Anything that increases your risk of getting cancer is called a “risk factor”. Having a risk factor does not automatically mean that you will get AML, but it does put you at higher risk compared to other people. Talk with your doctor if you think you may be at risk.
Risk factors for AML include:
- Older age: As mentioned earlier, the risk of developing AML increases as people get older. AML is more common in people aged 65 and older.
- Previous treatment with chemotherapy or radiation: People who have been treated for lymphoma or breast cancer with chemotherapy drugs or radiation therapy are at increased risk of developing AML several years after they were treated. Radiation or chemotherapy drugs can damage the DNA of blood-forming cells in the bone marrow. With time, these cells can become more and more abnormal looking and can eventually transform into leukemia cells. Abnormal changes in blood-forming cells in the bone marrow are also referred to as “myelodysplasia”. When AML develops in people who have received chemotherapy or radiation therapy, it is commonly referred to as “therapy-related AML”.
It is important to remember that although the risk of developing AML after receiving chemotherapy or radiation therapy exists, it is still very small. Less than 2% of patients who have been treated with chemotherapy or radiation will end up developing AML.
- Exposure to benzene: Benzene is a chemical commonly used in making plastic, rubber, paint and detergents. Gasoline and some pesticides also contain benzene. Exposure to benzene over a long period of time has been associated with greater risk of developing AML. Just like radiation or chemotherapy, chronic benzene exposure can also lead to alterations in the DNA of blood-forming cells that predispose people to develop acute leukemia.
Levels of exposure putting someone at risk for developing AML sometimes occur in people who work in oil refineries, rubber, paint, detergent or gasoline-related industries.
- Smoking: Smoking cigarettes can increase the risk of developing AML. There is a dose-response relationship between cigarette smoking and AML (this means that the risk increases with the number of cigarettes smoked per day and the number of years the person has smoked).
The mechanism by which smoking influences leukemia risk is not entirely clear. It is thought that benzene and other DNA-damaging carcinogens found in cigarette smoke are likely to be the culprits.
- Exposure to very high doses of radiation: People who got exposed to very high levels of radiation from an atomic bomb blast (e.g. Hiroshima and Nagasaki nuclear bombing) or nuclear reactor accident (Chernobyl accident) were found to be at higher risk for developing AML several years after radiation exposure.
- Certain blood disorders: Having certain blood disorders, such as polycythemia vera, primary myelofibrosis, essential thrombocythemia, increases someone’s risk of developing AML several years after being diagnosed with these disorders. Some people who have a condition called myelodysplastic syndrome (or MDS for short) are also at increased risk of developing AML. In MDS, damage to the DNA of blood-forming cells occurs leading to abnormal changes in the bone marrow cells (“myelodysplasia”). It is unknown why DNA damage occurs because the majority people with MDS have not been exposed to radiation or chemotherapy.
- Certain genetic conditions: For example, children with Down syndrome are at increased risk for AML (approximately 1-2% of children with Down syndrome develop AML). People with inherited genetic disorders such as Fanconi anemia, Bloom syndrome, ataxia-telangiectasia, Li-Fraumeni syndrome are at higher risk of developing AML during their life.