Sex differences in the incidence of chronic myeloid leukemia

Abstract

The incidence of chronic myeloid leukemia (CML), which is caused by BCR/ABL chimeric oncogene formation in a pluripotent hematopoietic stem cell (HSC), increases with age and exposure to ionizing radiation. CML is a comparatively well-characterized neoplasm, important for its own sake and useful for insights into other neoplasms. Here, Surveillance, Epidemiology and End Results (SEER) CML data are analyzed after considering possible misclassification of chronic myelo-monocytic leukemia as CML. For people older than 25 years, plots of male and female CML log incidences versus age at diagnosis are approximately parallel straight lines with males either above or to the left of females. This is consistent with males having a higher risk of developing CML or a shorter latency from initiation to diagnosis of CML. These distinct mechanisms cannot be distinguished using SEER data alone. Therefore, CML risks among male and female Japanese A-bomb survivors are also analyzed. The present analyses suggest that sex differences in CML incidence more likely result from differences in risk than in latency. The simplest but not the sole interpretation of this is that males have more target cells at risk to develop CML. Comprehensive mathematical models of CML could lead to a better understanding of the role of HSCs in CML and other preleukemias that can progress to acute leukemia.

Gender and BCR‐ABL transcript type are correlated with molecular response to imatinib treatment in patients with chronic myeloid leukemia

“…Women were also less susceptible to CML as evident in our cohort, a finding that has previously been reported by others . This sex difference has been proposed to be related to the different amounts of target cells in men vs. women , an impact of hormonal status on the disease course , or other genetic and/or environmental factors . For example, a recent study found that men express lower hepatic level of RIG‐I protein, a critical factor in myeloid differentiation, innate immunity, and a prognostic factor for survival and response to interferon therapy in hepatocellular patients with carcinoma .…”

Epidemiology of MPN: What Do We Know?

“…The HemaCare group published a European CML incidence rate of 1.10 per 100,000 persons for 2000-2002 [19], while incidence in Germany was recently reported at 0.89 per 100,000 [16]. Male incidence rates of CML are higher than those of females in the USA, and diagnosis often occurs at a younger age [20]. CML prevalence has been estimated at 70,000 cases in the USA and is anticipated to increase due to therapeutic advancements [21].…”

Parameter perturbations in a post-treatment chronic myeloid leukemia model capture the essence of pre-diagnosis A-bomb survivor mysteries

“…This occurs with aging (Radivoyevitch et al 1999 ) and with exposures to ionizing radiation (Radivoyevitch and Hoel 1999 ), reviewed in (Radivoyevitch et al 2012 ). Across adult ages, CML incidence is either higher in males by a factor of ~ 1.6 or delayed in females by ~ 10 years (Radivoyevitch et al 2014 ).…”