Etiology and prevention of acute leukemias in children

Abstract

Acute leukemia (AL) is the most common type of cancer in children under 15 years of age and represents one of the leading causes of mortality among children worldwide. Despite advancements in the knowledge of the biology and treatment of AL, the etiology remains unresolved. A small number of risk factors have been reported as established for the development of this disease, but they explain less than 10 % of cases, leaving 90 % of cases without an identified causation. Case-control studies have been the main research designs used to investigate the causes of AL in children. The importance of case-control studies rests on the assumption that data on individuals is essential for gaining an understanding of the environmental causes of childhood leukemia and adds great value to the genetic research. Genetic or environmental factors alone may not be responsible for causing childhood AL. Rather, it is thought that an interaction between genetic susceptibility and exposures to certain environmental factors in a specific time window can contribute to the development of this disease. Identifying the causes of childhood AL would lead to the establishment of effective preventive measures in children who are at high risk of developing this disease, reducing incidence and mortality rates, the costs of medical care, and other consequences associated with childhood leukemia. Therefore, we need to implement a new framework for the etiology of AL. We believe that solving key elements of this puzzle can lead to prevention of the development of AL in children.