Acute promyelocytic leukemia risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2] Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [3]; Grammar Reviewer: Natalie Harpenau, B.S.[4]

Risk factors for acute promyelocytic leukemia are similar to risk factors for acute myeloid leukemia. These include advanced age, benzene exposure, prior myelodysplastic syndrome, and germline mutations.

• Advanced age
  • This is the most common risk factor for acute leukemia.
  • Elderly patients are more likely to develop myeloid leukemia, due to a longer duration and opportunity for mutations to accumulate in cells.
  • These mutations are more likely to accumulate in hematopoietic stem cells through a process called clonal evolution.^[1]
• Benzene
  • Benzene is a chemical solvent and aromatic hydrocarbon, for which exposure is a significant risk factor for acute leukemia.^[2]
• Prior myelodysplastic syndrome:
  • Myelodysplastic syndrome is a disorder characterized by ineffective hematopoiesis, defective maturation of blood cells, and peripheral cytopenias.
  • Antecedant myelodysplastic syndrome is implicated in some forms of acute leukemia, such as acute myeloid leukemia.
  • Myelodysplastic syndrome is a precursor for leukemia, as this disease is characterized by the presence of dysplastic or cancerous cells that do not meet the requirements for a formal diagnosis of leukemia.^[3]
• Germline mutations
  • In general, germline predisposition to acute promyelocytic leukemia is rare. In patients with acute myeloid leukemia, germline mutations in the RUNX1 gene can predispose to the development of the cancer.^[4]

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