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Acute Lymphoblastic Leukemia

 

 

 

Radiation

 

Ionizing radiation is strongly associated with childhood acute leukemia.

In utero exposure to ionizing radiation has been a known causal factor for childhood cancer for > 50 years.

Preconception paternal irradiation (PPI) leads to postconception genomic instability (window of sensitivity corresponding to post-meiotic stages of spermatogenesis during the few months leading up to conception).

 

Association of Radiation with pediatric leukemias:

Ionizing radiation

Atom bomb

  • Strongest evidence.
  • Increased risk of leukemia in survivors of the atom bomb.
  • Dose related: Risk was greatest for those closest to the epicenter of the explosion.
  • If dose was more than 100 cGy then the dose response curve was linear.
  • In atom bomb survivors no increase in leukemia in children who were exposed in utero - different from diagnostic imaging experience.
  • Children living downwind of Nevada Test Site had significant increase in leukemia related to estimated fallout exposure

Diagnostic Imaging

and

Radiation Therapy (RT)

  • Increased risk for children who had RT for thymic enlargement or tinea capitis
  • 5X risk for leukemia in a child who had diagnostic imaging procedures in the first trimester
  • 1.5X risk for leukemia in a child who had diagnostic imaging procedures in the second and third trimester
  Preconception Paternal Irradiation (PPI)
  • Epidemiology studies in UK: Children with leukemia or non-Hodgkin lymphoma significantly more likely than controls to have fathers who were radiation workers.

Dickinson and Parker (2002)

Low-frequency Electromagnetic frequencies

Inconclusive
  • Increased risk associated with high voltage power lines is greatly disputed.

 

Radiation exposure secondary to the Chernobyl accident has thus far not been shown to increase the risk of leukemia in children who were exposed after birth (but there is a significant increase in the risk of thyroid cancer).

 

 

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