Myelodysplastic syndromes in Chernobyl clean-up workers

Abstract

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.

Clinical features and prognosis of patients with myelodysplastic syndromes who were exposed to atomic bomb radiation in Nagasaki

“…Few studies have investigated the clinical characteristics of primary MDS after accidental radiation exposure. Recently, Gluzman et al . reported data on MDS among clean‐up workers who were exposed to radiation at the Chernobyl nuclear power plant accident during 1986–1987 (exposure dose range, 0.075–0.25 Gy).…”

“…Few studies have investigated the clinical characteristics of primary MDS after accidental radiation exposure. Recently, Gluzman et al (17) reported data on MDS among clean-up workers who were exposed to radiation at the Chernobyl nuclear power plant accident during 1986-1987 (exposure dose range, 0.075-0.25 Gy). They diagnosed 23 MDS and five CMML cases based on the WHO classification during 1996-2012, but did not assess the effect of exposure dose on the clinical course.…”

Myeloid neoplasms after chemotherapy and PRRT: myth and reality

“…A clear dose-effect relationship, evident and linear with the dose for irradiation such as nuclear blasts (Gluzman et al 2015), is not apparent in radionuclide therapies such as PRRT. In the latter, the doses delivered to the bone marrow are generally low (mean 0.02-0.07 Gy/GBq), resulting in a mean dose, for typical administrations of 7.4 GBq, of 0.15-0.5 Gy.…”

“…A critical parameter is the different sensitivities of DNA to radiation during the cell cycle and intrinsic host repair mechanisms (Bourguignon et al 2005). High-dose total body irradiation, as in atomic bomb survivors, Chernobyl nuclear disaster liquidators, or large-field conditioning radiotherapy before bone marrow transplantation, is known to be leukemogenic in a dose-dependent manner (Gluzman et al 2015). However, the absolute rate of MDS is very low.…”