Mele A, Stazi M A, Pulsoni A, Visani G, Monarca B, Castelli G, Rocchi L, Avvisati G, Mandelli F
Istituto Superiore di Sanità, Roma, Italy.
Haematologica. 1995 Sep-Oct;80(5):405-8.
The estimated incidence of acute promyelocytic leukemia (APL) is approximately 6 cases per 10 million people per year with no apparent differences between sexes. The age of APL cases is younger than that of other acute myeloid leukemias (AML). Spatial and temporal clusters of APL have been reported. These observations suggest a possible selective role for environmental and/or occupational factors in APL development.
A multicenter case-control study was carried out on risk factors for acute leukemias and preleukemias. In this report data related to APL are selectively analyzed from the larger study to identify specific risk factors.
The case-control study on 38 cases of APL showed a strong association with shoemaking (odds ration 6.3, 95% confidence interval 1.3-31.1). A moderate leukemogenic effect from living in houses built with tuff, a polous building material containing gamma-emitting radionuclides and having a high radon concentration, and from using hair dyes was also suggested.
These data, together with the reported spatial and temporal clustering of APL, support the hypothesis of specific environmental and/or occupational risk factors for APL among other AML subtypes and indicate the need for additional ad hoc multicenter studies.
急性早幼粒细胞白血病（APL）的估计发病率约为每年每1000万人中有6例，男女之间无明显差异。APL患者的年龄比其他急性髓系白血病（AML）患者的年龄小。已有报道称APL存在时空聚集现象。这些观察结果表明环境和/或职业因素在APL发病过程中可能起到选择性作用。
针对急性白血病和白血病前期的危险因素开展了一项多中心病例对照研究。在本报告中，从规模更大的研究中选择性分析了与APL相关的数据，以确定具体的危险因素。
对38例APL患者进行的病例对照研究显示，APL与制鞋行业密切相关（优势比为6.3，95%置信区间为1.3 - 31.1）。研究还表明，居住在用凝灰岩建造的房屋中以及使用染发剂也有一定的致白血病作用，凝灰岩是一种含有发射γ射线的放射性核素且氡浓度较高的多孔建筑材料。结论：这些数据，连同已报道的APL时空聚集现象，支持了在其他AML亚型中APL存在特定环境和/或职业危险因素的假说，并表明有必要开展更多专门的多中心研究。
