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Research on the aetiology of childhood leukaemia

  • Environmental risk factors – among others chemical, physical or biological impacts - 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).
  • The knowledge about environmental risk factors for childhood leukaemia is unsatisfactory and characterised by little progress.
  • Epidemiological studies point to an association between childhood leukaemia and living in the vicinity of nuclear power plants as well as weak low-frequency magnetic fields.
  • The BfS has taken these scientific findings as a reason to put great effort into supporting the research on the causes of childhood leukaemia. On the basis of five pilot projects which were conducted in the years 2012 - 2013, the BfS is continuing research in this area with follow-up projects.
  • Childhood leukaemia is a topic area of the research programme "Radiation Protection in the Process of Power Grid Expansion"

Environmental risk factors – among others chemical, physical or biological impacts - 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). Cancer may, however, also occur spontaneouslyor be induced by genetic predisposition or lifestyle (especially diet) . In contrast to this, knowledge about environmental risk factors for childhood leukaemia is unsatisfactory and characterised by little progress.

As a result of the KiKK study, sponsored by the BfS, an association between childhood leukaemia and living in the vicinity of nuclear power plants was found. Moreover statistical associations between childhood leukaemia and weak low-frequency magnetic fields have been consistently observed in epidemiological studies. However, a causal relationship between the mentioned environmental impacts and the risk for childhood leukaemia cannot yet 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
  • Epidemiology
  • 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. BMUV, 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; Ziegelberger et al. Prog Biophys Mol Biol 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 and 2019, the BfS organised two additional international workshop in Munich on behalf of the Federal Environment Ministry (BMUV). These events were aimed at determining new research approaches to aetiology of childhood leukemia as well at the further development of research strategies. A summary and discussion of the 2019 workshop results were published (Schmidt et al., Front Public Health 2021). A 6th international workshop on the causes of childhood leukemia will be hosted by the BfS in November 2022 in Munich.

Pilot projects and publications

The final reports of the pilot projects were published in German language in the BfS "Digital Online Repository and Information System" (DORIS).

  • Investigation of combined effects of environmental risk factors and genetic as well as other endogenous factors on the development of childhood leukemia; Pilot study: Sequencing and bioinformatic analysis (project number 3611S70014).
  • Overview of available animal models that can be applied in leukemia research (project number 3612S70029).
  • Identification of preleukemic cells in children through detection of chromosomal translocations by genomic PCR; Pilot study for development and validation of appropriate probes (project number 3611S70019).
  • Feasibility study for implementation of a birth cohort and for investigating genetic predispositions in childhood leukemias (prospective research approaches) (project number 3611S70020).
  • Pilot study for the comparison of childhood leukemia incidences in different countries (Website: GALnet: The Global Acute Leukemia network) (project number 3612S70028).

The results of some projects gave rise to further projects to validate the results or new models were added to the issue regarding effects of ionizing radiation in the low-dose range:

  • Follow-up project: Validation of a genomic PCR approach to detect chromosomal translocations to identify pre-leukaemic cells in children – Pilot study (project number 3614S30034)
  • Follow-up project: Determination of the frequency of preleukemic translocations in umbilical cord blood (project number: 3619S32275)
  • Influence of low-dose radiation on leukaemia development in a genetically predisposed mouse model (project number: 3618S32274)

Publications from the pilot and follow-up projects

Moreover, the scientists published the results of the pilot projects in well-respected scientific journals:

Childhood leukaemia is a topic area of the research programme "Radiation Protection in the Process of Power Grid Expansion"

Within the scope of the research programme "Radiation Protection in the Process of Power Grid Expansion" which is being carried out by the BfS, currently 8 projects addressing the aetiology of childhood leukaemia and the effects of weak ionizing radiation and weak low-frequency magnetic fields are planned. Among other things a 6th international workshop on the current state of research on the aetiology of childhood leukaemia was organized from 20th to 22nd November 2019. A summary of the workshop results, including a discussion in the context of the current scientific literature, has been published (Schmidt et al., Front Public Health 2021). The abstracts of the workshop contributions can be found in DORIS.

State of 2022.10.14

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