TAILIEUCHUNG - Chapter 104. Acute and Chronic Myeloid Leukemia

The myeloid leukemias are a heterogeneous group of diseases characterized by infiltration of the blood, bone marrow, and other tissues by neoplastic cells of the hematopoietic system. In 2006 the estimated number of new myeloid leukemia cases in the United States was 16,430. These leukemias comprise a spectrum of malignancies that, untreated, range from rapidly fatal to slowly growing. Based on their untreated course, the myeloid leukemias have traditionally been designated acute or chronic. | Chapter 104. Acute and Chronic Myeloid Leukemia The myeloid leukemias are a heterogeneous group of diseases characterized by infiltration of the blood bone marrow and other tissues by neoplastic cells of the hematopoietic system. In 2006 the estimated number of new myeloid leukemia cases in the United States was 16 430. These leukemias comprise a spectrum of malignancies that untreated range from rapidly fatal to slowly growing. Based on their untreated course the myeloid leukemias have traditionally been designated acute or chronic. Acute Myeloid Leukemia Incidence The incidence of acute myeloid leukemia AML is per 100 000 people per year and the age-adjusted incidence is higher in men than in women versus . AML incidence increases with age it is in individuals 65 years and in those 65. A significant increase in AML incidence has occurred over the past 10 years. Etiology Heredity radiation chemical and other occupational exposures and drugs have been implicated in the development of AML. No direct evidence suggests a viral etiology. Heredity Certain syndromes with somatic cell chromosome aneuploidy such as trisomy 21 noted in Down syndrome are associated with an increased incidence of AML. Inherited diseases with defective DNA repair . Fanconi anemia Bloom syndrome and ataxia telangiectasia are also associated with AML. Congenital neutropenia Kostmann syndrome is a disease with mutations in the granulocyte colony-stimulating factor G-CSF receptor and often neutrophil elastase that may evolve into AML. Myeloproliferative syndromes may also evolve into AML Chap. 103 . Germ-line mutations of CCAAT enhancer-binding protein a C EBP a runt-related transcription factor 1 RUNX1 and tumor protein p53 TP53 have also been associated with a higher predisposition to AML in some series. Radiation Survivors of the atomic bomb explosions in Japan had an increased incidence of myeloid leukemias that peaked 5-7 years after exposure. Therapeutic radiation .

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