Etiology of common childhood acute lymphoblastic leukemia: the adrenal hypothesis

Leukemia
Kjeld SchmiegelowHenrik Hjalgrim

Abstract

The pattern of infections in the first years of life modulates our immune system, and a low incidence of infections has been linked to an increased risk of common childhood acute lymphoblastic leukemia (ALL). We here present a new interpretation of these observations--the adrenal hypothesis--that proposes that the risk of childhood ALL is reduced when early childhood infections induce qualitative and quantitative changes in the hypothalamus-pituitary-adrenal axis that increase plasma cortisol levels. This may directly eliminate leukemic cells as well as preleukemic cells for the ALL subsets that dominate in the first 5-7 years of life and may furthermore suppress the Th1-dominated proinflammatory response to infections, and thus lower the proliferative stress on pre-existing preleukemic cells.

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Citations

Aug 7, 2009·Leukemia·S DahlK Schmiegelow
Jul 28, 2011·Journal of Pediatric Hematology/oncology·Therese Risom VestergaardKjeld Schmiegelow
Aug 19, 2011·BMC Cancer·María Luisa Pérez-SaldivarJuan Manuel Mejia-Arangure
Sep 3, 2010·American Journal of Epidemiology·Jérémie RudantJacqueline Clavel
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Feb 16, 2016·European Journal of Medical Genetics·Kjeld Schmiegelow
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Oct 17, 2009·Cancer Epidemiology·Fernanda Azevedo-SilvaMaria S Pombo-de-Oliveira
Aug 24, 2012·Pediatric Blood & Cancer·Therese Risom VestergaardHenrik Hjalgrim
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