title: Epidemiology of acute promyelocytic leukemia.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Istituto Superiore di Sanità, Roma, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mele
authors.forename: M A
authors.initials: MA
authors.lastname: Stazi
authors.forename: A
authors.initials: A
authors.lastname: Pulsoni
authors.forename: G
authors.initials: G
authors.lastname: Visani
authors.forename: B
authors.initials: B
authors.lastname: Monarca
authors.forename: G
authors.initials: G
authors.lastname: Castelli
authors.forename: L
authors.initials: L
authors.lastname: Rocchi
authors.forename: G
authors.initials: G
authors.lastname: Avvisati
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001554:Benzene / Q000009:adverse effects; D016022:Case-Control Studies; D016000:Cluster Analysis; D003252:Construction Materials; D004781:Environmental Exposure; D005260:Female; D005720:Gamma Rays / Q000009:adverse effects; D006202:Hair Dyes / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D015473:Leukemia, Promyelocytic, Acute / Q000453:epidemiology* / Q000209:etiology; D007953:Leukemia, Radiation-Induced / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology; D016017:Odds Ratio; D011289:Preleukemia / Q000453:epidemiology; D011886:Radon / Q000009:adverse effects; D012307:Risk Factors
chemical_list: D006202:Hair Dyes; D001554:Benzene; D011886:Radon