Diagnostic radiography as a risk factor for chronic myeloid and monocytic leukaemia (CML)

Abstract

Summary This interview study included 136 Los Angeles County residents aged 20-69 with CML diagnosed from 1979 to 1985 (cases) and 136 neighbourhood controls. During the 3-20 years before diagnosis of the case, more cases than controls had radiographic examinations of the back, gastrointestinal (GI) tract and kidneys, and cases more often had GI and back radiography on multiple occasions (odds ratio (OR) for back X-rays on five or more occasions = 12.0; P<0.01). Published estimates were used to assign a minimum dose to the active bone marrow for various radiographic procedures. ORs were estimated for cumulative marrow doses for each of four time periods (3-5 years, 6-10 years, 11-20 years and 3-20 years before the diagnosis of the case). The ORs for exposure to 0.99, 100-999, 1000-1999 and >2000 mrad in the 3-20 years before diagnosis were 1.0, 1.4, 1.6 and 2.4 (P br highest exposure category and P for trend both <0.05). The association was strongest for the period 6-10 years before diagnosis, and the effects of radiation exposure during this period remained significant after consideration of other risk factors in a logistic regression analysis.

Epigenetics in radiation biology: a new research frontier

“…While modern cancer radiation therapy has led to increased patient survival rates, the risk of treatment-related deleterious effects, including secondary cancers, is becoming a growing clinical problem (Leone et al, 1999). Relatively recent findings suggest that even fairly low doses of IR, such as those used in diagnostic procedures (e.g., X-ray or computer tomography), can lead to the development of radiation-induced cancers (Preston-Martin et al, 1989; Doody et al, 2000; Liu et al, 2002; Brenner and Hall, 2004). This risk of developing secondary treatment-related cancers is even more pronounced in children and young adults who received either diagnostic or therapeutic exposure to IR (Hildreth et al, 1989; Infante-Rivard et al, 2000; Hall, 2002; Shu et al, 2002; Kleinerman, 2006).…”

The causes and prevention of cancer.

“…Potent immunosuppressive agents such as cyclosporin also increase the risk of a variety of cancers (129), and estrogen replacement therapy increases risk of endometrial and breast cancer. Diagnostic x-rays have contributed to malignancies (130). Although these side effects should weigh in therapeutic decisions, the overall contribution of medications and diagnostic procedures to cancer incidence is small.…”

Risks of myeloid malignancies in patients with autoimmune conditions

“…The main risk factors identified for AML are cigarette smoking (Kasim et al, 2005;Xu et al, 2007) and exposure to benzene or ionising radiation (Descatha et al, 2005). Chronic myeloid leukaemia arises from a translocation t(9;22)(q34;q11), known as the Philadelphia chromosome, and is thought to be associated with radiation exposure (Preston-Martin et al, 1989). Myelodysplastic syndrome is a heterogeneous clonal haematological disorder that can progress to AML.…”