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Aetiology of childhood leukaemia
Cancer may occur spontaneously, but can also be induced by genetic predisposition, lifestyle (especially diet) and environmental (chemical, physical or biological) impacts. Environmental risk factors have long been known for many types of tumours (e.g. lung cancer from cigarette smoke, skin cancer from UV, genital tumours from tumour viruses). In contrast to this, knowledge about environmental risk factors for childhood leukaemia is unsatisfactory and characterised by little progress.
Statistical associations between childhood leukaemia and low-level ionising radiation as well as weak low-frequency magnetic fields, have been consistently observed in epidemiological studies. However, the results cannot yet causally be explained by current knowledge. This is why the BfS has taken these scientific findings as a reason to put great effort into supporting the research into the causes of childhood leukaemia.
Wide range of topics for aetiology
The development of childhood leukaemia is a multifactorial process with an interaction between genetic predisposition, other endogenous factors and external factors. In spite of several efforts in a variety of scientific fields, the disease is still poorly understood in its complexity. It is necessary to identify its causes through targeted research and to thus provide a basis for being able to reduce environmental risk factors.
The range of topics for the aetiology of childhood leukaemia is very wide and among other things it includes:
- Ionising radiation and risk of leukaemia in children
- Magnetic fields and risk of leukaemia in children
- Aetiology and mechanisms of the disease
- Genetics, epigenetics and environmental influences
- The importance of the immune system for the development of the disease
- New findings from animal models
- International consortia and transnational research approaches.
BfS as initiator of the international exchange on aetiology
In order to find new ways of identifying the complex causes of childhood leukaemia and to continuously follow scientific progress, the BfS has been organising international workshops since 2008. The events address interested scientists such as paediatricians, epidemiologists, biologists, radiation researchers among others and representatives of German, European and international authorities and organisations (e.g. BMU, BfS, WHO, ICNIRP):
- Together with the World Health Organization (WHO) and the International Commission on Non-Ionizing Radiation Protection (ICNIRP), the BfS conducted an international workshop on the known risk factors for childhood leukaemia in Berlin in May 2008.
- Based on the workshop in Berlin, a BfS expert talk with international experts aimed at developing a strategic, interdisciplinary research agenda was held in July 2010 (Ziegelberger et al., Blood Cancer Journal (2011)).
- In June 2012, a conference organised by the French radiation protection authority IRSN (Institut de Radioprotection et de Sûreté Nucléaire) together with the BfS, under the auspices of MELODI (Multidisciplinary European Low Dose Initiative), was held in Bombon near Paris. At the conference, the research agenda developed at the BfS expert talk in July 2010 was presented and updated (Laurier et al., J Radiol Prot. 2014).
- In December 2013, the BfS hosted an expert talk with international experts and research contractors in order to present the findings of five pilot projects and to discuss them in the context of current scientific knowledge. On the basis of the research agenda developed in July 2010, (Ziegelberger et al., Blood Cancer Journal (2011)) , the BfS had selected some of the main topics and had launched corresponding pilot projects within the framework of the environmental research plan UFOPLAN which were conducted in the years 2012-2013.
In November 2016, the BfS organised another international workshop in Munich on behalf of the Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety (BMUB). This event was aimed at determining new research approaches to aetiology of childhood leukemia as well at the further development of research strategies.
The final reports of the pilot projects were published in German language in the BfS "Digital Online Repository and Information System" (DORIS).
Moreover the scientists published the results of the pilot projects in well-respected scientific journals:
- Ernst S A, Günther K, Frambach T, Zeeb, H 2015: Prenatal recruitment of participants for a birth cohort study including cord blood collection: results of a feasibility study in Bremen, Germany. GMS Ger Med Sci; doi. 10.3205/000208.
- Fischer U et al. 2015: Genomics and drug profiling of fatal TCF3-HLF−positive acute lymphoblastic leukemia identifies recurrent mutation patterns and therapeutic options. Nature Genetics doi: 10.1038/ng.3362.
- Fueller E, Schaefer D, Fischer U et al. 2014: Genomic Inverse PCR for Exploration of Ligated Breakpoints (GIPFEL), a New Method to Detect Translocations in Leukemia. PLoS ONE 9(8): e104419. https://doi.org/10.1371/journal.pone.0104419
State of 2017.07.06