CORRELATION BETWEEN SELECTED ENVIRONMENTAL EXPOSURES AND KARYOTYPE INACUTE MYELOCYTIC-LEUKEMIA

Many bone marrow cytogenetic abnormalities in acute myelogenous leukem ia (AML) are tumor specific, clonal, nonrandom, and related to prognos is; it has been hypothesized that they may be markers of exposure to e tiological agents, A previous report from our institution revealed sev eral such associations; the purpose of the current study was to determ ine whether previous findings were present in a new group of patients, Subjects included 84 newly diagnosed AML patients (French-American-Br itish M(1) and M(2)); exposure data were gathered using self-report qu estionnaires at the time of registration, Two sets of comparisons were made: (a) patients with all (AA) or some (AN) cytogenetically abnorma l cells versus those with normal karyotypes (NN) and (b) patients with specific abnormalities [-5/5q-, -7/7q-, +8, t(8;21)] versus all other s, Odds ratios (ORs) were 4.64 for the association between prior cytot oxic therapy and -5/5q- and 6.38 for the association with -7/7q-, but were <1.00 for +8 and t(8;21), There were no ORs >2.0 for specific abn ormalities in any of the other exposures evaluated (cigarette smoking, alcohol use, occupational exposure to organic chemicals, paints, or p esticides/herbicides), with the exception of exposure to paints and -7 /7q- (OR, 7.50), The ORs for AA/AN versus NN patients were 1.43 and 3. 81 for smoking and alcohol use, and weak dose-response trends were pre sent, The most consistent positive associations between the two series were for prior cytotoxic therapy (-5/5q-; -7/7q-), cigarette smoking (AA/AN versus NN) and alcohol use (AA/AN versus NN), Reasoning from th e known association between prior cytotoxic therapy and -7/7q-, we wou ld have predicted relatively high ORs (>4.0) if specific abnormalities acted as markers for the exposures assessed, but none were present, H owever, in both series, AA/AN patients were more likely to smoke and u se alcohol than were NN patients, and weak dose-response patterns were present for both, This finding suggests that both smoking and alcohol use may play a role in the pathogenesis of cytogenetic abnormalities in AML-M(1)/M(2); however, the mechanism by which they work and whethe r they are involved in the etiology of these diseases remain unclear.