Bhatia S, Neglia J P
Division of Pediatric Hematology/Oncology, University of Minnesota School of Medicine, Minneapolis, USA.
J Pediatr Hematol Oncol. 1995 May;17(2):94-100. doi: 10.1097/00043426-199505000-00002.
Acute myelogenous leukemia (AML) is the second most common leukemia in children, with approximately 400 new cases occurring annually in the United States. Worldwide, the highest rates of childhood AML occur in Asia and the lowest rates are reported from India and South America. Numerous genetic risk factors for childhood AML have been defined, including Down syndrome, neurofibromatosis, and Fanconi anemia. Research into environmental risk factors has been limited by the rarity of this disease; however, studies of AML in adults have implicated ionizing radiation, solvents, and petroleum products as potential etiologic agents. The largest analytic study of childhood AML found that occupational exposures of either parent to pesticides, paternal exposure to petroleum products, and postnatal exposures to pesticides are increased in children with AML. In addition, maternal use of marijuana during pregnancy was associated with an increased risk of AML, especially the monocytic subtypes. Further study of childhood AML, including occurrence of the disease as a second malignancy, is needed in order to confirm these findings and to increase our understanding of this leukemia.
急性髓细胞白血病（AML）是儿童中第二常见的白血病，在美国每年约有400例新发病例。在全球范围内，儿童AML发病率最高的地区是亚洲，而印度和南美洲的发病率最低。已经确定了许多儿童AML的遗传风险因素，包括唐氏综合征、神经纤维瘤病和范可尼贫血。由于这种疾病罕见，对环境风险因素的研究受到限制；然而，对成人AML的研究表明，电离辐射、溶剂和石油产品是潜在的病因。一项关于儿童AML的最大规模分析研究发现，AML患儿的父母任何一方的职业性接触杀虫剂、父亲接触石油产品以及出生后接触杀虫剂的情况都有所增加。此外，母亲在孕期使用大麻与AML风险增加有关，尤其是单核细胞亚型。需要对儿童AML进行进一步研究，包括将该疾病作为第二种恶性肿瘤的发生情况，以证实这些发现并增进我们对这种白血病的了解。
