Topics in Pediatric Leukemia -- Acute Myeloid Leukemia

Jerry Cheng, MD; Kathleen M. Sakamoto, MD, PhD

In This Article


Acute leukemia is the most common childhood malignancy, representing close to 35% of all childhood cancers. Acute myelogenous leukemia (AML) constitutes 15% to 20% of acute leukemias. There are close to 500 new cases of childhood AML per year in the United States.[1] The incidence reaches a peak at 2 years of age with 12 cases per 1 million people, and a nadir of 3.8 cases per million at 9 years of age. There is another peak after age 16 with close to 9 cases per million.[2,3] Unlike acute lymphoblastic leukemia (ALL), boys and girls are affected equally by AML and disease rates are similar among different racial groups.[4,5]

There are several conditions or external factors that predispose children to develop AML. Environmental exposures include ionizing radiation, chemotherapy (eg, alkylating agents and topoisomerase II inhibitors), and organic solvents.[6] Some hereditary conditions that are associated with a higher incidence of AML include Fanconi's anemia, Diamond-Blackfan syndrome, Li-Fraumeni syndrome, and Down syndrome. Children with Down syndrome have a 15-fold higher incidence of leukemia and are prone to develop a subtype of AML known as acute megakaryocytic leukemia (or M7-AML).[7,8,9]


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