Chapter 14
Congenital malformations and acute leukemia in children: Children who develop
cancer have a greater frequency of mutations in germline CA predisposition genes
compared to other kids. Mutations in proto-oncogenes, tumor suppressor and
mismatch repair genes are associated with the development of childhood CA. When a
tumor suppressor gene acquires mutations, normal cell function is lost and cancer
can develop. Congenital malformations are associated with a higher incidence of Ca
development.
Most childhood CA arise from the mesodermal germ layer. This layer develops into
connective tissue, bone, cartilage, muscle, blood, blood vessels, gonads, kidney and
lymphatic system. The most common childhood CA include leukemias, sarcomas and
embryonic tumors.
Pediatric CAs and the N-myc oncogene: Oncogene identified in pediatric Ca is MYCN
which is involved in neuroblastoma and glioblastoma.
Trisomy 21 (Down syndrome) is the most common genetic defect linked to the
development of Acute Leukemia.
Childhood CA are most often diagnosed during peak times of physical growth.
DES has been identified as a transplacental chemical carcinogen. May develop
adenocarcinomas of the vagina.
More than 80% of children with cancer have curable Ca.
Most childhood CA originate from the mesodermal germ layer.
Wilms tumor is linked to congenital malformation syndromes.
Strongest association between viruses and development of CA has been Epstein-Barr
virus, Burkitt lymphoma, nasopharyngeal carcinoma and Hodgkin disease.
Children with AIDs have an increased risk of developing non-Hodgkin lymphoma and
Kaposi sarcoma.
Mortality rates have decreased because of participation in clinical trials.
Children treated with radiation therapy have an increased risk for developing adult
Ca.
Research suggests repeated CT scans can increase the risk of developing brain CA.
Childhood exposure to ionizing radiation, cigarette smoke and Hodgkin’s disease.
Cancers in children are very different from adult CAs and associated with fewer
genetic mutations.
Most childhood CAs originate from the mesodermal germ layer, which gives rise to
connective tissue, bone cartilage, muscle, blood, blood vessels, gonads, kidney and
lymph system.
Childhood CAs are most likely diagnosed during peak times of physical growth. They
are extremely fast growing and have high risk for metastasis usually by time of
diagnosis.
Most common CAs among adolescent and young adult population include Hodkin’s
lymphoma, leukemia, germ cell tumors (testicular), CNS tumors, non-Hodgkin
lymphoma, thyroid CA, melanoma, osteosarcomas, breast, cervical, liver, thyroid and
colorectal CA. Lung CA generally develops after chronic inhalation of
nicotine-containing products.