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We finally know what causes childhood leukemia — and how to prevent it

A number of different things have to happen for a child to develop leukemia.

PORTLAND, ME - DECEMBER 24: Hailey Steward, an 8-year-old girl with leukemia, awaits a visit from Santa Claus and his elf on Christmas Eve at the Barbara Bush Children's Hospital at Maine Medical Center.

Ben McCanna/Portland Press Herald via Getty Images

The cause of the most common type of childhood cancer has been a century-long debate among those in the medical community. Now, thanks to the work of Prof. Mel Greaves, of the Institute of Cancer Research in London, the mystery is at its end. Acute lymphoblastic leukemia (ALL) affects 1 in 2,000 children. Ironically, it's our modern germ-free lifestyle, particularly our high level of cleanliness, that contributes to the disease's formation. What's really exciting is that we may even have the knowledge we need to make ALL a thing of the past.


To make this breakthrough, Prof. Greaves conducted a meta-analysis, combing through 30 years of medical literature and gathering data from colleagues all across the globe. His search included research on genetics, epidemiology, immunology, cellular biology, and much more. Along this journey, Prof. Greaves ruled out chemicals in the environment, ionizing radiation, electromagnetic waves, and the influence of high tension wires (electrical cables) as possible causes.

Putting together so many disparate puzzle pieces and eliminating false causes allowed him to formulate a “unified theory of leukemia." Although a horrifying condition for a child and parents to endure, Prof. Greaves' analysis, published in the journal Nature Reviews Cancer, has a bright spot. This type of leukemia may be wholly preventable.


A lack of exposure to microbes in the environment contributes to ALL. Image credit: Donnie Ray Jones, Flickr.

This exhaustive work supports the “delayed infection theory." According to Prof. Greaves, “The research study strongly suggests that acute lymphoblastic leukemia has a clear biological cause and is activated by a variety of infections in predisposed kids whose immune systems have not been properly primed."

Children born with a certain genetic mutation have merely the potential for developing ALL. This mutation takes place by accident within the womb. It will remain latent until the second “hit" comes, when the immune system fails to encounter enough microbes during the first year of life to prime it, or in other words train it.

A healthy amount of germ exposure allows the immune system to learn how to deal with pathogens correctly. If the infant grows into childhood without exposure to microbes from the environment or other children, they may develop ALL. But it takes a run-of-the-mill infection later on to ultimately trigger this form of leukemia. All told, full-blown ALL only occurs in 1% of cases where the mutation is present. The absence of pathogens as a factor explains why this form of childhood leukemia is common in wealthy, developed countries, but nearly absent in developing ones.


Allowing young children to play with older ones and be exposed to microbes in the environment could prevent ALL. Image credit: Pixababy.

What's fascinating is some of the disparate pieces of the puzzle Prof. Greaves put together to formulate this discovery. For instance, one clue was an outbreak of swine flu in Milan, which resulted in seven children developing ALL. Another clue was that infants born vaginally over cesarean section have a lower risk of developing this form of cancer.

That's because infants passing through the vaginal canal are exposed to more microbes than those born through c-section. Also, infants who are breastfed have less of a risk, as they often pickup healthy bacteria this way. On another front, animals, particularly mice, when living in an environment devoid of pathogens, often develop leukemia.

Prof. Greaves urges parents not to worry too much about keeping a clean house, and he offer some tips for preventing the disease, which include being less worried about normal, run-of-the-mill infections, and allowing young children to play with other kids, especially older children.

This research may even someday help us prevent the onset of other autoimmune disorders, including type 1 diabetes and allergies. In the future, giving young children a special yogurt drink or somehow purposefully exposing them to healthy microbes could help prevent ALL and perhaps other autoimmune conditions as well.

To hear Prof. Greaves explain his breakthrough himself, click here:

Hints of the 4th dimension have been detected by physicists

What would it be like to experience the 4th dimension?

Two different experiments show hints of a 4th spatial dimension. Credit: Zilberberg Group / ETH Zürich
Technology & Innovation

Physicists have understood at least theoretically, that there may be higher dimensions, besides our normal three. The first clue came in 1905 when Einstein developed his theory of special relativity. Of course, by dimensions we’re talking about length, width, and height. Generally speaking, when we talk about a fourth dimension, it’s considered space-time. But here, physicists mean a spatial dimension beyond the normal three, not a parallel universe, as such dimensions are mistaken for in popular sci-fi shows.

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A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

Lee Jae-Sung of Korea Republic lies on the pitch holding his knee during the 2018 FIFA World Cup Russia group F match between Korea Republic and Germany at Kazan Arena on June 27, 2018 in Kazan, Russia.

Photo by Alexander Hassenstein/Getty Images
Technology & Innovation
  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
  • The blend of three polymers provides enough flexibility and durability to mimic the knee.
  • The next step is to test this hydrogel in sheep; human use can take at least three years.
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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

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