Hematological malignancies among Chernobyl Liquidators

我们发现，在切尔诺贝利事故后，维捷布斯克地区（1423000人）的清理人员中急性白血病的发病率很高。在基辅的乌克兰放射医学中心（Bebeshko主任），Klimenko教授每年对120,000名清算者进行检查。他们被设定为低于25毫西弗的辐射剂量，但据推测，其中一些人受到的辐射剂量超过100毫西弗。我参与调查诊断这些清算者，直到1993年发现141名白血病患者。其中86例被诊断为急性白血病。从1993年到1995年，我们发现了42例血液系统恶性肿瘤。16例急性髓性白血病，按FAB分型分为AML M1（2例）、AML M2（2例）、AML M3（2例）、AML M4（5例）、AML M5（4例）。我们发现2例急性淋巴细胞白血病（ALL L2: FAB）。我们还发现8例慢性骨髓性白血病和8例慢性淋巴细胞性白血病。我们分析了AML病例的DNA，发现p53抑制癌基因的外显子5和外显子6的缺失是由于p53基因突变。我们调查了居住在第聂伯罗彼得罗夫斯克（21,906人）、第涅茨克（26,506人）和恰尔科夫（28,314人）地区的清算者白血病和恶性淋巴瘤的发病率。通过性别匹配统计分析，我们发现1986年和1987年的清算者的相对风险分别为0.02和0.05。1986年和1987年清理者患恶性淋巴瘤的相对风险分别为0.35和0.75。在这些发现的基础上，我们认为血液恶性肿瘤的发展是依赖于辐射剂量。提示近年来清除者白血病包括骨髓增生异常综合征的发病率呈上升趋势。

We had found high incidence of acute leukemias in liquidators in Vitebsk region (1,423,000 population) after Chernobyl accident. In Ukrainian Center of Radiation Medicine in Kiev (Director Bebeshko), Prof. Klimenko has been examining 120,000 liquidators in every year. They were set to be lower than 25 mSv irradiation dose, however, it was speculated that some of them were exposed more than 100 mSv . I co-investigated to diagnose those liquidators and found 141 patients with leukemia until 1993. Among them, 86 patients were diagnosed as acute leukemia. During from 1993 to 1995, we found 42 patients with hematological malignancies. They were 16 cases of acute myelogenous leukemia, which were classified as AML M1 (2 cases), AML M2 (2 cases), AML M3 (2 cases), AML M4 (5 cases), AML M5 (4 cases) according to FAB classification, respectively. We found 2 cases of acute lymphoblastic leukemia (ALL L2: FAB). We also found 8 patients with chronic myelogenous leukemia and 8 patients with chronic lymphocytic leukemia. We analysed DNA from cases of AML and found that deletion of exon 5 and exon 6 of p53 suppressor oncogene due to p53 gene mutation.We investigated the incidence of leukemias and malignant lymphomas among liquidators living in the regions, Dnepropetrovsk (21,906 person), Dnetsk (26,506), and Charkov (28,314). By sex-matched statistical analysis, we found that the relative risk was 0.02 and 0.05, for liquidators of 1986 and 1987, respectively.The relative risk for malignant lymphomas was 0.35 and 0.75, for 1986 and 1987 liquidators, respectively. On the bases of these findings, we suggest that the development of hematological malignancies is dependent on radiation dose. It is suggested that the incidence of leukemia including myelodysplastic syndrome among liquidators is increasing tendency, recently.