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.
Similar content being viewed by others
References
Preston DL, Kusumi MA, Izumi S, Ron E, Kuramoto A, Kamada N, Dohy H, Matsui T, Nonaka H, Thompson DE, Soda M, Mabuchi K (1994) Cancer incidence in atomic bomb survivors. Part III. Leukemia, lymphoma and multiple myeloma, 1950–1987. Radiat Res 137:S68–S97
Pierce DA, Shimizu Y, Preston DL, Vaeth M, Mabuchi K (1996) Studies of the mortality of atomic bomb survivors report 12, part I. Cancer: 1950–1990. Radiat Res 146:1–27
Preston DL, Pierce DA, Shimizu Y, Cullings HM, Fujita S, Funamoto S, Kodama K (2004) Effect of recent changes in atomic bomb survivor dosimetry on cancer mortality risk estimates. Radiat Res 162(4):377–389
Hsu WL, Preston DL, Soda M, Sugiyama H, Funamoto S, Kodama K, Kimura A, Kamada N, Dohy H, Tomonaga M, Iwanaga M, Miyazaki Y, Cullings HM, Suyama A, Ozasa K, Shore RE, Mabuchi K (2013) The incidence of leukemia, lymphoma and multiple myeloma among atomic bomb survivors: 1950–2001. Radiat Res 179(3):361–382
Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, Sultan C (1982) Proposals for the classification of the myelodysplastic syndromes. Br J Haematol 51(2):189–199
Aul C, Gattermann N, Schneider W (1992) Age-related incidence and other epidemiological aspects of myelodysplastic syndromes. Br J Haematol 82(2):358–367
Kaplan HG, Malmgren JA, Atwood MK (2011) Increased incidence of myelodysplastic syndrome and acute myeloid leukemia following breast cancer treatment with radiation alone or combined with chemotherapy: a registry cohort analysis 1990–2005. BMC Cancer 11:260–269
Vardiman JW, Arber DA, Brunning RD, Larson RA, Matutes E, Baumann I, Thiele J (2008) Therapy-related myeloid neoplasms. In: Swerdlow SE, Campo E et al (eds) WHO classification of tumours of haematopoietic and lymphoid tissues. IARC press, Lyon, pp 127–129
Finch SC (2004) Myelodysplasia and radiation. Radiat Res 161:603–606
Matsuo T, Tomonaga M, Bennett JM, Kuriyama K, Imanaka F, Kuramoto A, Kamada N, Ichimaru M, Finch SC, Pisciotta AV, Ishimaru T (1988) Reclassification of leukemia among A-bomb survivors in Nagasaki using French-American-British (FAB) classification for acute leukemia. Jpn J Clin Oncol 18:91–96
Ichimaru M, Tomonaga M, Amenomori T, Matsuo T (1991) Atomic bomb and leukemia. J Radiat Res 32(1):162–167
Iwanaga M, Hsu WL, Soda M, Takasaki Y, Tawara M, Joh T, Amenomori T, Yamamura M, Yoshida Y, Koba T, Miyazaki Y, Matsuo T, Preston DL, Suyama A, Kodama K, Tomonaga M (2011) Risk of myelodysplastic syndromes in people exposed to ionizing radiation: a retrospective cohort study of Nagasaki atomic bomb survivors. J Clin Oncol 29:428–434
Chihara D, Ito H, Katanoda K, Shibata A, Matsuda T, Sobue T, Matsuo K (2014) Incidence of myelodysplastic syndrome in Japan. J Epidemiol 24(6):469–473
Bacher U, Haferlach C, Alpermann T, Schnittger S, Kern W, Haferlach T (2013) Patients with therapy-related myelodysplastic syndromes and acute myeloid leukemia share genetic features but can be separated by blast counts and cytogenetic risk profiles into prognostically relevant subgroups. Leuk Lymphoma 54:639–642
Zhang L, Wang SA (2014) A focused review of hematopoietic neoplasms occurring in the therapy-related setting. Int J Clin Exp Pathol 7:3512–3523
