STEP 1: Prevention and early detection
This step outlines recommendations for the prevention and early detection of childhood, adolescent and young adult acute leukaemia (CAYA leukaemia).
Evidence shows that not smoking, avoiding or limiting alcohol intake, eating a healthy diet, maintaining a healthy body weight, being physically active, being sun smart and avoiding exposure to oncoviruses or carcinogens may help reduce general cancer risk (Cancer Council Australia 2018).
Although risk factors have been identified, the cause of CAYA acute leukaemia remains unknown. There is currently no evidence that lifestyle plays a role in CAYA acute leukaemia. It is important to ensure the patient and their family are aware of this to avoid feeling responsible for the illness.
The risk factors for developing CAYA acute leukaemia include the following.
Genetic predisposition
Some genetic disorders may increase the likelihood of developing CAYA acute leukaemia. These include, but are not limited to, Down syndrome, neurofibromatosis type-1, ataxia telangiectasia, inherited bone marrow failure syndromes and, rarely, inherited cancer predisposition syndromes (D’Orazio et al. 2010; Eden et al. 2010). Most cases of CAYA acute leukaemia do not have a genetic predisposition identified.
Siblings
Although the risk is still extremely low, siblings of CAYA acute leukaemia patients have a slightly increased risk of developing leukaemia compared with the general population.
Environmental factors
There is no evidence to suggest environmental factors contribute to CAYA acute leukaemia. CAYA patients who have been treated with certain chemotherapy agents for another cancer may be at a marginally increased risk of developing a secondary leukaemia, particularly treatment-related AML.
There are no screening tools for early detection of newly diagnosed CAYA acute leukaemia at the moment. In CAYA with an identified cancer predisposition, a specialist may recommend screening full blood count examinations or bone marrow examination. Routine full blood count examination is not indicated for asymptomatic siblings of those diagnosed with CAYA acute leukaemia.
