The impact of the COVID-19 pandemic on the future incidence of acute lymphoblastic leukaemia in children: Projections for Germany under a COVID-19 related scenario
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
Dear Editor, There is convincing scientific evidence that the most frequent malignancy in childhood, acute lymphoblastic leukaemia (ALL) and in particular its major subtype B-precursor ALL (BCP-ALL), is related to patterns of exposure to infectious agents in early life.1, 2 Therefore, as already put forward by others,3, 4 it is likely that the current COVID-19 pandemic will impact on the risk of children of developing ALL and, consequently, on the ALL incidence on a population level. The underlying infections-related model acting on the two-hit hypothesis for ALL is the one developed by Greaves. According to this model, ALL results from two genetic hits, with the first occurring before birth, induced by prenatal exposures or random mutations. The second hit is induced by an abnormal reaction of the immune system to exposure to common infections, more commonly so in children with insufficient training of their immune system through lesser-than-required social contacts in their first 2 to 3 years of life.2 For one particular genetic subtype of BCP-ALL, namely the ETV6/RUNX1 fusion type comprising about 25% of all BCP-ALL, it was shown that 5% of all healthy new-borns carry the first hit of which 0.2% later develop BCP-ALL
International Journal of Cancer , éditorial en libre accès, 2021