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Sci Rep. 2017 Nov 22;7(1):15986. doi: 10.1038/s41598-017-16067-0.

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

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Faculty of Medicine, Al Azhar University, Cairo, 11884, Egypt.
Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 30000, Vietnam.
Faculty of Medicine, Cairo University, Cairo, 11562, Egypt.
Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt.
University of Jordan, Faculty of Medicine, Amman, 11942, Jordan.
Faculty of Medicine, Tanta University, Tanta, 31527, Egypt.
University of California, Los Angeles, CA, 90095, United States.
Hoan My Cuu Long Hospital, Can Tho, 900000, Vietnam.
Department of Pharmacology, Loyola University Chicago, Illinois, 60546, USA.
Department of Dermatology, Cairo University Hospital, Cairo, 11562, Egypt.
Telethon Kids Institute, The University of Western Australia, Crawley, Australia.
Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
Evidence Based Medicine Research Group & Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam.
Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.


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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