Acute Lymphoblastic Leukemia: Causes

Pathogenesis (disease development)

In acute lymphoblastic leukemia, there is a mass shedding of immature blasts (young, not finally differentiated cells) into the peripheral blood.

Biographic causes

Genetic burden from parents, grandparents
- Genetic risk depending on gene polymorphisms:
  - Genes/SNPs (single nucleotide polymorphism):
    - Genes: ARIDB5, IKZF1
    - SNP: rs7089424 in the gene ARIDB5
      - Allele constellation: GT (2.0-fold).
      - Allele constellation: GG (4.0-fold)
    - SNP: rs4132601 in the gene IKZF1.
      - Allele constellation: GT (1.7-fold).
      - Allele constellation: GG (2.5-fold)
- Genetic diseases
  - Ataxia teleangiectatica (synonyms: ataxia teleangiectasia; Louis-Bar syndrome; Boder-Sedgwick syndrome) – genetic disorder with autosomal recessive inheritance that leads to ataxia (gait abnormalities), short stature, and high susceptibility to infection, among other symptoms.
  - Trisomy 21 (Down syndrome) – special genomic mutation in humans in which the entire 21st chromosome or parts of it are present in triplicate (trisomy). In addition to physical characteristics considered typical for this syndrome, the cognitive abilities of the affected person are usually impaired; furthermore, there is an increased risk of leukemia.
Children after elective caesarean section (cesarean section):
- Wg. Delivery before labor began (23% increased risk of ALL); delivery after labor began (no increased risk).
Socioeconomic factors – higher social classes.

Behavioral causes

Disease-related causes

HTLV (human T-cell lymphotropic virus)-1 virus infection – endemic in the Caribbean and southern Japan.
Trisomy 21 (Down syndrome)

Chemotherapy

Environmental exposure – intoxications (poisonings).