Breastfeeding and early infection in the aetiology of childhood leukaemia in Down syndrome

BACKGROUND: For a child to develop acute leukaemia (AL), environmental exposure may not be sufficient: interaction with a susceptibility factor to the disease, such as Down syndrome (DS), may also be necessary. We assessed whether breastfeeding and early infection were associated with the risk of developing AL in children with DS. METHODS: Children with DS in Mexico City, and either with or without AL, were the cases (N = 57) and controls (N = 218), respectively. Population was divided in children with AL and with acute lymphoblastic leukaemia (ALL) and also in children <= 6 and 46 years old. RESULTS: Breastfeeding and early infections showed moderate (but not significant) association for AL, whereas hospitalisation by infection during the first year of life increased the risk: odds ratios (confidence interval 95%) were 0.84 (0.43-1.61), 1.70 (0.82-3.52); and 3.57 (1.59-8.05), respectively. A similar result was obtained when only ALL was analysed. CONCLUSION: We found that breastfeeding was a protective factor for developing AL and ALL, and during the first year of life, infections requiring hospitalisation were related to a risk for developing the disease in those children with DS 46 years of age. These data do not support the Greaves's hypothesis of early infection being protective for developing ALL. British Journal of Cancer ( 2009) 101, 860-864. doi:10.1038/sj.bjc.6605244 www.bjcancer.com (C) 2009 Cancer Research UK