Epidemiology of childhood acute leukemias
Marzena Ciesielska
Laboratory of Medical Microbiology, Hirszfeld Institute of Immunology and Experimental Therapy Polish Academy of SciencesWroclaw, Poland
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, Beata Orzechowska
Laboratory of Virology, Hirszfeld Institute of Immunology and Experimental Therapy Polish Academy of SciencesWroclaw, Poland
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, Andrzej Gamian
Laboratory of Medical Microbiology, Hirszfeld Institute of Immunology and Experimental Therapy Polish Academy of SciencesWroclaw, Poland
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and Bernarda Kazanowska
Department of Bone Marrow Transplantation, Pediatric Oncology and Hematology Wroclaw Medical UniversityWroclaw, Poland
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Mar 14, 2024
About this article
Article Category: Review
Published Online: Mar 14, 2024
Page range: 22 - 36
Received: Aug 08, 2023
Accepted: Nov 13, 2023
DOI: https://doi.org/10.2478/ahem-2023-0023
Keywords
© 2024 Marzena Ciesielska et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Figure 1.
![Incidence statistics of childhood acute leukemias in 2020 in WHO regions. a. Number of new cases; b. Number of new deaths [1,10]](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/65e6324ea96a436ce011782e/j_ahem-2023-0023_fig_001.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20250929%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20250929T223713Z&X-Amz-Expires=3600&X-Amz-Signature=8aeb60cecc198aff14b93a04fd682cf85d6bfcdff63636ef59693ce4a14027d1&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Figure 2.
![Incidence trends of pediatric leukenia in 2020–2030. a. Percent of new cases; b. Percent of new deaths [16]](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/65e6324ea96a436ce011782e/j_ahem-2023-0023_fig_002.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20250929%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20250929T223713Z&X-Amz-Expires=3600&X-Amz-Signature=990b37a417a53df240a0406e40e65ca20ba71def654d4eee2e7422e800bc633c&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Figure 3.
![a. Incidence percantage of childhood ALL by age; b. Incidence percantageof childood AML by age [17,18,19]](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/65e6324ea96a436ce011782e/j_ahem-2023-0023_fig_003.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20250929%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20250929T223713Z&X-Amz-Expires=3600&X-Amz-Signature=653388cce146a6596e9b3c9a8a2524d8065ae038696744f0d0cfc969d4f60ede&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Estimated number of new cases and mortality in 2020 for childhood leukemia [20,21]
| Population | New incident | Mortality | ||
|---|---|---|---|---|
| Females | Male | Females | Male | |
| WHO South-East Asia | 40.8 % | 59.2 % | 38.3 % | 61.7 % |
| WHO Western Pacific | 40.6 % | 59.4 % | 43.1 % | 56.9 % |
| WHO Americas | 44 % | 56 % | 41.5 % | 58.5 % |
| WHO East Mediterranean | 43.5 % | 56.5 % | 40.1 % | 59.9 % |
| WHO Europe | 41.7 % | 58.3 % | 42.1 % | 57.9 % |
| WHO Africa | 42.3 % | 57.7 % | 43.9 % | 56.1 % |
| all WHO regions | 42.1 % | 57.9 % | 41.5 % | 58.5 % |
Genetic predisposition to childhood leukemia
| Acquired syndromes/Genetic disorders | Type of leukemia | Mutation | |
|---|---|---|---|
| Down Syndrome | |||
| Down Syndrome (DS) | ALL/AML |
|
|
| DNA repair gene syndromes and chromosomal instability syndromes | |||
| Fanconi anemia (FA) | MDS/AML | ||
| Bloom’s syndrome (BS) |
ALL AML |
||
| Ataxia-telangiectasia (AT) | ALL | ||
| Constitutional Mismatch Repair Deficiency (CMMRD) | ALL |
|
|
| Robertson translocation(RT) | ALL | ||
| Tumor suppressor gene syndromes | |||
| Li-Fraumeni syndrome(LFS) | ALL | ||
| Neurofibromatosis (NF1) | ALL AML (JMML) | ||
| Beckwith-Wiedemann syndrome (BWS) | ALL | ||
| Pure familial leukemia | |||
| Acquired monosomy 7 | MDS/AML | ||
| Hereditary platelet disorders (HPDs) | MDS/AML |
|
|
| Bone marrow failure syndromes | |||
| Shwachman-Diamond syndrome (SDS) | AML | ||
| Diamond Blackfan anemia (DBA) | MDS/AML | ||
| Congenital amegakaryocytic thrombocytopenia (CAMT) | MDS/AML | ||
| Cyclic neutropenia (CyN) | MDS/AML | ||
| Severe congenital neutropenia (SCN) | AML | ||
| Amegakaryocytic thrombocytopenia (AMT) | MDS/AML | ||
| Hereditary platelet disorders (HPDs) | MDS/AML |
|
|
| Aplastic anemia (AA) | MDS/AML |
|
|
The International Consensus Classification of AML [9]
| AML with defining genetic abnormalities |
| AML with RUNX1::RUNX1T1 Fusion |
| AML with CBFB::MYH11 Fusion |
| Acute promyelocytic leukaemia with PML::RARA Fusion |
| AML with KMT2A rearrangement |
| AML with DEK::NUP214 Fusion |
| AML with MECOM rearrangement |
| AML with RBM15::MRTFA Fusion |
| AML with NUP98 rearrangement |
| AML with other (rare) defined genetic alterations |
| AML with NPM1 mutation |
| AML with CEBPA mutation |
| AML defined by differentiation |
| AML with minimal differentiation |
| AML without maturation |
| AML with maturation |
| Acute myelomonocytic leukemia |
| Acute monoblastic/monocytic leukemia |
| Pure erythroid leukemia |
| Acute megakaryoblastic leukemia |
| Acute basophilic leukemia |
The International Consensus Classification of ALL [6]
| B-ALL with t(12;21)(p13.2;q22.1)/ETV6::RUNX1 |
| B-ALL. hyperdiploid |
| B-ALL. low hypodiploid |
| B-ALL. near haploid |
| B-ALL with t(5;14)(q31.1;q32.3)/IL3::IGH |
| B-ALL with t(1;19)(q23.3;p13.3)/TCF3::PBX1 |
| B-ALL. BCR::ABL1–like, ABL-1 class rearranged |
| B-ALL. BCR::ABL1–like, JAK-STAT activated |
| B-ALL. BCR::ABL1–like, NOS (undefined) |
| B-ALL with iAMP21 |
| B-ALL with MYC rearrangement |
| B-ALL with DUX4 rearrangement |
| B-ALL with MEF2D rearrangement |
| B-ALL with ZNF384(362) rearrangement |
| B-ALL with NUTM1 rearrangement |
| B-ALL with HLF rearrangement |
| B-ALL with UBTF::ATXN7L3/PAN3,CDX2 (“CDX2/UBTF”) |
| B-ALL with mutated IKZF1 N159Y |
| B-ALLwith mutated PAX5 P80R |
| Provisional entity: B-ALL. ETV6::RUNX1-like |
| Provisional entity: B-ALL. with PAX5 alteration |
| Provisional entity: B-ALL. with mutated ZEB2 (p.H1038R)/IGH::CEBPE |
| Provisional entity: B-ALL. ZNF384 rearranged-like |
| Provisional entity: B-ALL. KMT2A rearranged-like |
| B-ALL, NOS (undefined) |
| T-ALL |
| Early T-cell precursor ALLwith BCL11B rearrangement |
| Early T-cell precursor ALL. NOS |
| T-ALL. NOS |
| Provisional entity: natural killer cell ALL |