Table of ContentsView AllTable of ContentsConfirmed and Probable Risk FactorsPossible Risk FactorsGeneticsFrequently Asked QuestionsNext in Leukemia GuideHow Leukemia Is Diagnosed
Table of ContentsView All
View All
Table of Contents
Confirmed and Probable Risk Factors
Possible Risk Factors
Genetics
Frequently Asked Questions
Next in Leukemia Guide
Leukemiais due to a series of mutations in genes that control the growth of cells, which leads to their uncontrolled growth in the bone marrow.While the exact causes of this are unknown, several risk factors for the disease have been identified.
Known risk factors vary with the different types of leukemia but include radiation (from atomic bomb exposures to medical radiation), exposures to chemicals such as benzene and pesticides, previous chemotherapy, some infections, and certain genetic conditions. There are others still under investigation as well, such as radon.
Chronic leukemia is much more common in older adults, and though acute leukemia is often thought of as being a childhood cancer, acute myeloid leukemia is actually much more common in adults.For unknown reasons, men are more likely than women to develop the four majortypes of leukemia.
Confirmed and Probable Risk Factors
There are several risk factors for the development of leukemia that have been documented in a number of studies. A risk factor is something that is associated with an increased risk of developing leukemia but does not necessarily cause the disease. Some of these include:
Age
Age as a risk factor for leukemia varies widely with the type of leukemia. Together, acute lymphocytic leukemia (ALL) and acute myelogenous leukemia (AML) account for 30% of childhood cancers .
While many people consider these diseases pediatric cancers, AML is actually much more common in adults (the average age at diagnosis is 68).
Around 40 percent of cases of ALL are in adults; when diagnosed in childhood, it is most common in children under the age of 5 years.
Chronic lymphocytic leukemia (CLL)and chronic myelogenous leukemia (CML) are much more common in older adults and are very uncommon in people under the age of 40.
Gender
The primary types of leukemia (AML, ALL, CML, and CLL) are slightly more common in males than females, but the reason for this is unknown.
Birth Weight
Children who have high birth weights (weight at birth greater than 8.9 pounds or 4000 grams) have a greater risk of developing ALL.
Ethnicity
Racial differences in incidence differ between the types of leukemia.
AML is similar among people of different ethnic backgrounds during childhood, but in adults is more common in non-Hispanic whites.
Radiation
Some types of radiation are known risk factors for leukemia, and others are only possible risk factors. There are two primary types of radiation:
There are a number of different ways in which ionizing radiation has been associated with leukemia. These include:
Previous Chemotherapy
While the benefits ofchemotherapyusually far outweigh the risks, some chemotherapy drugs can predispose a person to leukemia later on.This is true even for the drugs commonly used for early-stage breast cancer.
For most of these drugs, the risk begins to increase two years after treatment and peaks between five and 10 years after treatment.
AML is the form of leukemia most often associated with chemotherapy, but ALL has also been linked to the treatment.Examples of drugs associated with leukemia include Cytoxan (cyclophosphamide); Leukeran (chlorambucil); VePesid (etoposide); Gleostine, CeeNu, and CCNSB (lomustine); Gliadel and BiCNU (carmustine); Myleran (busulfan); Mustargen (mechlorethamine); and Novantrone (mitoxantrone).
Drugssuch as Adriamycin (doxorubicin) and other anthracyclines, Platinol (cisplatin) and other platinum drugs, and bleomycin have been associated with leukemia but less commonly than the drugs mentioned earlier.
Medical Conditions
Some medical conditions are associated with an elevated risk of developing leukemia.Myelodysplastic syndromesare disorders of the bone marrow that have been referred to as “preleukemia” and carry a significant risk of developing into AML (up to 30%).Other conditions such as essential thrombocytopenia, primary myelofibrosis, and polycythemia vera also carry an increased risk.
Furthermore, people who are immunosuppressed, such as those who take immunosuppressive medications due to an organ transplant, have a significantly increased risk of developing leukemia.
Associations have been noted between leukemia in adults and medical conditions such as inflammatory bowel disease (ulcerative colitis and Crohn’s disease), rheumatoid arthritis, systemic lupus erythematosus (lupus), celiac disease, and pernicious anemia, among others. However, a large 2012 studylooking into these associations only found an increased risk relationship with ulcerative colitis and AML, and peptic ulcer disease and CML.
Genetic syndromes may also increase the risk of leukemia (see below).
Smoking
At the current time, it’s thought that around 20 percent of AML cases are linked to smoking.
There is some evidence that leukemia in children may be linked with parent’s smoking, and mothers exposed to secondhand smoke appear to have a slightly elevated risk of developing ALL.
Home and Occupational Exposures
There are a number of exposures that have been associated with leukemia, though the risk varies with the different types of the disease.Some of the substances have been linked clearly in many studies, while others are still uncertain. Some exposures of interest include:
Noting that the incidence of childhood leukemia has been increasing in California, studies looking at environmental exposures that may be associated with this risk are in progress.
Infections
HTLV-1 is relatively uncommon in the United States, but is found in the Caribbean (especially Haiti and Jamaica), Japan, central and west Africa, and Middle East (especially Iran). It’s thought that between 1 and 4% of people who are exposed to the virus will develop leukemia; the most common age of onset is between 30 and 50.
