Sandler D P
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709.
Semin Oncol. 1987 Dec;14(4):359-64.
The epidemiologic literature suggests that environmental exposures, familial susceptibility, and cytogenetic changes affect AML risk in childhood and adulthood. Unfortunately, many studies are limited by inadequate sample sizes, imprecise case definition, or inadequate exposure measurement. Few studies have singled out AML alone, either because of insufficient numbers or because methods of case ascertainment made it difficult to distinguish specific cell types. Studies of total leukemia or all acute leukemias offer insights into potential risk factors for AML, but may also be misleading in instances when few AML patients were actually included. Future studies should include adequate numbers of patients with AML. At the same time, further refinement of case definition through parameters such as specific cytogenetic changes may make risk factor identification in epidemiologic studies more likely.
流行病学文献表明，环境暴露、家族易感性和细胞遗传学改变会影响儿童期和成年期患急性髓系白血病（AML）的风险。不幸的是，许多研究受到样本量不足、病例定义不精确或暴露测量不充分的限制。很少有研究单独针对AML进行研究，要么是因为数量不足，要么是因为病例确定方法难以区分特定细胞类型。对总白血病或所有急性白血病的研究提供了有关AML潜在危险因素的见解，但在实际纳入的AML患者很少的情况下也可能产生误导。未来的研究应纳入足够数量的AML患者。同时，通过特定细胞遗传学改变等参数进一步完善病例定义，可能会使流行病学研究中更有可能识别出危险因素。
