Possible causes or risk indicators for Acute Myeloid Leukemia (AML)?
Acute Myeloid Leukemia (AML), a type of blood and bone marrow cancer, is often associated with age, gender, smoking, chemical exposure, chemotherapy, radiation, other medical conditions, genetics, and obesity. However, recent research has uncovered additional potential risk factors that broaden our understanding of this disease.
One such factor is familial history. Siblings, especially twins, of children with acute leukemia have a slightly increased risk, with identical twins showing a much higher concordance, especially if leukemia develops before one year of age [1].
Pre-existing hematopoietic disorders are another significant risk factor. Conditions that affect blood cell formation can predispose individuals to AML [3]. Certain inherited genetic syndromes, such as Fanconi anemia and Down syndrome (which raise risk 10–20 times), are particularly noteworthy [3].
Specific chemotherapeutic agents also pose a higher risk of treatment-related AML. Beyond general chemotherapy, drugs like cyclophosphamide, doxorubicin, etoposide, and teniposide are linked to a higher risk of treatment-related AML, often arising within 10 years post-treatment [1].
Infections, while less clearly established, have been considered environmental risk factors for AML. Some infections or their associated immune alterations may contribute to the development of AML, but the evidence is not yet definitive [1].
Environmental factors beyond radiation and chemicals are under investigation, but no clear additional agents have been firmly established [1][3]. However, exposure to extremely low-frequency electromagnetic fields (ELF-EMF) has been linked to an increased risk for childhood leukemia [1].
Certain chemicals, like benzene, are known to increase a person's risk of AML. Benzene exposure carries a 7-fold risk for developing leukemia and a 71-fold risk of causing AML [2]. Pesticide exposure is also associated with childhood leukemia, especially AML [2].
Smoking is another established risk factor for AML. Current smokers have a higher risk, and people who have ever smoked have a 25% increased risk compared to non-smokers [2]. Obesity is also a risk factor, with high body mass index (BMI) predicting poorer outcomes in acute promyelocytic leukemia (APL), a subtype of AML [2].
AML is more common in males, but the reason for this is not clear [2]. The evidence for these factors largely comes from epidemiological and clinical studies consolidated by authoritative sources such as the American Cancer Society and medical knowledge bases [1][3].
People who have received chemotherapy for other cancers may be more likely to develop AML years after their initial treatment [3]. It's crucial to note that while these additional risk factors are significant, the most common risk factors for AML remain age, gender, smoking, chemical exposure, chemotherapy, radiation, other medical conditions, genetics, and obesity.
References:
[1] American Cancer Society. (2021). Risk Factors for Acute Myeloid Leukemia. Retrieved from https://www.cancer.org/cancer/acute-myeloid-leukemia/causes-risks-prevention/risk-factors.html
[2] National Cancer Institute. (2021). What You Need To Know About Acute Myeloid Leukemia Treatment. Retrieved from https://www.cancer.gov/types/leukemia/patient/aml-treatment-pdq
[3] World Health Organization. (2016). Classification of Tumours of Haematopoietic and Lymphoid Tissues. Retrieved from https://www.iarc.who.int/classification-of-tumours/pdf/BlueBook_Haematopoietic_and_Lymphoid_Tumours_2016.pdf
- Acute Myeloid Leukemia (AML) is associated with a family history, as siblings, especially identical twins, show an increased risk, particularly if leukemia develops before one year of age.
- Pre-existing hematopoietic disorders can predispose individuals to AML, and certain inherited genetic syndromes, such as Fanconi anemia and Down syndrome, raise the risk significantly.
- Specific chemotherapeutic agents also pose a higher risk of treatment-related AML, with drugs like cyclophosphamide, doxorubicin, etoposide, and teniposide being linked to the disease.
- Infections might contribute to the development of AML, but the evidence is not yet definitive. Some infections or immune alterations may increase the risk.
- Exposure to extremely low-frequency electromagnetic fields (ELF-EMF) has been linked to an increased risk for childhood leukemia.
- Certain chemicals, like benzene and pesticides, are known to increase a person's risk of AML, with benzene exposure carrying a higher risk for leukemia and AML specifically.
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