Implications of infectious diseases and the adrenal hypothesis for the etiology of childhood acute lymphoblastic leukemia

Brazilian Journal of Medical and Biological Research

F. Azevedo-silva¹  B.de Camargo¹  M.s. Pombo-de-oliveira¹ 

[1] ,Instituto Nacional de Câncer Centro de Pesquisa Programa de Hematologia e Oncologia PediátricosRio de Janeiro RJ ,Brasil

关键词: Lymphoblastic leukemia;    Childhood infections;    Epidemiology;    Kala-azar;    Adrenal hypothesis;   

DOI  :  10.1590/S0100-879X2010007500011

来源: SciELO

【 摘 要 】

Acute leukemia is the most frequent cancer in children. Recently, a new hypothesis was proposed for the pathogenesis of childhood acute lymphoblastic leukemia (ALL). The so-called "adrenal hypothesis" emphasized the role of endogenous cortisol in the etiology of B-cell precursor ALL. The incidence peak of ALL in children between 3 to 5 years of age has been well documented and is consistent with this view. The adrenal hypothesis proposes that the risk of childhood B-cell precursor ALL is reduced when early childhood infections induce qualitative and quantitative changes in the hypothalamus-pituitary-adrenal axis. It suggests that the increased plasma cortisol levels would be sufficient to eliminate all clonal leukemic cells originating during fetal life. Because Brazil is a continental and tropical country, the exposure to infections is diversified with endemic viral and regionally non-viral infections, with some characteristics that support the recent adrenal hypothesis. Here we discuss this new hypothesis in terms of data from epidemiological studies and the possible implications of the diversity of infections occurring in Brazilian children.

【 授权许可】

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