title: Global characteristics of childhood acute promyelocytic leukemia.
abstract: Acute promyelocytic leukemia (APL) comprises approximately 5-10% of childhood acute myeloid leukemia (AML) cases in the US. While variation in this percentage among other populations was noted previously, global patterns of childhood APL have not been thoroughly characterized. In this comprehensive review of childhood APL, we examined its geographic pattern and the potential contribution of environmental factors to observed variation. In 142 studies (spanning >60 countries) identified, variation was apparent-de novo APL represented from 2% (Switzerland) to >50% (Nicaragua) of childhood AML in different geographic regions. Because a limited number of previous studies addressed specific environmental exposures that potentially underlie childhood APL development, we gathered 28 childhood cases of therapy-related APL, which exemplified associations between prior exposures to chemotherapeutic drugs/radiation and APL diagnosis. Future population-based studies examining childhood APL patterns and the potential association with specific environmental exposures and other risk factors are needed.
authors.affiliation: School of Public Health, University of California, Berkeley, USA. Electronic address: luoping@berkeley.edu.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.affiliation: School of Public Health, University of California, Berkeley, USA. Electronic address: aaida.samad@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Samad
authors.affiliation: Pediatric Hematology-Oncology Program, Research Center-National Institute of Cancer, Rio de Janeiro, Brazil. Electronic address: mpombo@inca.gov.br.
authors.forename: M S
authors.initials: MS
authors.lastname: Pombo-de-Oliveira
authors.affiliation: International Agency for Research on Cancer (IARC), Lyon, France. Electronic address: scelog@iarc.fr.
authors.forename: G
authors.initials: G
authors.lastname: Scelo
authors.affiliation: School of Public Health, University of California, Berkeley, USA. Electronic address: martynts@berkeley.edu.
authors.forename: M T
authors.initials: MT
authors.lastname: Smith
authors.affiliation: Department of Hematology, Children's Hospital and Research Center Oakland, Oakland, USA. Electronic address: jfeusner@mail.cho.org.
authors.forename: J
authors.initials: J
authors.lastname: Feusner
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, USA. Electronic address: joe.wiemels@ucsf.edu.
authors.forename: J L
authors.initials: JL
authors.lastname: Wiemels
authors.affiliation: School of Public Health, University of California, Berkeley, USA. Electronic address: cmetayer@berkeley.edu.
authors.forename: C
authors.initials: C
authors.lastname: Metayer
mesh_terms: D002648:Child; D003582:Cytogenetics; D004781:Environmental Exposure / Q000009:adverse effects; D062306:Geography, Medical; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D011379:Prognosis; D012307:Risk Factors
keywords: AML-M3; Acute promyelocytic leukemia; Environmental exposure; Pediatric leukemia; Risk factors; Therapy-related leukemia