Download - Editorial Acute Leukemia in Childrendownloads.hindawi.com/journals/bmri/2015/787194.pdf · Editorial Acute Leukemia in Children JuanManuelMejía-Aranguré 1 andRichardJ.Q.McNally

EditorialAcute Leukemia in Children

Juan Manuel Mejía-Aranguré1 and Richard J. Q. McNally2

1Unit of Clinical Epidemiology, Pediatrics Hospital, National Medical Center “Century XXI”,Mexican Institute of Social Security (IMSS) and Health Research Coordination, 06720 Mexico, DF, Mexico2Institute of Health & Society, Newcastle University, Newcastle upon Tyne NE1 4LP, UK

Correspondence should be addressed to Juan Manuel Mejıa-Arangure; [email protected]

Received 1 April 2015; Accepted 1 April 2015

Copyright © 2015 J. M. Mejıa-Arangure and R. J. Q. McNally. This is an open access article distributed under the CreativeCommons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided theoriginal work is properly cited.

Acute lymphoblastic leukemia (ALL) is the most commoncancer during childhood. Nevertheless, in recent years therehave been marked improvements in treatment and conse-quent survival.There are a number of patients that experiencerelapses and patients that cannot be cured. In this specialissue different aspects relating to factors influencing the bestresponse to treatment are described.M. Czogała et al. showedthat plasma ammonia concentration reflexes L-asparaginaseactivity may be a useful tool for assessing treatment inchildren with ALL. In another study A. Medina-Sanson etal. identified the importance of a genetic polymorphism ofdeoxycytidine kinase and cytidine deaminase in assessingthe toxicity by cytarabine in children with acute myeloidleukemia and found that this polymorphism might predictdeath in affected children.

A. Vilchis-Ordonez et al. addressed a very interestingtopic about subpopulations of leukemic cells that contributeto a proinflammatory microenvironment within B-ALL bonemarrow that may cause a delay in the normal hematopoiesis.

Two studies assessed the participation of environmentalrisk factors in the development of acute leukemia.A.Morales-Sanchez et al. did not find that EBV, HCMV, HHV6, andHHV7were related to the development of ALL. Furthermore,J. D. Ferreira et al. did not show that maternal alcohol con-sumption during pregnancy was associated with leukemia inyoung children.

Finally a study by V. C. Bekker-Mendez et al. demon-strated differences in the frequency of gene rearrangementbetween the Mexican population and populations fromdeveloped countries.

From these articles it is clear that throughout the worldthe survival of children with acute leukemia is a greatconcern, especially in less developed countries. It is veryimportant to search for factors associated with treatmentcompliance in children and those factors that may be relatedto treatment response.

The microenvironment in the leukemic bone marrow isa very important factor in the etiology of acute leukemia.Recovery of the bone marrow during treatment is also veryimportant and further studies are needed to address thisimportant aspect.

The environmental etiology of acute leukemia is a chal-lenge that still has not been resolved. To identify environ-mental risk factors is not easy. It is important to identify boththe environmental risk factors and also the gene-environmentinteractions that increase the susceptibility to development ofleukemia.

The presentation of acute kinds of leukemia in Hispanicchildren is different from other populations; notably clinicalfeatures, the age incidence peak, and molecular factors aredifferent.

In this special issue the complexity of the molecular andclinical epidemiology of acute leukemia in children has beenshown. There are countries where success has been clearlydemonstrated, but in other countries this is not apparent.This disease kills more children in developed countries andsome emerging economies. There is a need to strengthenthe research groups that are working to identify the factorsthat affect the adherence to treatment and the response totreatment. However, there is also a need for integration with

Hindawi Publishing CorporationBioMed Research InternationalVolume 2015, Article ID 787194, 2 pageshttp://dx.doi.org/10.1155/2015/787194

2 BioMed Research International

those research groups that are working on the etiology ofleukemia, especially including epidemiology and cellular andmolecular biology.

We need to understand more about leukemia, in orderto be able to cure and prevent it. The challenge continuesbecause it is not a dream to think that one day almost all kindsof leukemia in children could be cured and that one day thisdisease could be prevented.

Juan Manuel Mejıa-ArangureRichard J. Q. McNally

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