Model for the origin of acute leukemias in children: Interaction of three factors-susceptibility, exposure, and window of vulnerability

Abstract

Various theoretical models concerning the origin of leukemias in children, especially acute lymphoblastic leukemia (ALL), attempt to explain why leukemia occurs and how it develops; the proposed model, being relatively simpler, attempts to specify the moment when a child develops acute leukemia. The causes of childhood leukemia have not yet been identified because the theoretical basis of the search has been at fault. The risk factors for acute leukemia (AL) are distinct, depending on the age at onset. It is probable that the older the child, the greater the necessity of risk factors to which the child must be exposed for the disease to develop and the less the susceptibility to AL with which the child was born. For this reason, I venture to say that the age at onset of AL is a reflection of the degree of susceptibility to the disease and of the number of factors of exposure to carcinogens that are necessary for the development of the disease. This conjecture also depends on the window of vulnerability in which the child is situated. This window of vulnerability is directly involved with the proliferation of the child's B or T cells, which cause the interaction between the degree of susceptibility and the degree of exposure to carcinogens, thereby provoking the onset of AL.