Skip to main content

Advertisement

Log in

Neonatal exposure to protoporphyrin-activating lighting as a contributing cause of childhood acute lymphocytic leukemia

  • Hypothesis
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

While being a relatively rare disease, acute lymphocytic leukemia (ALL) is the leading form of cancer in children in the developed world today. ALL sharply peaks in incidence at ages three to four years. In the United States there have been persistent, unexplained increases in incidence of ALL in the past two decades. We hypothesize that exposure to photosensitizing lighting immediately after birth may be a contributing cause of ALL. Fluorescent lamps and other light sources with strong illumination, around 400 nanometers, are protoporphyrin-activating. Activation of protoporphyrin produces superoxides and free radicals that can induce breaks in DNA. In newborn nurseries in the US, the intensity of lighting has increased five-to 10-fold over the past two decades. Thus, protoporphyrin-activating light may be a contributing cause of childhood ALL. Additional retrospective and prospective studies should be undertaken of the relationship between exposure of newborns to protoporphyrin-activating illumination and the development of childhood ALL, along with in vitro studies of the hematologic effects of fluorescent lighting. Protoporphyrin-activating lighting is clearly not the sole determinant of ALL, but it could be a completely preventable cause. Inexpensive plastic filters could reduce these exposures substantially.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. US National Cancer Institute. Cancer Statistics Review 1973–1987. Bethesda, MD, USA: National Institutes of Health, 1990.

    Google Scholar 

  2. Campana, D, Janossy, G. Proliferation of normal and malignant human immature lymphoid cells. Blood 1988; 71: 1201–10.

    Google Scholar 

  3. Ichimaru, M, Ohkita, T, Ishimaru, T. Leukemia, multiple myeloma and malignant lymphoma. In: Shigematsu, I, Kagan, A, eds. Cancer in Atomic Bomb Survivors. New York: Plenum Press, 1986; Gann Monograph on Cancer Research, No. 32: 113–28.

    Google Scholar 

  4. Stewart, AM, Kneale, GW. Age-distribution of cancers caused by obstetric X-rays and their relevance to cancer latent period. Lancet 1970; ii: 4–8.

    Google Scholar 

  5. Smith, PG, Doll, R. Mortality among patients with ankylosing spondylitis after a single treatment course with X-rays. Br Med J 1982; 284: 449–60.

    Google Scholar 

  6. Pinkel, D, Nefzger, D. Some epidemiological features of childhood leukemia in the Buffalo, NY area. Cancer 1959; 12: 351–8.

    Google Scholar 

  7. Elliott, E, Githens, JH, Saunders, LH. The influence of socioeconomic factors on the incidence of childhood leukemia. Am J Dis Child Soc Trans 1961; 102: 483–4.

    Google Scholar 

  8. Fasal, E, Jackson, EW, Klauber, MR. Birth characteristics and leukemias in childhood. JNCI 1971; 47: 501–9.

    Google Scholar 

  9. McWhirter, WR. The relationship of incidence of childhood lymphoblastic leukaemia to social class. Br J Cancer 1982; 46: 640–5.

    Google Scholar 

  10. Birch, JM, Swindell, R, Marsden, HB, Morris Jones, PH. Childhood leukaemia in North West England 1954–1977: epidemiology, incidence and survival. Br J Cancer 1981; 43: 324–9.

    Google Scholar 

  11. Van, Steensel-Moll, HA, Valkenburg, HA, Van, Zanen, GE. Childhood leukemia and parental occupation: A register-based case-control study. Am J Epidemiol 1985; 121: 216–24.

    Google Scholar 

  12. Burbank, F, Fraumeni, JF Jr. US cancer mortality: non-white predominance. JNCI 1972; 49: 649–59.

    Google Scholar 

  13. Rosenthal, P, Rimm, IJ, Umiel, T, et al. Ontogeny of human hematopoietic cells: analysis utilizing monoclonal antibodies. J Immunol 1983; 131: 232–7.

    Google Scholar 

  14. Foon, KA, Schroff, RW, Gale, RP. Surface markers on leukemia and lymphoma cells: recent advances. Blood 1982; 60: 1–19.

    Google Scholar 

  15. Kamps, WA, Cooper, MD. Microenvironmental studies of pre-B and B cell development in human and mouse fetuses. J Immunol 1982; 129: 526–31.

    Google Scholar 

  16. Broxmeyer, HE, Douglas, GW, Hangoc, G, et al. Human umbilical cord blood as a potential source of transplantable hematopoietic stem/progenitor cells. Proc Natl Acad Sci 1989; 86: 3828–32.

    Google Scholar 

  17. Eales, L. Liver involvement in erythropoietic protoporphyria (EP). Int J Biochem 1980; 12: 915–23.

    Google Scholar 

  18. Malik, Z, Djaldetti, M. Destruction of erythroleukemia, myelocytic leukemia and Burkitt lymphoma cells by photoactivated protoporphyrin. Int J Cancer 1980; 26: 495–500.

    Google Scholar 

  19. Kappas, A, Sassa, S, Anderson, KE. The porphyrias. In: Stanbury, JB, Wyngaarden, JB, Fredrickson, DS, goldstein, JL et al, eds. The Metabolic Basis of Inherited Disease, 5th edn, New York: McGraw-Hill, 1983: 1301–84.

    Google Scholar 

  20. Magnus, IA. Dermatological Photobiology: Clinical and Experimental Aspects. Oxford: Blackwell Scientific Publications, 1976: 41–53, 236–59.