Alcohol
While alcohol consumption is linked with a number of cancers, a 2014 studyfound no association between alcohol use and the four major types of leukemia. There has been a link noted, however, between maternal alcohol consumption during pregnancy and AML in children born to these mothers.
In addition to known and probable risk factors for leukemia, there are several risk factors that are being evaluated for their association with leukemia. Some possible risk factors include:
Western Diet
With many types of leukemia, especially acute leukemia in children, there appears to be little association with dietary practices. In CLL, however, the most common type of leukemia in American adults, diet may play a role.
A 2018 study in Spain found that those who ate a Western diet were 63 percent more likely to develop CLL than those who consumed a Prudent diet or Mediterranean diet.
Sucralose
There has been controversy surrounding a possible connection between the artificial sweetenersucralose and cancer.
Sucralose (with brand names including Splenda and others) was approved in 1999 and is currently in thousands of products worldwide.
Despite a multitude of reassuring studies prior to its approval, a2016 Italian study on micefound that rodents who were exposed to sucralose throughout their lives (beginning in utero) had a significantly increased risk of developing leukemia.
It’s important to note that this was an animal study, and the doses given were equivalent to an adult consuming four times the average amount of sucralose every single day.That said, with the popularity of sucralose as a sugar substitute, it’s thought that young children could easily exceed the FDA’s acceptable daily intake of 5 mg/kg daily.
(Keep in mind that, despite a focused concern about sucralose, questions have been raised about the use of otherartificial sweetenersas well. Ideally, any of these products should be used sparingly in a healthy diet.)
Electromagnetic Fields (Power Lines)
Since 1979, when a study found an increased risk of leukemia in children who lived near high voltage power lines, a number of studies have looked at this possible association with mixed results.Some showed an increased risk with high levels of exposure, and others showed little, if any, effect.
Three analyses that have compared results of studies to date (totaling 31 studies in all) found that high exposures (0.3 uT or higher) were associated with a 1.4 to 2.0 times increased risk of leukemia. This level of exposure, however, is not common. In these studies, only 0.5 to 3.0% of children had an exposure equal to or exceeding 0.3 uT.
Radon
At the current time, there is a possibility that radon in homes, a form of ionizing radiation, may increase the risk of chronic lymphocytic leukemia (CLL).
Radon is a well-known carcinogen, and it’s thought that roughly 27,000 people die from radon-induced lung cancer each year in the United States.
A 2016 studyfound that the areas in the United States where CLL is most common are also the regions known to have the highest radon levels (northern and central states). While the association between radon and leukemia is uncertain, some researchers propose that radon could lead to leukemia in a way similar to how it increases lung cancer risk.
Coffee and Tea
Coffee and tea have both been looked at with regard to the risk of leukemia, and the studies have been mixed.Some indicated an increased risk with more consumption, while others instead showed a potential protective effect (a reduced risk of leukemia). Since people metabolize coffee and tea in different ways (fast metabolizers vs. slow metabolizers), it could be that the effects vary between different people.
Sedentary Lifestyle
While some studies have found no association between level of physical activity and leukemia, a 2016 studyfound that people who engaged in more “leisure physical activity” were around 20% less likely to develop myeloid leukemias than those who were less active.
The role of family history and genetics varies between the different types of leukemia.
ALL does not appear to run in families, with the exception being identical twins, in which one of the siblings in the pair has an increased risk of developing ALL if the other developed the disease before one year of age.That said, there are certain genetic syndromes that are associated with an increased risk of this type of leukemia (see below).
In contrast, family history plays an important role in CLL.
People who have a first-degree family member who has had CLL (parent, sibling, or child) have more than twice the risk of developing the disease themselves.
A family history of AML in first-degree relatives increases risk, but the age at diagnosis is important.Siblings of children with AML have up to a four times higher risk of developing the disease, with the risk in identical twins being around 20%. In contrast, children who have a parent who has adult-onset leukemia do not appear to be at a higher risk.
Family history doesn’t appear to play a significant role in the development of CML.
Genetic conditionsand syndromes that are associated with an increased risk of some types ofleukemia include:
Frequently Asked QuestionsSome of the risk factors for leukemia in childhood include:Genetic disorders, such as Down syndromeInherited immune problems, such as ataxia-telangiectasiaHaving a sibling, particularly a twin, with leukemiaHigh levels of radiation exposureCertain chemotherapy drugs, including cyclophosphamide, doxorubicin, teniposide, and etoposideSymptomsof leukemia can depend on the type of leukemia you have. Some of the common signs and symptoms include:Feeling tired easilyFeverEasy bruising and bleedingSwollen lymph nodesFrequent infectionsUnexplained weight lossBone or joint pain
Some of the risk factors for leukemia in childhood include:Genetic disorders, such as Down syndromeInherited immune problems, such as ataxia-telangiectasiaHaving a sibling, particularly a twin, with leukemiaHigh levels of radiation exposureCertain chemotherapy drugs, including cyclophosphamide, doxorubicin, teniposide, and etoposide
Some of the risk factors for leukemia in childhood include:
Symptomsof leukemia can depend on the type of leukemia you have. Some of the common signs and symptoms include:Feeling tired easilyFeverEasy bruising and bleedingSwollen lymph nodesFrequent infectionsUnexplained weight lossBone or joint pain
Symptomsof leukemia can depend on the type of leukemia you have. Some of the common signs and symptoms include:
How Leukemia Is Diagnosed
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