Approximately 730 children between the ages of 0 and 19 are diagnosed with AML in the United States each year. Boys and girls are equally affected. Risk factors include:

• Having a brother or sister (especially a twin) who has leukemia
• Being Hispanic
• Having relatives who had AML
• Having past treatment with chemotherapy or radiation
• Being exposed to high levels of certain chemicals (e.g., benzene)
• Having a genetic disorder such as Down syndrome, Fanconi anemia, Bloom syndrome, Li-Fraumeni syndrome, neurofibromatosis type 1, Diamond-Blackfan anemia, or Shwachman-Diamond syndrome. However, most children with these syndromes do not develop AML.

Environmental exposures

Several studies have found weak associations (not causes) of environmental exposures with development of childhood cancer. For example, prenatal exposure to x-rays and exposure to high levels of pesticides during pregnancy or infancy/childhood have all appeared in the news as being linked to development of AML. However, none of these has been identified as a cause. It’s important for parents to remember that nothing they did or did not do caused their child’s AML.

Prior treatment for cancer

Certain types of chemotherapy (e.g., etoposide, doxorubicin, daunorubicin, mitoxantrone, idarubicin, nitrogen mustard, cyclophosphamide, cisplatin, and others) used to treat other cancers can increase the risk of developing AML (called secondary AML). In these cases, AML generally develops three to ten years after exposure to these drugs. Radiation treatments for prior cancers can also increase a child or teen’s risk of developing AML. However, most children diagnosed with AML have never been treated for cancer before.

Risk for twins

Identical twins. If one identical twin develops AML as an infant, the risk of the other twin also developing AML is almost 100%. This is not believed to be a genetic risk; instead, it is thought that leukemia cells are shared during fetal development (when the identical twins are inside the mother’s womb). If an identical twin develops AML between ages one and seven, the other twin has twice the risk of being diagnosed with AML compared to a child in the general population.

Fraternal twins. The risk is low that both fraternal twins will develop AML, and the risk decreases with age. After age 6, there is no increased risk of the fraternal twin of a child with AML developing the disease.