    Google Scholar 

  21. Spikes, JD. Photobiology of porphyrins. Prog Clin Biol Res 1984; 170: 19–39.

    Google Scholar 

  22. Buettner, GR, Oberley, LW. Superoxide formation by protoporphyrin as seen by spin trapping. FEBS Lett 1979; 98: 18–20.

    Google Scholar 

  23. Evensen, JF, Moan, J. Photodynamic action and chromosomal damage: A comparison of haematoporphyrin derivative (HpD) and light with X-irradiation. Br J Cancer 1982; 45: 456–65.

    Google Scholar 

  24. Kessel, D. Components of hematoporphyrin derivatives and their tumor-localizing capacity. Cancer Res 1982; 42: 1703–6.

    Google Scholar 

  25. Gottuso, MA, Oski, BF, Oski, FA. Free erythrocyte porphyrins in cord blood. J Pediatr 1978; 92: 810–2.

    Google Scholar 

  26. Heese, HD, Dempster, WS, Pocock, F. Free erythrocyte protoporphyrin levels in the first year of life. S Afr Med J 1983; 64: 237–9.

    Google Scholar 

  27. McDonagh, AF, Falma, LA, Lightner, DA, Blue light and bilirubin excretion. Science 1980; 208: 145–51.

    Google Scholar 

  28. Sideris, EG, Papageorgiou, GC, Charalampous, SC, et al. A spectrum response study on single strand DNA breaks, sister chromatid exchanges, and lethality induced by phototherapy lights. Pediatr Res 1987; 15: 1019–23.

    Google Scholar 

  29. Hopkinson RG. Lighting and lighting devices. In: The Encyclopedia Britannica, 15th edn, 1974; 10: 957–65.

  30. Glass, P, Avery, GB, Subramanian, KN, et al. Effect of bright light in the hospital nursery on the incidence of retinopathy of prematurity. N Engl J Med 1985; 313: 401–4.

    Google Scholar 

  31. Everett, MA, Yeargers, E, Sayre, RM, et al. Penetration of epidermis by ultraviolet rays. Photochem Photobiol 1966; 5: 533–42.

    Google Scholar 

  32. Dougherty, TJ, Lawrence, G, Kaufman, JH, et al. Photoradiation in the treatment of recurrent breast carcinoma. JNCI 1979; 62: 231–7.

    Google Scholar 

  33. Magnus, IA, Janousek, V, Jones, K. The effect of environmental lighting on porphyrin metabolism in the rat. Nature 1974; 250: 504–5.

    Google Scholar 

  34. Le, Beau, MM, Rowley, JD. Chromosomal abnormalities in leukemia and lymphoma: clinical and biological significance. Adv Hum Genet 1986; 15: 1–54.

    Google Scholar 

  35. Roos, D, Weening, RS, Voetman, AA, et al. Protection of phagocytic leukocytes by endogenous glutathione: Studies in a family with glutathione reductase deficiency. Blood 1979; 53: 851–66.

    Google Scholar 

  36. Babior, BM. Oxygen-dependent microbial killing by phagocytes (first of two parts). N Engl J Med 1978; 298: 659–68.

    Google Scholar 

  37. Perianin, A, Labro-Bryskier, MT, Marquetty, C, et al. Glutathione reductase and nitroblue tetrazolium reduction deficiencies in neutrophils of patients with primary idiopathic myelofibrosis. Clin Exp Immunol 1984; 57: 244–8.

    Google Scholar 

  38. Bentfeld, ME, Nichols, BA, Bainton, DF. Ultrastructural localization of peroxidase in leukocytes of rat bone marrow and blood. Anat Rec 1977; 187: 219–40.

    Google Scholar 

  39. Arrick, BA, Nathan, CF. Glutathione metabolism as a determinant of therapeutic efficacy: a review. Cancer Res 1984; 44: 4224–32.

    Google Scholar 

  40. Gustafsson, G, Kreuger, A. Incidence of childhood leukemia in Sweden 1975–1980. Acta Paediatr Scand 1982; 71: 887–92.

    Google Scholar 

  41. Baijal, E, Roworth, M, Walker, D, et al. An investigation of apparent leukaemia clusters in Fife by validation of cancer register data and a case-control study. Public Health 1989; 103: 91–7.

    Google Scholar 

  42. Van, Steensel-Moll, HA, Van, Duijn, CM, Valkenburg, HA, Van, Zanen, GE. Predominance of hospital deliveries among children with acute lymphocytic leukemia: speculations about neonatal exposure to fluorescent light (Comment), 1992. Cancer Causes Control 1992; 3: 389–390.

    Google Scholar 

  43. Zack, M, Adami, HO, Ericson, A. Maternal and perinatal risk factors for childhood leukemia. Cancer Res 1991; 51: 3696–701.

    Google Scholar 

Download references

Authors

Additional information

Dr Ben-Sasson is with The Hubert H. Humphrey Center for Experimental Medicine and Cancer Research, The Hebrew University-Hadassah Medical School, Jerusalem, Israel. Dr Davis is with the National Academy of Sciences, Washington, DC, and the Department of Environmental and Occupational Medicine, Mount Sinai Medical School, New York, NY, USA. Address correspondence to Dr Davis at the National Academy of Sciences, National Research Council, 2101 Constitution Avenue NW, Washington, DC 20418, USA. This work was supported by the Abraham de Vries Vanderbrock Foundation and the US National Research Council.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ben-Sasson, S.A., Davis, D.L. Neonatal exposure to protoporphyrin-activating lighting as a contributing cause of childhood acute lymphocytic leukemia. Cancer Causes Control 3, 383–387 (1992). https://doi.org/10.1007/BF00146893

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00146893

Key words

Navigation