Abstract

Simple SummaryAcute leukemias are some of the most common cancers affecting all age groups. Despite a significant improvement made in the treatment of acute leukemias, their cause remains unknown. A number of genetic and environmental factors for the development of acute leukemias have been proposed, but none have been proven. Undoubtedly, genetics have a major role in the development of these diseases. The effects of a variety of environmental factors, occupations and hobbies have been explored. A recent “two-hit” theory” for the development of acute lymphoblastic leukemia has been proposed. This combines genetic factors and exposure to infections for the development of this disease. Several genetic factors are suggested. Most recently, for the infection portion, exposure to a virus containing Aspergillus Flavus has been proposed. This review summarizes what is currently known about the factors that are proposed for the development of acute leukemias.Acute leukemias constitute some of the most common malignant disorders. Despite significant progress made in the treatment of these disorders, their etiology remains unknown. A large and diverse group of genetic and environmental variables have been proposed. The role of a variety of factors, including pre-existing and acquired genetic mutations, exposure to radiation and various chemicals during preconception, pregnancy and throughout life, have been explored. The effects of inherited genetic variations and disorders, pre-existing diseases, infectious agents, hobbies, occupations, prior treatments, and a host of other factors have been proposed, but none is universally applicable to all cases. Variation in the incidence and prognosis based on the age, sex, race, type of the disease, geographic area of residence and other factors are intriguing but remain unexplained. Advances in genomic profiling, including genome-wide gene expression, DNA copy number and single nucleotide polymorphism (SNP) genotype, may shed some light on the role of genetics in these disparities. Separate two-hit hypotheses for the development of acute myeloblastic and lymphoblastic leukemia have been proposed. The latter combines genetics and infection factors resulting in leukemogenesis. A number of pre- and post-natal environmental conditions and exposure to infections, including a mycovirus infected Aspergillus flavus, have been suggested. The exact nature, timing, sequence of the events and mechanisms resulting in the occurrence of leukemia requires further investigations. This review summarizes some of the above factors in acute lymphoblastic and myeloblastic leukemias and the direction for future research on the etiology of these disorders.

Highlights

  • Based on the Cancer Facts and Figures provided by the American Cancer Society, for the year 2020, it was estimated that 178,520 individuals were to be diagnosed with leukemia, lymphoma and myeloma in the United States

  • Advances in genomic profiling, including genome-wide gene expression, DNA copy number, and single nucleotide polymorphism (SNP) genotype, may shed some light regarding the roles of genetics in these disparities [11]

  • This study reports that using an ELISA technique, the plasma of patients with Acute lymphoblastic leukemia (ALL) in a complete remission, and long-term survivors, had antibodies to the products of this mycovirus containing Aspergillus Flavus

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Summary

Background

Based on the Cancer Facts and Figures provided by the American Cancer Society, for the year 2020, it was estimated that 178,520 individuals were to be diagnosed with leukemia, lymphoma and myeloma in the United States. This accounts for 9.9 percent of the estimated 1,806,590 new cancer cases diagnosed in that year. While both sexes are affected, leukemia is more prevalent in males. Acute leukemias are malignant clonal disorders of blood-forming organs involving one or more cell-lines in the hematopoietic system. Chronic leukemias are classified depending on the type of hemopoietic cells involved

Age and Race
Genetics
Environment and Occupations
Effects of Radiation
Prior Immunosuppressive and Chemotherapy
Parental and Residential Factors
Infections
Acute Myeloblastic Leukemia
10. Acute Lymphoblastic Leukemia
Findings
11. Conclusions
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