A number of risk factors for developing AML have been identified, including: other blood disorders, chemical exposures, ionizing radiation, and genetics.
Preleukemia
"Preleukemic" blood disorders such as myelodysplastic syndrome or myeloproliferative disease can evolve into AML; the exact risk depends on the type of MDS/MPS.
Chemical exposure
Exposure to anti-cancer chemotherapy, in particular alkylating agents, can increase the risk of subsequently developing AML.
The risk is highest about 3–5 years after chemotherapy. Other chemotherapy agents, specifically epipodophyllotoxins and anthracyclines, have also been associated with treatment-related leukemia.
These treatment-related leukemias are often associated with specific chromosomal abnormalities in the leukemic cells.
Occupational chemical exposure to benzene and other aromatic organic solvents is controversial as a cause of AML. Benzene and many of its derivatives are known to be carcinogenic ''in vitro''.
While some studies have suggested a link between occupational exposure to benzene and increased risk of AML, others have suggested that the attributable risk, if any, is slight.
Radiation
Ionizing radiation exposure can increase the risk of AML. Survivors of the atomic bombings of Hiroshima and Nagasaki had an increased rate of AML, as did radiologists exposed to high levels of X-rays prior to the adoption of modern radiation safety practices.
Genetics
A hereditary risk for AML appears to exist. There are numerous reports of multiple cases of AML developing in a family at a rate higher than predicted by chance alone.
The risk of developing AML is increased threefold in first-degree relatives of patients with AML.
Several congenital conditions may increase the risk of leukemia; the most common is probably Down syndrome, which is associated with a 10- to 18-fold increase in the risk of AML.
Further Reading
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"Acute myeloid leukemia"
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