Acute Leukemias - Republican Scientific Medical Library

a References 89
antihistamines and allergy remedies was associated
with an increased risk of ALL.
5.4 Summary
ALL is a complex, heterogeneous disease that is difficult
to study. It is rare, comprehensive exposure assessments
are complicated to conduct, and most studies are potentially
plagued by possible reporting biases, for example
by parents; selection biases, for example in selection of
control and comparison populations; and substantial
confounding, for example by SES. Nonetheless, as the
most common childhood cancer, it has a substantial
public health impact and is of great concern to parents
and the public, in general, and demands prompt, thorough,
and reliable research.
Studies have shown associations of ALL with several
risk factors, such as maternal exposure to solvents, residential
proximity to electric power lines, and pesticides,
but none save ionizing radiation are thorough
and convincing. These studies provide numerous leads
and suggestions for further study.
One topic of investigation that has sparked considerable
research, particularly in the UK, is the role of infection
and immune response in the occurrence of childhood
leukemia. This set of etiologic hypotheses includes
consideration of biological, genetic, physical, and chemical
risk factors in conjunction with the molecular basis
of this dreaded disease. And yet, here, too, after more
than 25 years of study and investigation, while numerous
patterns and associations have been detected and
documented, the underlying debate of what causes
childhood leukemia remains largely unresolved.
We hope that with the recent gains in understanding
the genetic basis and variation of ALL, and the many
advances in molecular and genetic technology, exposure
assessment, and study design and implementations, will
provide additional clues and avenues for future investigation.
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