Is There Any Relationship Between Leukemia And Mothers' Breastfeeding In Iranian Children?: A systematic review of case-control studies

Is There Any Relationship Between Leukemia And Mothers' Breastfeeding In Iranian Children?: A systematic review of case-control studies
AmirAli Moodi Ghalibaf,^1,* Mehdi Atayee Karizmeh,² Mohsen Asadi,³ Mohammad Naseri,⁴ Saeed Farkhondeh,⁵ Alireza Hadipour,⁶
1. Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2. Student Research Committee, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
3. Student Research Committee, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
4. Student Research Committee, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
5. Student Research Committee, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
6. Student Research Committee, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
Introduction: Leukemias are hematologic disorders that caused by mal-differentiation of immature white blood cells. This malignancy categorized by the cell type (lymphoid or myeloid) to acute forms, including acute myeloid leukemia and acute lymphoblastic leukemia, and chronic forms, including chronic lymphoblastic leukemia and chronic myeloid leukemia. According to WHO reports, acute lymphoblastic leukemia is the most common childhood malignancy in children under 15 years old. Although leukemia is a multifactorial disease, but its exact etiology has not been determined. Many studies have been shown the effect of breastfeeding on the prevention of some diseases such as infections, but the role of breastfeeding in preventing leukemia is not fully understood. In this study, we investigated the relationship between breastfeeding and leukemia in Iranian children.
Methods: A comprehensive search was conducted in electronic databases Embase, Pubmed, Scopus, Web of science, Sciencedirect and Magiran with the keywords “breastfeeding”, “leukemia” and all MeSH related words since 2000. The case-control studies have been done on the Iranian children that mentioned the duration of breastfeeding were included in this review.
Results: 1475 children were studied in this review. 668 case-patients and 807 control children were included in the study. The selected studies were done in Tehran, Shiraz, Hamedan, and Sistan and Baluchestan. All studies showed that breastfeeding was significantly associated with leukemia in children. Although most studies investigate the protective role of breastfeeding duration, but several studies mentioned that breastfeeding duration doesn't have any effect to protect children against leukemia. The most effective duration of breastfeeding was continuously up to 2 years. Male gender was observed as a risk factor for leukemia. Other risk factors such as family income, residence place, ABO blood group, and RH blood group were indicated in several studies, but the data was incomplete to analysis.
Conclusion: Regarding the protective and other beneficial roles of breastfeeding, it is recommended for adequate duration. Although more studies are necessary to determine the exact relationship between breastfeeding and leukemia.
Keywords: Breastfeeding, Iran, leukemia