Epidemiology of Leukemia and Multiple Myeloma in Golestan, Iran

  • Rajabli, Niloofar (Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences) ;
  • Naeimi-Tabeie, Mohammad (Department of Health, Golestan University of Medical Sciences) ;
  • Jahangirrad, Ataollah (Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences) ;
  • Sedaghat, Seyed-Mehdi (Department of Health, Golestan University of Medical Sciences) ;
  • Semnani, Shahryar (Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences) ;
  • Roshandel, Gholamreza (Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences)
  • Published : 2013.04.30


Background: The aim of this paper was to present the incidence rates of leukemia and multiple myeloma (MM) in Golestan province located in northeastern Iran during 2004-2009. Materials and Methods: This was a descriptive cross-sectional study. Data on newly diagnosed (incident) leukemia and MM cases were obtained from collected from Golestan population-based cancer registry. Data was entered into CanReg-4 software. Age standardized incidence rates (ASR) (per 100000 person-years) for leukemia and MM were calculated. Data on Golestan population was obtained from the data of Iranian national census in 2006. Results: Totally, 11036 new cancer cases were registered in GPRC from 2004-2009. Leukemia and MM accounted for 693 and 124 of cases, respectively. The mean age in patients with leukemia and MM was 43.8 and 62.4 years, respectively. The ASRs for leukemia among men and women were 10.4 and 7.8, respectively (p<0.001). The ASRs for MM were 2.1 and 2 in men and women, respectively (p=0.93). The rate of leukemia was significantly higher in rural areas (p=0.02) whereas the incidence of MM was higher in urban areas (p<0.001). Conclusions: Our results showed a high incidence rate of leukemia in Golestan province of Iran. The incidence of leukemia was significantly higher in males and residents of rural areas. High exposure to pesticides and other agricultural related products may be a possible explanation for epidemiological pattern of leukemia in this area. Determining and controlling important risk factors, especially environmental factors, of leukemia may lead to decrease in its burden in Golestan province of Iran.


  1. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917.
  2. Fritz A, Percy C, Jack A, et al (2000). International Classification of Diseases for Oncology, Geneva: World Health Oganization.
  3. International Agency for Reseach on Cancer, 2004. International rules for multiple primary cancers ICD-O-3rd ed, International Agency for Reseach on Cancer, Lyon.
  4. Laubach JP, Mitsiades CS, Mahindra A, et al (2009). Novel therapies in the treatment of multiple myeloma. J Natl Compr Canc Netw, 7, 947-60.
  5. Novak I, Jaksic O, Kulis T, Batinjan K, Znaor A (2012). Incidence and mortality trends of leukemia and lymphoma in Croatia, 1988-2009. Croat Med J, 53, 115-23.
  6. Parkin DM, Ferlay J (2001). Canreg: computer software for cancer registries. 4th ed. Lyon: International Agency for Research on Cancer.
  7. Baris D, Silverman DT, Brown LM, et al (2004). Occupation, pesticide exposure and risk of multiple myeloma. Scand J Work Environ Health, 30, 215-22.
  8. Brown LM, Blair A, Gibson R, et al (1990). Pesticide exposures and other agricultural risk factors for leukemia among men in Iowa and Minnesota. Cancer Res, 50, 6585-91.
  9. Rhomberg LR, Bailey LA, Goodman JE, Hamade AK, Mayfield D (2011). Is exposure to formaldehyde in air causally associated with leukemia?-A hypothesis-based weight-ofevidence analysis. Crit Rev Toxicol, 41, 555-621.
  10. Romanenko AY, Finch SC, Hatch M, et al (2008). The Ukrainian-American study of leukemia and related disorders among chornobyl cleanup workers from Ukraine: III. Radiation risks. Radiat Res, 170, 711-20.
  11. Roshandel G, Sadjadi A, Aarabi M, et al (2012). Cancer incidence in Golestan province: report of an ongoing population-based cancer registry in Iran between 2004 and 2008. Arch Iran Med, 15, 196-200.
  12. Salim EI, Moore MA, Al-Lawati JA, et al (2009). Cancer epidemiology and control in the arab world-past, present and future. Asian Pac J Cancer Prev, 10, 3-16.
  13. Salim EI, Moore MA, Bener A, et al (2010). Cancer epidemiology in South-West Asia-past, present and future. Asian Pac J Cancer Prev, 11, 33-48.
  14. Thygesen LC, Nielsen OJ, Johansen C (2009). Trends in adult leukemia incidence and survival in Denmark, 1943-2003. Cancer Causes Control, 20, 1671-80.
  15. Turner MC, Wigle DT, Krewski D (2011). Residential pesticides and childhood leukemia: a systematic review and metaanalysis. Cien Saude Colet, 16, 1915-31.
  16. Xie Y, Davies SM, Xiang Y, Robison LL, Ross JA (2003). Trends in leukemia incidence and survival in the United States (1973-1998). Cancer, 97, 2229-35.
  17. Yiin JH, Anderson JL, Daniels RD, et al (2009). A nested case-control study of multiple myeloma risk and uranium exposure among workers at the Oak Ridge Gaseous Diffusion Plant. Radiat Res, 176, 637-645.

Cited by

  1. Overview of Cancer Registration Research in the Asian Pacific from 2008-2013 vol.14, pp.8, 2013,
  2. No Association between Traffic Density and Risk of Childhood Leukemia: a Meta-analysis vol.15, pp.13, 2014,
  3. Increased Frequency of Micronuclei in Binucleated Lymphocytes among Occupationally Pesticide-exposed Populations: A Meta-analysis vol.15, pp.16, 2014,
  4. Epidemiological Assessment of Leukemia in Kazakhstan, 2003-2012 vol.15, pp.16, 2014,
  5. The effect of dietary intake changes on nutritional status in acute leukaemia patients after first induction chemotherapy vol.24, pp.4, 2014,
  6. Clinicopathology Profile and Bone Involvement of Multiple Myeloma Patients in Dharmais National Cancer Hospital, Indonesia vol.16, pp.15, 2015,
  7. Leukemia in Iran: Epidemiology and Morphology Trends vol.16, pp.17, 2015,
  8. The Immunotyping Distribution of Serum Monoclonal Paraprotein and Environmental Impact on Multiple Myeloma (MM) and Monoclonal Gammopathy of Uncertain Significance (MGUS) in Taiwan: A Medical Center-Based Experience vol.17, pp.1, 2016,
  9. Copper and zinc in stage I multiple myeloma: relation with ceruloplasmin, lipid peroxidation, and superoxide dismutase activity vol.0, pp.0, 2018,