Epidemiology of childhood leukemia: a targeted overview
Epidemiology of childhood leukemia: a targeted overview
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儿童白血病的流行病学：有针对性的概述
DOI：
10.11406/rinketsu.62.733
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Kevin Y. Urayama
中科院分区：
文献类型：
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作者：
Kevin Y. Urayama
尽管在研究一种罕见疾病的流行病学方面存在挑战，但过去20年提供了大量关于儿童白血病可能原因的信息，目前的证据表明，遗传易感性和源于环境的外部因素在其中发挥了重要作用。全基因组关联研究方法导致了几个相关基因的确定，从而证实了儿童白血病的多基因性质。正在进行的研究表明，这些最初在欧洲血统的人群中发现的许多基因座在日本人群中也很重要。关于潜在的外部暴露，越来越多的证据正在变得可以用来阐明感染性病原体的作用和早期生命中免疫成熟的影响。流行病学证据支持关于人口混合对儿童白血病发病率短暂增加的影响的流行假设，以及延迟暴露于常见感染在传播异常免疫反应和随后的白血病风险中的作用。由于严格的样本量要求，以支持统计上可靠的比较和独立验证的机会，在儿童白血病和其他罕见疾病的调查方面需要未来的进展以及协调的研究和合作。
Despite the challenges involved in studying the epidemiology of a rare disease, the last two decades have provided considerable information regarding the probable causes of childhood leukemia, in which current evidence suggests an important role for genetic susceptibility and external factors originating from the environment. The genome-wide association study approach has led to the identification of several associated genes, thereby confirming the polygenic nature of childhood leukemia. Ongoing studies have shown that many of these loci, which were originally identified in populations of European ancestry, are also important in the Japanese population. Regarding potential external exposures, increasing evidence is becoming available to elucidate the role of infectious agents and the influence of immune maturation in early life. Epidemiological evidence supports the prevailing hypotheses related to the effect of population mixing on transient increases in the childhood leukemia rates, as well as the role of delayed exposures to common infections in propagating an aberrant immune response and subsequent leukemia risk. Future advances in the investigation of childhood leukemia and other rare diseases along with coordinated studies and collaborations are needed, owing to stringent sample size requirements to support statistically robust comparisons and opportunities for independent validation.