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His work has cut through the myths about childhood leukemia and for the first time set out a single unified theory for how most cases are caused."It's exciting to think that, in future, childhood leukemia could become a preventable disease as a result of this work.Preventing childhood leukemia would have a huge impact on the lives of children and their families in the UK and across the globe." What is ALL? Scientist reveals likely cause of childhood leukemia: Landmark paper sets out 'unified theory' for cause of childhood leukemia -- and finds it is likely to be preventable. "Scientist reveals likely cause of childhood leukemia: Landmark paper sets out 'unified theory' for cause of childhood leukemia -- and finds it is likely to be preventable." Science Daily. Leukemia researchers have traced the origins of relapse in acute myeloid leukemia (AML) to rare therapy-resistant leukemia stem cells that are already present at diagnosis and before chemotherapy ...
Professor Mel Greaves from The Institute of Cancer Research, London, assessed the most comprehensive body of evidence ever collected on acute lymphoblastic leukemia (ALL) -- the most common type of childhood cancer.
His research concludes that the disease is caused through a two-step process of genetic mutation and exposure to infection that means it may be preventable with treatments to stimulate or 'prime' the immune system in infancy.
The second mutation arises after birth and is different in the two twins.
Population studies in people together with animal experiments suggest this second genetic 'hit' can be triggered by infection -- probably by a range of common viruses and bacteria.
Professor Greaves suggests childhood ALL is a paradox of progress in modern societies -- with lack of microbial exposure early in life resulting in immune system malfunction.
In a landmark paper published in today (Monday), Professor Greaves compiled more than 30 years of research -- his own and from colleagues around the world -- into the genetics, cell biology, immunology, epidemiology and animal modelling of childhood leukemia.In one unique cluster of cases investigated by Professor Greaves and colleagues in Milan, all cases were infected with flu virus.Researchers also engineered mice with an active leukemia-initiating gene, and found that when they moved them from an ultra-clean, germ-free environment to one that had common microbes, the mice developed ALL.Eighteen patients were treated, 8 for first remission consolidation, 4 with relapse sensitive disease, 3 primary refractory and 3 relapsed refractory.The median age was 56 (38 - 65) and the median number of prior regimens was 3 (1 - 8).The first step involves a genetic mutation that occurs before birth in the fetus and predisposes children to leukemia -- but only 1 per cent of children born with this genetic change go on to develop the disease. The disease is triggered later, in childhood, by exposure to one or more common infections, but primarily in children who experienced 'clean' childhoods in the first year of life, without much interaction with other infants or older children.Acute lymphoblastic leukemia is particularly prevalent in advanced, affluent societies and is increasing in incidence at around 1 per cent per year.Professor Mel Greaves, Director of the Centre for Evolution and Cancer at The Institute of Cancer Research, London, said: "I have spent more than 40 years researching childhood leukemia, and over that time there has been huge progress in our understanding of its biology and its treatment -- so that today around 90 per cent of cases are cured.But it has always struck me that something big was missing, a gap in our knowledge -- why or how otherwise healthy children develop leukemia and whether this cancer is preventable.It also busts some persistent myths about the causes of leukemia, such as the damaging but unsubstantiated claims that the disease is commonly caused by exposure to electro-magnetic waves or pollution."I hope this research will have a real impact on the lives of children.