| Risk Factors for Acute Leukemia in Children: A Review Martin Belson, Beverely Kingsley, and Adrianne Holmes Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Health Studies Branch, Atlanta, Georgia, USA Abstract
Although overall incidence is rare, leukemia is the most common type of childhood cancer. It accounts for 30% of all cancers diagnosed in children younger than 15 years. Within this population, acute lymphocytic leukemia (ALL) occurs approximately five times more frequently than acute myelogenous leukemia (AML) and accounts for approximately 78% of all childhood leukemia diagnoses. Epidemiologic studies of acute leukemias in children have examined possible risk factors, including genetic, infectious, and environmental, in an attempt to determine etiology. Only one environmental risk factor (ionizing radiation) has been significantly linked to ALL or AML. Most environmental risk factors have been found to be weakly and inconsistently associated with either form of acute childhood leukemia. Our review focuses on the demographics of childhood leukemia and the risk factors that have been associated with the development of childhood ALL or AML. The environmental risk factors discussed include ionizing radiation, nonionizing radiation, hydrocarbons, pesticides, alcohol use, cigarette smoking, and illicit drug use. Knowledge of these particular risk factors can be used to support measures to reduce potentially harmful exposures and decrease the risk of disease. We also review genetic and infectious risk factors and other variables, including maternal reproductive history and birth characteristics. Key words: acute, ALL, AML, children, environment, leukemia, risk factors. Environ Health Perspect 115:138–145 (2007) . doi:10.1289/ehp.9023 available via http://dx.doi.org/ [Online 30 November 2006]
This article is part of the mini-monograph "Cancer Cluster Activities at the Centers for Disease Control and Prevention." Address correspondence to M. Belson, FAAP, CDC/NCEH/EHHE/HSB, 4770 Buford Hwy. NE, Building 101, Room 1154, Atlanta, Georgia 30341 USA. Telephone: (770) 488-3425. Fax: (770) 488-3450. E-mail: mbelson@cdc.gov Supplemental Material is available online at http://www.ehponline.org/docs/2006/9023/suppl.pdf The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the CDC. The authors declare they have no competing financial interests. Received 18 January 2006 ; accepted 13 July 2006.
Correction In the Abstract and in the section "Risk Factors," the sentences "Only two environmental risk factors (benzene and ionizing radiation) have been significantly linked to ALL or AML" in the original manuscript published online have been changed to "Only one environmental risk factor (ionizing radiation) has been significantly linked to ALL or AML" here.
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