Hematological Malignancies in Chernobyl Clean-Up Workers (1996-2010)

Gluzman, D F; Sklyarenko, L M; Zavelevich, M P; Koval, S V; Ivanivska, Tetiana S

doi:10.5430/jhm.v2n4p43

Cited by 13 publications

(25 citation statements)

References 13 publications

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“…The proportion of CLL cases in our study (58%) was higher than the approximately 40% reported by most population-based cancer registries (Dores et al 2007) and 44% of all diagnosed leukemias among males in Ukraine (Gluzman et al 2006). [Note that this number differs from the 29.32% reported in Gluzman et al (2006), which was calculated as a proportion of CLL among all hematological malignancies, including multiple myeloma and NHL.]…”

Section: Discussioncontrasting

confidence: 76%

“…[Note that this number differs from the 29.32% reported in Gluzman et al (2006), which was calculated as a proportion of CLL among all hematological malignancies, including multiple myeloma and NHL.] An earlier study suggested that cancer registries may be missing as much as 38% of CLL compared with the incidence of CLL detected using sophisticated measures such as flow cytometric immunophenotypic analysis (Zent et al 2001).…”

Section: Discussionmentioning

confidence: 92%

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Radiation and the Risk of Chronic Lymphocytic and Other Leukemias among Chornobyl Cleanup Workers

Zablotska

Bazyka

Lubin

et al. 2013

Environ Health Perspect

118

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Background: Risks of most types of leukemia from exposure to acute high doses of ionizing radiation are well known, but risks associated with protracted exposures, as well as associations between radiation and chronic lymphocytic leukemia (CLL), are not clear.Objectives: We estimated relative risks of CLL and non-CLL from protracted exposures to low-dose ionizing radiation.Methods: A nested case–control study was conducted in a cohort of 110,645 Ukrainian cleanup workers of the 1986 Chornobyl nuclear power plant accident. Cases of incident leukemia diagnosed in 1986–2006 were confirmed by a panel of expert hematologists/hematopathologists. Controls were matched to cases on place of residence and year of birth. We estimated individual bone marrow radiation doses by the Realistic Analytical Dose Reconstruction with Uncertainty Estimation (RADRUE) method. We then used a conditional logistic regression model to estimate excess relative risk of leukemia per gray (ERR/Gy) of radiation dose.Results: We found a significant linear dose response for all leukemia [137 cases, ERR/Gy = 1.26 (95% CI: 0.03, 3.58]. There were nonsignificant positive dose responses for both CLL and non-CLL (ERR/Gy = 0.76 and 1.87, respectively). In our primary analysis excluding 20 cases with direct in-person interviews < 2 years from start of chemotherapy with an anomalous finding of ERR/Gy = –0.47 (95% CI: < –0.47, 1.02), the ERR/Gy for the remaining 117 cases was 2.38 (95% CI: 0.49, 5.87). For CLL, the ERR/Gy was 2.58 (95% CI: 0.02, 8.43), and for non-CLL, ERR/Gy was 2.21 (95% CI: 0.05, 7.61). Altogether, 16% of leukemia cases (18% of CLL, 15% of non-CLL) were attributed to radiation exposure.Conclusions: Exposure to low doses and to low dose-rates of radiation from post-Chornobyl cleanup work was associated with a significant increase in risk of leukemia, which was statistically consistent with estimates for the Japanese atomic bomb survivors. Based on the primary analysis, we conclude that CLL and non-CLL are both radiosensitive.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 92%

Radiation and the Risk of Chronic Lymphocytic and Other Leukemias among Chornobyl Cleanup Workers

Zablotska

Bazyka

Lubin

et al. 2013

Environ Health Perspect

118

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“…The MDS risk existed in atomic bomb survivors from 40 to 60 years after the radiation exposure and showed a significant linear response to exposure dose level (p<0.001) with an ERR of 4.3 per Gy (95% CI: 1.6 to 9.5; p<0.001). The incidence of MDS among the ChNPP accident clean-up workers tended to exceed a respective value among population of Ukraine examined at the same period (4.58 vs. 3.70%) [4]. Monitoring of the cohort of acute radiation syndrome (ARS) survivors in the post-accidental period of the Chornobyl accident at the National Research Centre for Radiation Medicine (NRCRM) was performed since 1986 [5].…”

