Leukemia Following the Chernobyl Accident

Howe, Geoffrey R.

doi:10.1097/01.hp.0000281178.75068.e3

Cited by 23 publications

(11 citation statements)

References 15 publications

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“…Most published studies of Chornobyl cleanup workers report an elevated risk of leukemia (1, 4), with much of the evidence coming from studies of Russian cleanup workers who received average doses of 100–200 mGy (5–8). Based on the dose and follow-up information for 168,000 workers from the Russian National Medical and Dosimetric Registry, Ivanov et al (5) reported an increased risk of all leukemia with an ERR of 4.3 per Gy (n=48).…”

Section: Discussionmentioning

confidence: 99%

“…The accident at the Chornobyl (Chernobyl) nuclear power plant in northern Ukraine in April 1986, as well as being a public health, social and economic disaster for the countries most affected, also provided an opportunity to evaluate the relationship between leukemia and low dose and low dose-rate radiation (4). After the accident, several hundred thousand workers, who were involved in cleaning up the site and its surroundings, received fractionated whole-body doses, primarily from external radiation (1).…”

Section: Introductionmentioning

confidence: 99%

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The Ukrainian-American Study of Leukemia and Related Disorders among Chornobyl Cleanup Workers from Ukraine: III. Radiation Risks

Romanenko¹,

Finch²,

Hatch³

et al. 2008

Radiation Research

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Leukemia is one of the cancers most susceptible to induction by ionizing radiation, but the effects of lower doses delivered over time have not been adequately quantified. Following the Chornobyl (Chernobyl) accident in Ukraine in April 1986, several hundred thousand workers who were involved in cleaning up the site and its surroundings received fractionated exposure, primarily from external gamma radiation. To increase our understanding of the role of protracted low-dose radiation exposure in the etiology of leukemia, we conducted a nested case-control study of leukemia in a cohort of cleanup workers identified from the Chornobyl State Registry of Ukraine. The analysis is based on 71 cases of histologically confirmed leukemia diagnosed in 1986-2000 and 501 age-and residence-matched controls selected from the same cohort. Study subjects or their proxies were interviewed about their cleanup activities and other relevant factors. Individual bone marrow radiation doses were estimated by the RADRUE dose reconstruction method (mean dose=76.4 (SD=213.4) milligray (mGy)). We used conditional logistic regression to estimate leukemia risks. The excess relative risk of total leukemia was 3.44 per Gy (95% confidence interval 0.47-9.78, p<0.01). The dose-response was linear and did not significantly differ by calendar period of first work in the 30-km Chornobyl zone, duration or type of work. We found a similar dose-response relationship for chronic and non-chronic lymphocytic leukemia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Ukrainian-American Study of Leukemia and Related Disorders among Chornobyl Cleanup Workers from Ukraine: III. Radiation Risks

Romanenko¹,

Finch²,

Hatch³

et al. 2008

Radiation Research

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“…Exposure to iodine 131 involves an element of whole-body radiation, as does exposure to other radioactive isotopes, especially cesium. Increases in leukemia incidence in exposed populations have been both claimed and denied; a recent assessment concludes that, apart from cleanup workers, there is no proof of a link to exposure (Howe, 2007). There have been reports, sometimes anecdotal, of increases in a variety of other tumors in those exposed to Chernobyl fallout, including brain and kidney.…”

