Leukaemia and lockdown: The delayed infection model of childhood acute lymphoblastic leukaemia and the COVID-19 pandemic.

Acute lymphoblastic leukaemia (ALL) is the most common type of leukaemia diagnosed in children. The prevailing hypothesis regarding pathogenesis of childhood ALL was developed by Greaves, and states that ALL is caused by an abnormal immune response to a common infection. The response arises either due to naivety of the immune system caused by a lack of common childhood infections, or genetic susceptibility due to specific alleles. The former explanation is known as the delayed infection hypothesis. COVID-19 is a new infection that no children in the UK were exposed to prior to 2020. Furthermore, the lockdown measures designed to prevent spread of this virus have also greatly reduced spread of other common infections. It is therefore important to examine the evidence for this hypothesis, and to consider it in the context of the pandemic to determine what effect lockdown measures may have on incidence of ALL in children.