Sunday 06 December 2009, 19:40

Childhood leukaemia: is it preventable?

Risk factors associated with childhood leukaemia

Childhood leukaemia: is it preventable?

Leukaemia is a cancer of the early blood-forming cells, most often involving white blood cells. It starts in bone marrow (a connective tissue where blood cells are formed) and quickly moves to the bloodstream through which it spread to distant sites and invades other organs, such as lymph nodes, spleen, liver, CNS.


Most childhood leukaemias are acute lymphocytic leukaemias, starting from lymphoid cells in the bone marrow. Less frequent is acute myeloid leukaemia (starting from progenitor cells that produce non-lymphocytic white blood cells, red blood cells and platelets), extremely rare are chronic leukaemias.


Although the exact cause of most cases of childhood leukaemia is not known, scientists have identified some (actually a few) risk factors that may increase a child’s chance of developing the disease. The most important are genetic risk factors, such as certain inherited syndromes (Li-Fraumeni syndrome, Down syndrome and Klinefelter syndrome) and certain inherited immune system disorders (ataxia teleangiectasia, Bloom syndrome and Wiscott-Aldrich syndrome).


While life-style related risk factors play a minor role in childhood cancer risk, some environmental risk factors may be associated with childhood leukaemia. These include the exposure to certain chemotherapeutic agents (cyclophosphamide, chlorambucil, teniposide) used to treat other types of cancer and, secondarily, radiation exposure. Leukaemia resulting from chemotherapy (usually acute myeloid leukaemia) develops after at least five years from treatment and tends to be hard to treat.


Studies on other possible risk factors, such as infections early in life, exposure to pesticides, and fetal exposure to hormones, have failed to demonstrate their link to childhood leukaemia.


Due to the fact that most patients (both adult and pediatric) have no known risk factors, currently there is no way to prevent leukaemia from developing. Even chemotherapy and radiation therapy, which might be theoretically manageable, actually are not. Chemotherapy and radiation therapy are essential part of the treatment of life-threatening diseases and, for now, they cannot be avoided: it wouldn’t make sense not to benefit from their positive effects on cancer patients’ survival just to lower the small chance of developing leukaemia several years later.


By Chiara De Carli

Category: Cancer

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