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IJE Advance Access published online on January 16, 2007

International Journal of Epidemiology, doi:10.1093/ije/dyl270
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.

Vaccination and the risk of childhood acute leukaemia: the ESCALE study (SFCE{dagger})

Nathalie Mallol-Mesnard1, Florence Menegaux1, Anne Auvrignon2, Marie-Françoise Auclerc3, Yves Bertrand4, Brigitte Nelken5, Alain Robert6, Gérard Michel7, Geneviève Margueritte8, Yves Perel9, Françoise Méchinaud10, Pierre Bordigoni11, Guy Leverger2, André Baruchel3, Denis Hémon1 and Jacqueline Clavel1,*

1 INSERM, U754, IFR69, Villejuif, France.
2 AP HP, Hôpital Armand Trousseau, Paris, France.
3 AP HP, Hôpital Saint-Louis and Hôpital Robert-Debré, Paris, France.
4 Hôpital Debrousse, Lyon, France.
5 Hôpital Jeanne de Flandre, Lille, France.
6 Hôpital des Enfants, Toulouse, France.
7 Hôpital La Timone, Marseille, France.
8 Hôpital Arnaud de Villeneuve, Montpellier, France.
9 Hôpital Pellegrin Tripode, Bor deaux, France.
10 Hôpital Mère Enfant and Hôpital pour enfants, Nantes, France.
11 Hôpital Brabois, Nancy, France.

* Corresponding author: Inserm U754, 16, av. Paul Vaillant-Couturier, F-94807 VILLEJUIF Cedex E-mail: clavel{at}vjf.inserm.fr


   Abstract

Background In 2002, a poster alerted the French health authorities to the possibility that the risk of childhood leukaemia might be increased by hepatitis B vaccination. Elucidating the role of vaccination in the aetiology of childhood acute leukaemia (AL) was therefore included in the objectives of an ongoing national study.

Methods The ESCALE study was a French national population-based case-control study conducted in France in 2003 and 2004 in order to investigate the role of infectious, environmental and genetic factors in four childhood neoplastic diseases (leukaemia, lymphoma, neuroblastoma and brain tumour). The controls were randomly selected from the French population and age and gender frequency matched with the cases. A total of 776 cases of AL (91% of the eligible cases) and 1681 controls (71% of the eligible controls) were included. In a specific standardized telephone interview, which was the same for both the cases and controls, each mother was asked to read out her child's complete vaccination record.

Results No association between vaccination and the risk of childhood AL: acute lymphoblastic leukaemia or acute myeloblastic leukaemia was observed. No relationship between the risk of leukaemia and the type of vaccine, number of doses of each vaccine, total number of injections, total number of vaccine doses or number of early vaccinations was evidenced. No confounding factor was observed.

Conclusion The study did not show any evidence of a role of vaccination in the aetiology of childhood leukaemia.


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