Acute Lymphoblastic Leukemia - Causes/Risk Factors

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Last Updated on Apr 04, 2018
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Causes/Risk Factors

The causes of Acute Lymphoblastic Leukemia are not very clear. Researchers have indicated that ALL is caused by a combination of genetic, biologic, and environmental factors.

Few of the risk factors / causes indicated for ALL are-

a) Medical Conditions

Children with Down syndrome harbor a several-fold increased risk for developing acute leukemia (both ALL and AML). ALL is more common among the Down Syndrome patients. Outcome for Down syndrome children affected by ALL has generally been reported as poorer than that of non–Down syndrome children.

b) Genetic Factors

Certain other genetic conditions that have been implicated are:

  • Neurofibromatosis
  • Shwachman syndrome
  • Bloom's syndrome
  • Ataxia telangiectasia
  • Myelodysplastic syndrome
  • Myeloproliferative disorders
  • A number of mutations have been associated with ALL. Translocations, or the rearrangement of genes between two chromosomes, have been associated with upto 65% of all leukemias.
  • The most common mutation in ALL is t (12:21). Occurs in 20% of ALL patients
  • Philadelphia (Ph) chromosome [t(9;22)] is observed in 5% children and in 20% adults with ALL

The Ikaros gene normally plays a role in regulating lymphoid differentiation. In ALL patients, it fuses with the BCL6 gene and results in a translocation, t(3;7)(q27;p12).

c) Environmental Factors

In children who are exposed to various hazardous substances and chemicals, the insult might have taken place early in life either as a fetus when they are in utero, or post-natally.

Approximately 75,000 synthetic chemicals have been introduced during the first half of the 21st century. It is important to study the role of these chemicals, including pesticides and herbicides, in causing leukemia. Broadly the environmental factors include:

  • In utero or postnatal exposure to high-dose ionizing radiation, such as X-rays or gamma rays
  • Radiotherapy for cancer treatment may lead to the development of leukemia in the future
  • Viral infections, such as those of Human Thymic Leukemia Virus (HTLV-1,) has been suspected to trigger T-cell leukemia in humans
  • Studies have reported a link between leukemia and increased exposure to electromagnetic radiation (EMR)
  • High voltage power lines have also been linked with leukemia. This theory is refuted by many.

References:

  1. Pui CH. Acute lymphoblastic leukemia. Pediatr Clin North Am 1997; 4: 831-846.
  2. Pui CH, Evans WE. Acute lymphoblastic leukemia. N Engl J Med 1998; 339: 605-615.
  3. Gurney JG, Severson RK, Davis S, Robinson L. Incidence of cancer in children in the United States. Cancer 1995; 75: 2186-2195.
  4. Young J, Gloeckler RL, Silverberg E, Horm J, Miller R. Cancer incidence, survival and mortality for children younger than age 15 years. Cancer 1986; 58: 598-602.

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hi my daughter , rashmi 5 year old female was admitted in a hospital with the c/o fever,and anemia diagnosed as a ALL ,B CELL,started chemotherapy there at the time of admission her haemoglobin is 4,platelet 10,000,peripheral smear shows blast presnt CSF NEGATIVE BONE MARROW NOT DONE induction chemotherapy started prednisolone oral inj.vincristine i.v 4 doses inj, daunorubicin 3 doses inj.L. asparaginase 8 doses IT ,methotrexate 3 times BONE MARRO DONE 3? BLAST SHOWS phase b inj.cyclophosphamide iv 2 time inj,cytarabine s/c [ arac] 4 days * 4 doses tab .6 mp 60 days IT METHOTREXATE 3 times tab.biotraxate RE INDUCTION PHASE tab.dexamethasone orally inj.vincristine iv 4 doses inj. dnr 4 doses inj.L .asparanginase 4 dose inj.cyclophosphamide 1 dose inj.cytarabine 2 dose it.methotrexate 2 doses BONE MARROW DONE SHOWS 3% BLASTS AND 5%LYMPHS CSF NEGATIVE given tab.6pm for one month review 20/8/2012 please given valuable comments how is the condition and what to do next?

Toni95

Non of this has helped me with my research :/ my sister has leukemia and none of the stuff above is even close!!

jasperkumar

i had ALL WEN I WAS 10. I was treated for a year and i was good for 10 years but i was diagnosed for ALL wen I WAS 20 . I was treated and i am okay now. is this possible?

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