EPIDEMIOLOGY OF ACUTE PROMYELOCYTIC LEUKEMIA

Background The estimated incidence of acute promyelocytic leukemia (AP L) is approximately 6 cases per 10 million people per year with no app arent differences between sexes. The age of APL cases is younger than that of other acute myeloid leukemias (AML). Spatial and temporal clus ters of APL have been reported. These observations suggest a possible selective role for environmental and/or occupational factors in APL de velopment. Method. A multicenter case-control study was carried out on risk factors for acute leukemias and preleukemias. In this report dat a related to APL are selectively analyzed from the larger study to ide ntify specific risk factors. Results. The case-control study on 38 cas es of APL showed a strong association with shoemaking (odds ratio 6.3, 95% confidence interval 1.3-31.1). A moderate leukemogenic effect fro m living in houses built with tuff, a porous building material contain ing gamma-emitting radionuclides and having a high radon concentration , and from using hair dyes was also suggested. Conclusions. These data , together with the reported spatial and temporal clustering of APL, s upport the hypothesis of specific environmental and/or occupational ri sk factors for APL among other AML subtypes and indicate the need for additional ad hoc multicenter studies.