Epidemiology

Epidemiology

  • In 2018, there were an estimated 19,520 new cases of acute myeloid leukemia (AML) in the United States, accounting for 1.1% of all new cancer cases.1
  • Approximately 10,670 individuals died from AML in the United States in 2018. AML-related deaths account for 1.8% of all cancer deaths yearly.1
  • It is estimated that 0.5% of men and women in the United States will be diagnosed with AML at some point during their lifetime.1
  • The percentage of individuals with AML who survive 5 years or more after diagnosis is 27.4%. The 5-year survival rate for people under 20 years of age is 67%.2
  • AML is most frequently diagnosed in people aged 65 to 74 years, with a median age at diagnosis of 68 years. AML is uncommon in people under the age of 45.1,2
  • The median age at death for AML patients is 72 years, with the highest rate of death in individuals aged 75 to 84.1
  • Rates of new AML cases and AML-related deaths have been stable over the last 10 years.1
  • AML accounts for approximately 32% of all adult leukemia cases, and it is the most common form of acute leukemia among adults.2
  • Approximately 60% to 70% of adults with AML can be expected to attain complete remission with appropriate induction therapy. About 45% of patients with complete remission will survive 3 or more years and may be cured. There is no survival benefit associated with partial remission.3
  • Remission rates in AML are inversely proportional to age, with an expected remission rate greater than 65% in patients younger than 60 years. Duration of remission is shorter in older individuals and induction therapy is associated with more morbidity and mortality in older patients.3

 

Prognostic and Risk Factors

  • Age: Although AML can occur at any age, it is more common in older adults, with half of AML patients diagnosed after the age of 65.4
  • Smoking: An increased risk of AML is associated with smoking.4
  • Previous cancer treatment: People exposed to chemotherapy and/or radiation to treat other types of cancer, such as breast cancer, ovarian cancer, or lymphoma, have a higher risk of developing AML in the future.4
  • Genetic disorders: AML occurs more often in patients with certain inherited genetic disorders, including Down syndrome, ataxia telangiectasia, Li-Fraumeni syndrome, Klinefelter syndrome, Fanconi anemia, Wiskott-Aldrich syndrome, Bloom syndrome, and Familial Platelet Disorder syndrome.4
  • Other bone marrow disorders: People with myeloproliferative and other bone marrow disorders have an increased risk of developing AML. These bone marrow disorders include polycythemia vera, myelofibrosis, essential thrombocytosis, myelodysplastic syndromes, and aplastic anemia.4
  • Environmental exposures: An increased risk of AML is associated with exposure to high levels of radiation, such as in long-term survivors of atomic bombs or nuclear reaction accidents, and long-term contact with benzene found in petroleum, cigarette smoke, and industrial workplaces.4
  • Adverse prognostic factors for AML include central nervous system involvement, systemic infection at diagnosis, elevated white blood cell counts (>100,000/mm3), treatment-induced AML, and a history of myelodysplastic syndromes or other hematological disorders.3
  • An inferior outcome is associated with progenitor cell antigen CD34 and/or the p-glycoprotein (MDR1 gene product) expression. FLT3 internal tandem duplication (FLT3/ITD mutation) is associated with inferior outcome and higher relapse rate.3

References

  1. National Cancer Institute. Surveillance, Epidemiology, and End Results Program (SEER). Cancer Stat Facts: Leukemia – Acute Myeloid Leukemia (AML). https://seer.cancer.gov/statfacts/html/amyl.html. Accessed March 20, 2019.
  2. Cancer.net Leukemia – Acute Myeloid – AML: Statistics. https://www.cancer.net/cancer-types/leukemia-acute-myeloid-aml/statistics. Accessed March 20, 2019.
  3. National Cancer Institute. Adult Acute Myeloid Leukemia Treatment (PDQ) – Health Professional Version. https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq. Accessed March 20, 2019.
  4. Cancer.net Leukemia – Acute Myeloid – AML: Risk Factors. https://www.cancer.net/cancer-types/leukemia-acute-myeloid-aml/risk-factors. Accessed March 20, 2019.