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Allergy and the risk of childhood leukemia: a meta-analysis

Leukemia volume 23, pages 2300–2304 (2009)Cite this article

Higher incidences of both childhood leukemia and allergic diseases are found in western industrialized countries compared with developing countries, and exposure to infectious agents has been linked to the pathogenesis of both diseases. Three independent hypotheses suggest a link between infections and childhood leukemia. Kinlen's1 population mixing theory proposes that the incidence of childhood leukemia increases both among the immigrants and the original residents of a defined geographical region due to exposure to previously unencountered leukemogenic infections. Greave's2 delayed infections hypothesis proposes that childhood acute lymphoblastic leukemia (ALL) is caused by two independent mutations; the first mutation occurs in utero, and if the child has limited exposure to early childhood infections, such infections will—when they occur later during childhood—lead to an excessive proliferative stress on the preleukemic cells, which cause the necessary additional leukemogenic chromosomal aberrations. Finally, the adrenal hypothesis of Schmiegelow et al.3 claims that the risk of childhood ALL is reduced, when early childhood infections increase plasma cortisol levels, as this may eliminate both leukemic and preleukemic cells for the ALL subsets that dominate in the first 5–7 years of life, and may further suppress the Th1-dominated (proinflammatory) response to infections, and thus lower the proliferative stress on preexisting preleukemic cells.

According to the hygiene hypothesis, lack of exposure to infections during early childhood is responsible for the increasing incidence of allergy in industrialized countries.4 Thus, the decline in exposure to infections in early childhood might have a role both in the etiology of allergy as well as in childhood leukemia. To explore the association between allergy and childhood leukemia, we conducted a systematic literature review and a meta-analysis of the relationship between different types of allergies and childhood leukemia.

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Acknowledgements

This study has received financial support from the Danish Childhood Cancer Foundation, Michael Goldschmidt Holding A/S, and the Danish Cancer Society (Grant no. DP06136). Kjeld Schmiegelow holds the Danish Childhood Cancer Foundation professorship in Paediatric Oncology.

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Authors and Affiliations

  1. The Paediatric Clinic, The University Hospital Rigshospitalet, Copenhagen, Denmark

    S Dahl, L S Schmidt, T Vestergaard & K Schmiegelow

  2. Institute of Cancer Epidemiology, The Danish Cancer Society, Copenhagen, Denmark

    L S Schmidt & J Schüz

  3. The Institute of Gynecology, Obstetrics, and Paediatrics, The Medical Faculty, The University of Copenhagen, Copenhagen, Denmark

    K Schmiegelow

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  1. S Dahl
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  2. L S Schmidt
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  3. T Vestergaard
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  4. J Schüz
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  5. K Schmiegelow
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Correspondence to K Schmiegelow.

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Dahl, S., Schmidt, L., Vestergaard, T. et al. Allergy and the risk of childhood leukemia: a meta-analysis. Leukemia 23, 2300–2304 (2009). https://doi.org/10.1038/leu.2009.162

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