findings presented in the published literature are inconsistent. Therefore, we conducted a PRISMA systematic review and meta-analysis. 14 studies were identified and meta-analyzed. Vaccinations studied comprised Bacillus Calmette-Guérin (BCG) vaccine, Triple vaccine, Hepatitis B vaccine (HBV), Polio, Measles, Rubella, Mumps, trivalent MMR vaccine and Haemophilus influenza type B (HiB) vaccine. We observed a protective association between any vaccination in the first year of life and risk of childhood leukemia (summary odds ratio (OR) 0.58 [95% confidence interval (CI) 0.36-0.91]). When individual vaccines were analysed, some evidence of an association was seen only for BCG (summary OR 0.73 [95% CI 0.50-1.08]). In conclusion, early vaccination appears to be associated with a reduced risk of childhood leukemia. This finding may be underpinned by the association observed for BCG. Given the relatively imprecise nature of the results of this meta-analysis, our findings should be interpreted cautiously and replicated in future studies.

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Morra ME, Kien ND, Elmaraezy A, Abdelaziz OAM, Elsayed AL, Halhouli O et al. Early vaccination protects against childhood leukemia: A systematic review and meta-analysis. Scientific Reports. 2017 Dec 1;7(1). 15986. https://doi.org/10.1038/s41598-017-16067-0