Die Rolle von genetischer Prädisposition bei Krebserkrankungen im Kindesalter

ZUSAMMENFASSUNG

Obwohl maligne Erkrankungen im Kindesalter seltener als bei Erwachsenen auftreten, sind sie die zweithäufigste Todesursache (nach tödlichen Unfällen) bei Kindern bis zum 15. Lebensjahr. Laut dem letzten Bericht des Deutschen Kinderkrebsregisters wurden im Jahr 2018 insgesamt 2255 Kinder mit einer bösartigen Tumorerkrankung diagnostiziert. Basierend auf diesen Zahlen entwickelt eines von 337 Neugeborenen bis zum 18. Lebensjahr eine maligne Erkrankung. Verschiedene Risikofaktoren, wie Ernährung, Tabak- und Alkoholkonsum, Alter, Exposition am Arbeitsplatz sowie chronische Infektionen, die die Tumorentstehung bei Erwachsenen begünstigen, sind im Kindesalter nicht vorhanden. Vielmehr spielen vererbte oder de novo erworbene Keimbahnmutationen im Sinne einer genetischen Krebsprädisposition bei einem signifikanten Prozentsatz der Kinder eine wichtige Rolle. Diese genetische Krebsprädisposition kann klinisch unauffällig sein oder mit anderen phänotypischen Auffälligkeiten als Teil einer syndromalen Erkrankung vorkommen. Die frühzeitige Erkennung von Kindern mit genetischem Tumorprädispositionssyndrom ist für die Therapieplanung und die Nachsorge der betroffenen Patient*innen von großer Bedeutung.

ABSTRACT

Malignancies in children are less common than in adults, but still affect a relevant proportion of children and are the second most common cause of death after accidents in children between 1–15 years of age. According to the latest report of the German Childhood Cancer Registry, 2255 children were diagnosed with a malignant disease in 2018. Consequently, it is calculated that on average one in 337 newborns will develop a malignancy by the age of 18 years. Several risk factors that favor carcinogenesis in adulthood as diet, tobacco and alcohol consumption, age, occupational exposures and chronic infections are negligible in childhood cancer. Instead, recent studies have shown, that especially in children and adolescents inherited or de novo germline mutations play a relevant role in predisposition for cancerogenesis. This genetic predisposition to cancer may manifest clinically as “silent”, or, more often, it may be associated with other abnormalities as part of a syndromic disease. The early clinical identification of children with tumor predisposition syndrome is of paramount importance for treatment decision and long-term follow-up.

Schlüsselwörter

Keimbahnveränderungen - genetische Prädisposition - Krebs

Keywords

Germline alterations - genetic predisposition - cancer

Publikationsverlauf

Eingereicht: 22. Juli 2021

Angenommen: 29. Juli 2021

Artikel online veröffentlicht:
25. Februar 2022

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