Acute myeloid leukemia: Epidemiology and etiology

• Published in: Cancer Vol. 107; no. 9; pp. 2099 - 2107
• Main Authors: Deschler, Barbara, Lübbert, Michael
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-11-2006; Wiley-Liss
• Subjects: acute myeloid leukemia; Age Distribution; Biological and medical sciences; epidemiology; etiology; Hematologic and hematopoietic diseases; Humans; Incidence; Leukemia, Myeloid - epidemiology; Leukemia, Myeloid - etiology; Leukemia, Myeloid - genetics; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Medical sciences; Risk Factors; survival; Survival Rate - trends; Treatment Outcome; Tumors; United States - epidemiology; United States; Cancerology; acute myeloid leukemia; Etiology; Acute; Malignant hemopathy; Epidemiology; Survival; Acute myelocytic leukemia
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.22233

Acute myeloid leukemias (AMLs) are infrequent, yet highly malignant neoplasms responsible for a large number of cancer‐related deaths. The incidence has been near stable over the last years. It continuously shows 2 peaks in occurrence in early childhood and later adulthood. With an incidence of 3.7 per 100,000 persons and an age‐dependent mortality of 2.7 to nearly 18 per 100,000 persons, there is a rising awareness in the Western world of AML's special attributes resulting from an ever‐aging population. To objectively describe epidemiologic data on this patient population, recent publications were evaluated to make transparent the current trends and facts. A review of the literature is presented, reflecting highlights of current research with respect to AML etiology. To estimate outcome and discuss informed treatment decisions with AML patients of different age groups and different biologic risk categories, it is mandatory to consider that the outcome results reported in clinical trials were until now heavily biased toward younger patients, whereas the overall dismal prognosis documented in population‐based studies most likely reflects the exclusion of older patients from aggressive treatment. The etiology for most cases of AML is unclear, but a growing knowledge concerning leukemogenenic agents within chemotherapy regimens for other malignancies is already available. This includes specific associations of the most frequent balanced translocations in AML, including the “good‐risk” abnormalities comprised by the core binding factor leukemias (i.e., AML with the translocation (8;21) and inversion of chromosome 16, and acute promyelocytic leukemia with the translocation (15;17)). In contrast to these genetic alterations, epigenetic lesions, e.g., promoter silencing by hypermethylation of the p15/INK4b and other genes, are increasingly recognized as important in the pathogenesis of AML. Cancer 2006. © 2006 American Cancer Society.
Despite rapid progress in basic science and clinical research, acute myeloid leukemias remain a leading cause of death due to cancer in the Western world. The current review presents facts concerning incidence and outcomes.