Section: Nonthyroid Diseasesmentioning

confidence: 99%

Radiation carcinogenesis: lessons from Chernobyl

2008

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Radiation is a carcinogen, interacting with DNA to produce a range of mutations. Irradiated cells also show genomic instability, as do adjacent non-irradiated cells (the bystander effect); the importance to carcinogenesis remains to be established. Current knowledge of radiation effects is largely dependent on evidence from exposure to atomic bomb whole body radiation, leading to increases in a wide range of malignancies. In contrast, millions of people were exposed to radioactive isotopes in the fallout from the Chernobyl accident, within the first 20 years there was a large increase in thyroid carcinoma incidence and a possible radiation-related increase in breast cancer, but as yet there is no general increase in malignancies. The increase in thyroid carcinoma, attributable to the very large amounts of iodine 131 released, was first noticed in children with a strong relationship between young age at exposure and risk of developing papillary thyroid carcinoma (PTC). The extent of the increase, the reasons for the relationship to age at exposure, the reduction in attributable fraction with increasing latency and the role of environmental factors are discussed. The large number of radiation-induced PTCs has allowed new observations. The subtype and molecular findings change with latency; most early cases were solid PTCs with RET-PTC3 rearrangements, later cases were classical PTCs with RET-PTC1 rearrangements. Small numbers of many other RET rearrangements have occurred in 'Chernobyl' PTCs, and also rearrangement of BRAF. Five of the N-terminal genes found in papillary carcinoma rearrangements are also involved in rearrangements in hematological malignancies; three are putative tumor suppressor genes, and two are further genes fused to RET in PTCs. Radiation causes double-strand breaks; the rearrangements common in these radiation-induced tumors reflect their etiology. It is suggested that oncogenic rearrangements may commonly involve both a tumor-suppressor gene (or a DNA repair gene) as well as an oncogene. Involvement of two relevant genes would give a greater chance of progression and a shorter latency than a single-gene mutation. More information is needed on germline mutations conferring susceptibility to radiation-induced PTCs, particularly DNA repair genes. The radiation exposure to the fallout after Chernobyl was very different from the whole body radiation after the atomic bombs. The type and molecular pathology of the thyroid tumors is changing with increasing latency, long latency tumors in other organs could occur in the future. A comprehensive follow up must continue for the lifetime of those exposed.

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“…Cancers, and in particular leukemias seem to represent the most serious effects of the exposure to ionizing radiation. Meanwhile, the question as to whether the incidence of leukemias and malignant lymphomas among 260,807 Ukrainian clean-up workers of 1986 and 43,366 of 1987 (average doses of 14.0 cGy in 1986 and 9.0 cGy in 1987) has increased in the 25 years since the catastrophe is still a point of much controversy [1][2][3][4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

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

Gluzman

Sklyarenko²,

Zavelevich³

et al. 2012

J Hemat Malig

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Background: Even 25 years after the Chernobyl catastrophe, the interpretation of the findings on leukemia risk among Chernobyl clean-up workers is still a point of much controversy. Precise diagnosis of the main types of hematopoietic malignancies according to FAB classification and new WHO classification may be helpful in estimating the relative contribution of the radiation factor to the overall incidence of such pathologies. Methods:The data on 295 consecutive cases of malignant tumors of hematopoietic and lymphoid tissues in Chernobyl clean-up workers diagnosed from 1996 to 2010 are given in comparison with the data of 2,697 consecutive patients other than clean-up workers of the same age group. For this study, a set of complex diagnostic techniques were used, including morphology, cytochemistry of bone marrow and peripheral blood cells, immunocytochemistry (APAAP, LSAB-AP) as well as the utilization of monoclonal antibodies to lineage specific and differentiation antigens of leukocytes.Results: All the main forms of tumors of hematopoietic and lymphoid tissues were diagnosed among clean-up workers under study in 10-25 years after the Chernobyl catastrophe including myelodysplastic syndromes (MDS), acute leukemias (ALL and AML), chronic myelogenous leukemia (CML) and other myeloproliferative neoplasms, chronic lymphocytic leukemia (B-CLL) and lymphoid neoplasms of B and T cell origin. Among 46 AML cases in clean-up workers, leukemia was preceded by MDS in seven patients. CML percentage tended to be higher in the group of patients representing clean-up workers (9.13% vs. 6.59%). B-CLL was a predominant form of hematopoietic malignancies in clean-up workers under study (26.10%). Nevertheless, the percentage of B-CLL in patients of clean-up workers group did not differ significantly from that in the non-exposed patients. The multiple myeloma percentage in our study was higher in the clean-up workers (6.46% vs. 4.00%). Conclusions:The verified diagnosis of tumors of hematopoietic and lymphoid tissues according to the up-to-date WHO classification could be prerequisite for further molecular genetics and analytical epidemiology study of leukemias that may be related to the Chernobyl catastrophe.

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Leukemia Following the Chernobyl Accident

Cited by 23 publications

References 15 publications

The Ukrainian-American Study of Leukemia and Related Disorders among Chornobyl Cleanup Workers from Ukraine: III. Radiation Risks

The Ukrainian-American Study of Leukemia and Related Disorders among Chornobyl Cleanup Workers from Ukraine: III. Radiation Risks

Radiation carcinogenesis: lessons from Chernobyl

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

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