Tebbi Cameron K
Children's Cancer Research Group Laboratory, 13719 North Nebraska Avenue, Tampa, FL 33613, USA.
Cancers (Basel). 2021 May 8;13(9):2256. doi: 10.3390/cancers13092256.
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 , 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.
急性白血病是一些最常见的恶性疾病。尽管在这些疾病的治疗方面取得了重大进展，但其病因仍然不明。人们提出了一大组多样的遗传和环境变量。已经探讨了多种因素的作用，包括先前存在的和获得性基因突变、孕前、孕期及一生中接触辐射和各种化学物质的情况。有人提出了遗传变异和疾病、先前存在的疾病、感染因子、爱好、职业、先前治疗以及许多其他因素的影响，但没有一个因素能普遍适用于所有病例。基于年龄、性别、种族、疾病类型、居住地理区域和其他因素的发病率和预后差异很有趣，但仍无法解释。基因组分析的进展，包括全基因组基因表达、DNA拷贝数和单核苷酸多态性（SNP）基因型分析，可能会揭示遗传学在这些差异中的作用。有人提出了急性髓细胞白血病和淋巴细胞白血病发生的独立双打击假说。后者将遗传和感染因素结合起来导致白血病发生。有人提出了一些产前和产后环境条件以及接触感染的情况，包括感染一种真菌病毒。导致白血病发生的确切性质、时间、事件顺序和机制需要进一步研究。本综述总结了急性淋巴细胞白血病和急性髓细胞白血病中的一些上述因素以及这些疾病病因未来研究的方向。
