Page 166 - Essential Haematology

152 / Chapter 11 Haematological malignancy: aetiology and genetics

Males Non-Hodgkin lymphoma
Leukaemia 9%
Colorectal 14% Myeloma
Hodgkin lymphoma
Bladder 5%
Lung 15% Stomach 4%
Oesophagus 3%
Kidney 3%
Melanoma 3%

Prostate 24%
Other 20%

Females Non-Hodgkin lymphoma
Leukaemia
Lung 11% 7%
Myeloma
Hodgkin lymphoma
Colorectal 11%
Uterus 5%
Ovary 5%
Melanoma 4%
Pancreas 3%
Bladder 2%

Breast 31%
Other 21%

Figure 11.2 The relative frequency of the haematological malignancies as a proportion of malignant disease.
(From Smith A. et al . (2009) Br J Haematol 148 ,739 – 53, with permission.)

Environmental i nfl uences with radiotherapy. Etoposide is associated with a
risk of the development of secondary leukaemias
Chemicals
associated with balanced translocations including
Chronic exposure to benzene is an unusual cause of that of the MLL gene at 11q23.
myelodysplasia or AML. Other industrial solvents
and chemicals less commonly cause leukaemia.
Radiation
Radiation, especially to the marrow, is leu-
Drugs

kaemogenic. This is illustrated by an increased

The alkylating agents (e.g. chlorambucil, melpha- incidence of all types of leukaemia (except CLL)
lan, procarbazine and nitrosoureas – BCNU, in survivors of the atom bomb explosions in
CCNU) predispose to AML, especially if combined Japan.