title: Childhood leukaemia and lymphoma: African experience supports a role for environmental factors in leukaemogenesis.
abstract: Major differences exist in the nature of leukaemia and lymphoma in low-income African children compared to those in the high-income countries. These include the absence of the peak incidence of acute lymphoblastic leukaemia (ALL) in under-five-year olds that characterizes the disease in high-income countries. Conversely, chloroma association with acute myelogenous leukaemia (CA-AML/AMML) and Burkitt's lymphoma (BL) are rare in the high-income countries. This report describes clinical and laboratory as well as epidemiological features of childhood leukaemia and lymphoma reported betwen 1982 and 1984 in the city of Ibadan, Nigeria. The observed pattern of distribution of childhood haematological malignancies in the city is more consistent with the observations of Ludwik Gross's experiments on environmental influences, such as malnutrition and infections, animal leukaemogenesis, and mirroring the consequences of the primordial pressures that have shaped human genetics and pathophysiology.
authors.affiliation: Department of Haematology, College of Medicine, University of Ibadan, Ibadan, Nigeria ; Hematology Oncology Consultancy, Port Angeles, WA 98362, USA ; FHCRC/UW Centre for AIDS Research (CFAR), Seattle, WA 98104, USA.
authors.forename: Christopher Ko
authors.initials: CK
authors.lastname: Williams
authors.affiliation: Department of Haematology, Royal Postgraduate Medicine School, London W12 ONN, England.
authors.forename: Letizia
authors.initials: L
authors.lastname: Foroni
authors.affiliation: Department of Haematology, Royal Postgraduate Medicine School, London W12 ONN, England.
authors.forename: Lucio
authors.initials: L
authors.lastname: Luzzatto
authors.affiliation: Department of Haematology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: Idris
authors.initials: I
authors.lastname: Saliu
authors.affiliation: Department of Haematology, Royal Postgraduate Medicine School, London W12 ONN, England ; Viral Epidemiology Branch, Landow Building 3C19, National Cancer Institute, Bethesda, MD 20205, USA.
authors.forename: Arthur
authors.initials: A
authors.lastname: Levine
authors.affiliation: Chester Beatty Laboratories, London SW3 6JB, England.
authors.forename: Mel F
authors.initials: MF
authors.lastname: Greaves
keywords: childhood leukaemia; chloroma; environmental factors; leukaemogenesis; lifestyle; lymphoblastic; socio-economic