Epidemiology of acute myelogenous leukemia.

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.