Section: Introductionmentioning

confidence: 99%

Myelodysplastic Syndrome in Patients with Acute Radiation Syndrome Following the Chornobyl Nuclear Power Plant Accident

Liubarets¹,

Kovalenko²

2016

J Leuk

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The MDS cases (n=3) among acute radiation syndrome (ARS) survivors after the ChNPP accident were analyzed. MDS diagnoses were based on FAB (1982) and WHO classifications and included the refractory anemia (RA) (patient D. with ARS grade III), refractory anemia with ringed sideroblasts (RARS) (patient B. with ARS grade III), and unclassified MDS (MDS-U) (patient S. with ARS grade I). Clinical management of MDS in ARS patients was analyzed taking into consideration the morphological, immunological, and cytochemical peculiarities of haemopoietic cells. The ARS diagnoses were confirmed in a survey on a regular basis using standard cytogenetic method. Described MDS cases in ARS patients may be the secondary MDS variants taking into consideration possible radiation-induced injuries of hematopoietic cell genome due to the high dose of IR (1.7-5.5 Sv). The possible role of previous irradiation in a range of occupational dose limits before the ChNPP catastrophe for patients D. and B. with ARS grade III, both with possible role of such a confounding factor as petroleum exposure for patient S. (ARS grade I) for the development of MDS cannot be excluded.

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“…Sixteen MDS cases (5.42 %) were revealed among clean-up workers with different forms of leukemia vs. 107 MDS cases (3.70 %) among the patients of Ukraine who were not exposed to radiation [29]. The major MDS forms such as refractory anemia (RA), refractory anemia with ring sideroblasts (RARS), refractory anemia with excess blasts (RAEB), and refractory anemia with excess blasts with transformation (RAEB-T) were delineated according to 1982 FAB classification until 2002.…”

mentioning

confidence: 95%

“…Nevertheless, in several studies, the data on CMML percentage among the patients having been exposed to ionizing radiation are also included. In our earlier study, the percentage of CMML was about the same in both clean-up workers and control groups of the patients [29]. Five CMML cases were recorded in the group of Chernobyl clean-up workers with the median time from 1986-1987 to diagnosis being 14.8 years.…”

mentioning

confidence: 99%

Myelodysplastic syndromes in Chernobyl clean-up workers

et al. 2015

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The studies of the recent decades posed the question of the association between radiation exposure and myelodysplastic syndromes (MDS). This association has been proved in secondary MDS originating upon exposure to chemotherapeutics and/or radiation therapy. The long-term study in Japanese atomic (A)-bomb survivors demonstrated the significant linear dose-response for MDS confirming the link between radiation exposure and this form of hematopoietic malignancies. All these findings provide the strong basis for studying MDS in the persons exposed to radiation following the Chernobyl disaster, especially those in the cohort of Chernobyl clean-up workers of 1986-1987. The data on MDS among Chernobyl clean-up workers (1986-1987) diagnosed in 1996-2012 at the reference laboratory of RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology are summarized. MDS cases were diagnosed in 23 persons (21 males and 2 females) having been exposed to radiation as clean-up workers of 1986-1987. Refractory anemia (RA) has been detected in 13, refractory anemia with ring sideroblasts (RARS)-in 2, and refractory anemia with excess blasts (RAEB)-in 8 patients. The median age of those MDS patients was 62.0 years. In addition, 5 cases of chronic myelomonocytic leukemia (CMML) were recorded in the group of Chernobyl clean-up workers with the median time of 14.8 years from 1986-1987 to diagnosis. The association between radiation exposure and MDS is discussed. The suggested life-long risk for myelodysplastic syndromes among A-bomb survivors in Japan highlights the importance of the continuing follow-up studies in the affected populations in the post-Chernobyl period.

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Hematological Malignancies in Chernobyl Clean-Up Workers (1996-2010)

Cited by 13 publications

References 13 publications

Radiation and the Risk of Chronic Lymphocytic and Other Leukemias among Chornobyl Cleanup Workers

Radiation and the Risk of Chronic Lymphocytic and Other Leukemias among Chornobyl Cleanup Workers

Myelodysplastic Syndrome in Patients with Acute Radiation Syndrome Following the Chornobyl Nuclear Power Plant Accident

Myelodysplastic syndromes in Chernobyl clean-up workers

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