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Meta-Analysis
. 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

Mostafa Ebraheem Morra  1 , Nguyen Dang Kien  2 , Ahmed Elmaraezy  1 , Omar Ayman M Abdelaziz  3 , Ahmed Lotfy Elsayed  4 , Oday Halhouli  5 , Ahmed Mosaad Montasr  6 , Tran Le-Huy Vu  7 , Chau Ho  8 , Amr Sayed Foly  3 , Anh Phan Phi  9 , Wessam Magdy Abdullah  3 , Marina Mikhail  10 , Elizabeth Milne  11 , Kenji Hirayama  12 , Nguyen Tien Huy  13   14
Affiliations
Meta-Analysis

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

Mostafa Ebraheem Morra et al. Sci Rep. .

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.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram of studies’ screening and selection.
Figure 2
Figure 2
Forest plot showing results of meta-analysis of association of early vaccination with childhood leukemia. Cl: confidence interval.
Figure 3
Figure 3
Forest plot showing results of meta-analysis of association of BCG vaccination with childhood leukemia. Cl: confidence interval.
Figure 4
Figure 4
Forest plot showing subgroup analysis of association between early BCG vaccination and childhood leukemia. Cl: confidence interval.
See this image and copyright information in PMC

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