Pediatric lymphoma may develop by "one-step" cell transformation of a lymphoid cell

TL;DR

This paper proposes that pediatric lymphomas may originate from a rapid, one-step transformation of lymphoid cells triggered by severe viral infections, offering a new perspective on their development mechanisms.

Contribution

It introduces a hypothesis that pediatric lymphomas develop through a rapid, one-step transformation of lymphoid cells, influenced by infections and thymic involution, which is a novel conceptual framework.

Findings

Pediatric lymphomas may result from rapid cell transformation.

Severe viral infections are potential triggers for transformation.

Different lymphoma types may follow distinct transformation pathways.

Abstract

Lymphomas are a large group of neoplasms developed from lymphoid cells (LCs) in lymph nodes (LNs) or lymphoid tissues (LTs). Some forms of lymphomas, including Burkitt lymphoma (BL), ALK+ anaplastic large cell lymphoma (ALK+-ALCL), and T-cell lymphoblastic lymphoma/leukemia (T-LBL), occur mainly in children and teenagers. Hodgkin's lymphoma (HL) has a peak incidence at age 20s. To understand pediatric lymphoma, we have recently proposed two hypotheses on the causes and the mechanism of cell transformation of a LC. Hypothesis A is: repeated bone-remodeling during bone-growth and bone-repair may be a source of cell injuries of marrow cells including hematopoietic stem cells (HSCs), myeloid cells, and LCs, and thymic involution may be a source of damage to the developing T-cells in thymus. Hypothesis B is: a LC may have three pathways on transformation: a slow, a rapid, and an accelerated. In this paper, we discuss pediatric lymphomas by this hypothesis. Having a peak incidence at young age, BL, T-LBL, ALK+-ALCL, and HL develop more likely as a result of rapid transformation of a LC. In BL, ALK+-ALCL, and HL, the cell transformations may be triggered by severe viral infections. In T-LBL, the cell transformation may be related to thymic involution. Occurring in both adults and children, diffuse large B-cell lymphoma (DLBCL) may develop via slow or accelerated pathway. In conclusion, pediatric lymphoma may develop as a result of "one-step" cell transformation of a LC, and severe viral infections may be the main trigger for the rapid transformation of a LC in a LN/LT.