Leukemias rarely debut by pleural involvement as the first manifestation of the hematologic malignancy

IRs ended up calculated total and in accordance to Idarubicin sex (male, woman), age (< 1, 1-4, 5-19, 20-39, 40-59, 60-74, and ≥ 75 years), race/ethnicity (non-Hispanic whites, Hispanic whites, blacks, Idarubicin Asians/Pacific Islanders [APIs], and other/unspecified), calendar year, and leukemia subtype (specified in Table 2). RS was calculated according to leukemia subtype and 4 age groups (< 20, 20-39, 40-59, and ≥ 60 years). We further divided the younger (< 1, 1-4, 5-19 years, or < 5, 5-19 years) and older (40-49, 50-59, 60-69, 70-79, and ≥ 80 years) age groups when the number of cases allowed. According to SEER Program convention, RS estimates based on fewer than 25 cases are not shown.

Overall AL patterns by sex, race, and age.

During 2001 to 2007, 29 682 individuals (IR = 57.2 per 1 000 000 person-years) were diagnosed with AL in SEER-17. Overall, AML accounted for 65.7% of cases (n = 19 497 IR = 38.0) ALL/L, 31.0% (n = 9,188 IR = 17.3) and AL of ambiguous lineage, 3.4% (n = 997 IR = 2.0). AML IRs were remarkably similar among Hispanic whites, blacks, and APIs (IR = 32.0-32.3), with rates for each racial/ethnic subgroup ∼ 20% lower than among non-Hispanic whites (IR = 39.9 Table 1). AML IRs demonstrated a bimodal age pattern, with an initial peak among infants (< 1 year, IR = 19.9), a decline in childhood, and then an exponential rise in IR with advancing age beginning in young adulthood (Table 1 Figure 1). Hispanic whites had the highest incidence of ALL/L (IR = 24.9), which was 50% higher than the incidence among non-Hispanic whites blacks had the lowest incidence of ALL/L (IR = 10.2), and non-Hispanic whites and APIs had intermediate IRs. ALL/L also was associated with a bimodal age pattern, but unlike AML, the initial age peak occurred among children 1 to 4 years of age with a decline at ages 20 to 59 years, followed by a modest rise in IRs at ages ≥ 60 years. The ALL/L predominance among Hispanic whites was absent in infants but was noted across virtually all older age groups.

AL subtypes and sex.

Incidence of AML was 48% higher among males than females, with a male predominance noted for all 3 AML groups (Table 2). With the exception of therapy-related myeloid neoplasms, which occurred approximately equally among males and females (male-to-female IRR = 0.99), all other AML subtypes had higher IRs among males, with male-to-female IRRs ranging from 1.08 for acute promyelocytic leukemia (APL) with t(1517) to greater than 2.0 for AML with myelodysplasia-related changes and acute erythroid leukemia. APL with t(1517) IRs were ∼ 20% lower among men than women up through ages 25 to 34 years, and at older ages IRs were generally higher among males (data not shown) however, only among the 75- to 84-year age group (male-to female IRR = 1.66 95% CI, 1.12%-2.47%) did IRs for APL with t(1517) differ significantly by sex.