Pulsoni A, Stazi A, Cotichini R, Allione B, Cerri R, Di Bona E, Nosari A M, Pagano L, Recchia A, Ribersani M, Rocchi L, Veneri D, Visani G, Mandelli F, Mele A
Department of Cellular Biotechnology and Haematology, University La Sapienza Roma, Italy.
Eur J Haematol. 1998 Nov;61(5):327-32. doi: 10.1111/j.1600-0609.1998.tb01096.x.
Acute promyelocytic leukaemia (APL) exhibits peculiar epidemiological, clinical, cytogenetic and molecular features, compared to the other acute myeloid leukaemias (AML). Data on epidemiology and occupational risk factors for APL desumed from the GIMEMA archive are reported and compared with those of the other AML. An exploratory case-case study was designed on AML patients from 56 haematology centres in Italy. Overall, 4296 patients older than 15 yr with a new diagnosis of acute leukaemia were recorded between July 1992 and July 1997. Of these, 335 were classified as APL, and 2894 as other AML. The median age of APL patients was 43 compared to 59 yr for the other AML (p < 0.00001). In order to identify peculiar risk factors for APL development, different parameters were compared in the 2 groups. After adjusting by age no significant differences were observed with regard to education, lifetime prevalence of cancer among siblings and previous diseases in the patient's history. Occupational exposure as a possible risk factor for APL showed no increased risk compared to other AML among farmers, builders and leather workers. A significant association was found in electricians (OR=4.4, 95% CI=2.0-9.7) and a weak association was found in wood workers (OR=3.2, 95% CI=0.8-10.8). The proportion of APL with respect to other AML was significantly higher in the north east of Italy compared to the rest of the country (OR=1.7, 95% CI=1.3-2.2). These data confirm the younger age of APL patients compared to the other AML. A possible role of electromagnetic fields is suggested by the higher risk of APL in electrical workers and in the more industrialized areas of the country.
与其他急性髓系白血病（AML）相比，急性早幼粒细胞白血病（APL）具有独特的流行病学、临床、细胞遗传学和分子特征。本文报告了从GIMEMA档案中得出的关于APL的流行病学和职业危险因素的数据，并与其他AML的数据进行了比较。对来自意大利56个血液学中心的AML患者进行了一项探索性病例对照研究。总体而言，在1992年7月至1997年7月期间，记录了4296例年龄超过15岁的新诊断急性白血病患者。其中，335例被归类为APL，2894例为其他AML。APL患者的中位年龄为43岁，而其他AML患者为59岁（p < 0.00001）。为了确定APL发生的特殊危险因素，对两组中的不同参数进行了比较。在按年龄调整后，在教育程度、兄弟姐妹中癌症的终生患病率以及患者病史中的既往疾病方面未观察到显著差异。与其他AML相比，农民、建筑工人和皮革工人中职业暴露作为APL的可能危险因素并未显示出风险增加。在电工中发现有显著关联（OR = 4.4，95% CI = 2.0 - 9.7），在木工中发现有微弱关联（OR = 3.2，95% CI = 0.8 - 10.8）。与该国其他地区相比，意大利东北部APL相对于其他AML的比例显著更高（OR = 1.7，95% CI = 1.3 - 2.2）。这些数据证实了APL患者比其他AML患者年龄更小。电工中APL风险较高以及该国工业化程度较高地区提示了电磁场可能发挥作用。
