Acute myeloid leukemia epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Rim Halaby, M.D. [3] Carlos A Lopez, M.D. [4] Shyam Patel [5]
Overview
In 2015, the incidence of acute myeloid leukemia was approximately 6.5 per 100,000 individuals with a case-fatality rate of approximately 50% in the United States. The incidence of acute myeloid leukemia increases with age; the median age at diagnosis is 63 years. Males are more commonly affected by acute myeloid leukemia than women. The male to female ratio is approximately 1.3 to 1. Incidence of acute promyelocytic leukemia is relatively rare. It predominantly affects people of Latin American descent and least commonly affects African Americans. It is more common in older adults.
Epidemiology and Demographics
Incidence
- Acute myeloid leukemia is a relatively rare cancer. There are approximately 20,500 new cases each year in the United States, and the incidence rate has remained stable from 1995 through 2005.
- Acute myeloid leukemia accounts for 1.2% of all cancer deaths in the United States.
- The case fatality rate of acute myeloid leukemia is approximately of 50% in the United States.
- In 2011, the age-adjusted incidence of acute myeloid leukemia was 4.05 per 100,000 persons in the United States.[1]
- The incidence of acute myeloid leukemia overall is estimated to be 6.5 per 100,000 individuals in the United States.
- In infants younger than 1 year old, the incidence is 1.5 per 100,000 persons.[2]
- In patients above the age of 80, the incidence of acute myeloid leukemia is 25 per 100,000 persons.[2]
- In the first decade of life, the incidence is 0.4 cases per 100,000 persons.[2]
- In the second decade of life, the incidence is 1 case per 100,000 persons.[2]
Incidence of Acute Promyelocytic Leukemia
Acute promyelocytic leukemia is a sub-category of acute myeloid leukemia and has a slightly different demographics than other forms of acute myeloid leukemia.
- The incidence of acute promyelocytic leukemia is 0.2 to 0.26 per 100,000 annually in the United States, which corresponds to 600-800 cases of acute promyelocytic leukemia per year.[3]
- Acute promyelocytic leukemia affects approximately 1,500 people per year in the United States.[4]
- Caucasians are more commonly affected by acute promyelocytic leukemia than African Americans.[3] The incidence in Caucasians is 0.18 per 100,000, while the incidence with African Americans is 0.14 per 100,000.[3]
- Asians and Pacific islanders are more commonly affected by acute promyelocytic leukemia than African Americans.[3]
- The incidence is higher in people of Latin American descent compared to Caucasian descent.
- Acute promyelocytic leukemia represents 10-15%% of all cases of acute myeloid leukemia in adults.[5] The median age is approximately 40 years, which is considerably younger than the other sub-types of acute myeloid leukemia (70 years).
- The incidence of acute promyelocytic leukemia has increased over time from 1975-2008.[3]
Age
- The incidence of acute myeloid leukemia increases with age; the median age at diagnosis is 63 years.
- Acute myeloid leukemia accounts for about 90% of all acute leukemias in adults but is rare in children.
- The rate of therapy-related Acute myeloid leukemia (that is, acute myeloid leukemia caused by previous chemotherapy) is rising. Therapy-related disease currently accounts for about 10–20% of all cases of acute myeloid leukemia.[6]
- While the overall age-adjusted incidence of acute myeloid leukemia in the United States between 2007 and 2011 is 3.8 per 100,000, the age-adjusted incidence of acute myeloid leukemia by age category is:[1]
- Under 65 years: 1.8 per 100,000
- 65 and over: 17.5 per 100,000
- Similarly, older patients are more likely to develop acute promyelocytic leukemia than younger patients.
- The incidence of acute promyelocytic leukemia in people above age 60 is 0.36 per 100,000. The incidence in people under age 20 is 0.06 per 100,000.
Gender
- Acute myeloid leukemia is slightly more common in men, with a male-to-female ratio of 1.3:1.[7]
- In the United States, the age-adjusted incidence of acute myeloid leukemia by gender on 2011 is:[1]
- In males: 4.97 per 100,000 persons
- In females: 3.32 per 100,000 persons
- Shown below is an image depicting the observed incidence of myeloid leukemia by gender the United States between 1975 and 2011. These graphs were adapted from SEER: The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.[1]
- In acute promyelocytic leukemia, men are more commonly affected than women. The incidence per year in men is 0.19 per 100,000, while for women is 0.17 per 100,000.[3]
Developed Countries
- There is some geographic variation in the incidence of acute myeloid leukemia. In adults, the highest rates are seen in North America, Europe, and Oceania.
- In contrast, childhood acute myeloid leukemia is less common in North America.
- In the United Kingdom, acute myeloid leukemia accounts for 34% of all leukemia cases, and around 2,900 people were diagnosed with the disease in 2011.[8]
Developing Countries
- Adult acute myeloid leukemia is more rare in Asian and Latin American countries.[9][10]
- Childhood acute myeloid leukemia is less common in India than in other parts of Asia.[11]
These factual differences may be due to population genetics, environmental factors, or a combination of the two.
References
- ↑ 1.0 1.1 1.2 1.3 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.
- ↑ 2.0 2.1 2.2 2.3 Lagunas-Rangel FA, Chávez-Valencia V, Gómez-Guijosa MÁ, Cortes-Penagos C (2017). "Acute Myeloid Leukemia-Genetic Alterations and Their Clinical Prognosis". Int J Hematol Oncol Stem Cell Res. 11 (4): 328–339. PMC 5767295. PMID 29340131.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Chen Y, Kantarjian H, Wang H, Cortes J, Ravandi F (2012). "Acute promyelocytic leukemia: a population-based study on incidence and survival in the United States, 1975-2008". Cancer. 118 (23): 5811–8. doi:10.1002/cncr.27623. PMC 4180246. PMID 22707337.
- ↑ Kumar S, Yedjou CG, Tchounwou PB (2014). "Arsenic trioxide induces oxidative stress, DNA damage, and mitochondrial pathway of apoptosis in human leukemia (HL-60) cells". J Exp Clin Cancer Res. 33: 42. doi:10.1186/1756-9966-33-42. PMC 4049373. PMID 24887205.
- ↑ Chen C, Huang X, Wang K, Chen K, Gao D, Qian S (2018). "Early mortality in acute promyelocytic leukemia: Potential predictors". Oncol Lett. 15 (4): 4061–4069. doi:10.3892/ol.2018.7854. PMC 5835847. PMID 29541170.
- ↑ Leone G, Mele L, Pulsoni A, et al: The incidence of secondary leukemias. Haematologica 84:937, 1999. PMID 10509043
- ↑ Greenlee RT, Hill-Harmon MB, Murray T, et al: Cancer statistics, 2001 erratum appears in CA Cancer J Clin 2001 Mar-Apr;51(2):144. CA Cancer J Clin 2001;51:15–36. PMID 11577478
- ↑ "Acute myeloid leukaemia acute myeloid leukemia statistics". Cancer Research UK. Retrieved 27 October 2014.
- ↑ Linet MS: The leukemias: Epidemiologic aspects. In Lilienfeld AM (ed): Monographs in Epidemiology and Biostatistics. New York, Oxford University Press, 1985, p I.
- ↑ Aoki K, Kurihars M, Hayakawa N, et al: Death Rates for Malignant Neoplasms for Selected Sites by Sex and Five-Year Age Group in 33 Countries 1953–57 to 1983–87. Nagoya, Japan, University of Nagoya Press, International Union Against Cancer, 1992.
- ↑ Bhatia S, Neglia JP: Epidemiology of childhood acute myelogenous leukemia. J Pediatr Hematol Oncol 17:94, 1995. PMID 7749772