Yin CC, Medeiros LJ, Bueso-Ramos CE (2010) Recent advances in the diagnosis and classification of myeloid neoplasms—comments on the 2008 WHO classification. Int J Lab Hematol 32:461–476
Kantarjian HM, Keating MJ, Walters RS, Smith TL, Cork A, McCredie KB, Freireich EJ (1986) Therapy-related leukemia and myelodysplastic syndrome: clinical, cytogenetic, and prognostic features. J Clin Oncol 4:1748–1757
Bhatia S (2013) Therapy-related myelodysplasia and acute myeloid leukemia. Semin Oncol 40(6):666–675
Hata T, Imanishi D, Miyazaki Y (2014) Lessons from the atomic bomb about secondary MDS. Curr Hematol Malig Rep 9(4):407–411
Tefferi A, Vardiman JW (2009) Myelodysplastic syndromes. N Engl J Med 361:1872–1885
Dyagil I, Adam M, Beebe GW, Burch JD, Gaidukova SN, Gluzman D, Gudzenko N, Klimenko V, Peterson L, Reiss RF, Finch SC (2002) Histologic verification of leukemia, myelodysplasia, and multiple myeloma diagnoses in patients in Ukraine, 1987–1998. Int J Hematol 76(1):55–60
Gluzman DF (1996) Leukemias and myelodysplastic syndromes following the Chernobyl accident. Exp Oncol 18:120–127
Gluzman DF (1997) Approaches for studying radiation-induced leukemia. Stem Cells 12(2):243–249
Kesminiene A, Evrard AS, Ivanov VK, Malakhova IV, Kurtinaitis J, Stengrevics A, Tekkel M, Anspaugh LR, Bouville A, Chekin S, Chumak VV, Drozdovitch V, Gapanovich V, Golovanov I, Hubert P, Illichev SV, Khait SE, Kryuchkov VP, Maceika E, Maksyoutov M, Mirkhaidarov AK, Polyakov S, Shchukina N, Tenet V, Tserakhovich TI, Tsykalo A, Tukov AR, Cardis E (2008) Risk of hematological malignancies among Chernobyl liquidators. Radiat Res 170:721–733
Ivanov VK, Tsyb AF, Khait SE, Kashcheev VV, Chekin SY, Maksioutov MA, Tumanov KA (2012) Leukemia incidence in the Russian cohort of Chernobyl emergency workers. Radiat Environ Biophys 51:143–149
Romanenko AY, Buzunov VO, Kartushyn GI (2007) State registry of Ukraine of persons suffered as a result of Chornobyl catastrophe. In: Vozianov A, Bebeshko V, Bazyka D (eds) Health effects of Chornobyl accident. DIA, Kyiv, pp 41–42 (in Ukrainian)
Bebeshko VG, Klymenko VI, Dyagil IS, Bilko NM, Kovalenko AN, Klymenko SV, Radchuk ZV, Oberenko OA, Lubarets TF, Kryachok IA, Kadnikova TV, Zotikov LA, Mikhailovskaya EV, Yukhimuk LN, Koval AI, Chervyakova EV, Sholoiko VV (2003) Hematological effects among Ukrainian population suffered from the Chornobyl accident. In: Vozianov A, Bebeshko V, Bazyka D (eds) Health effects of Chornobyl accident. DIA, Kyiv, pp 104–128
Zharlyganova D, Harada H, Harada Y, Shinkarev S, Zhumadilov Z, Zhunusova A, Tchaizhunusova NJ, Apsalikov KN, Kemaikin V, Zhumadilov K, Kawano N, Kimura A, Hoshi M (2008) High frequency of AML1/RUNX1 point mutations in radiation-associated myelodysplastic syndrome around Semipalatinsk nuclear test site. J Radiat Res 49:549–555
Gluzman DF, Sklyarenko LM, Zavelevich MP, Koval SV, Ivanivska TS (2012) Hematological malignancies in Chernobyl clean-up workers (1996–2010). J Hematol Malignancies 2:43–50
Arber DA, Brunning RD, Orazi A, Bain BJ, Porwit A, Vardmasn JW, LeBeau MM, Greenberg PL (2008) Acute myeloid leukemia with myelodysplasia-related changes. In: Swerdlow SE, Campo E et al (eds) WHO classification of tumours of haematopoietic and lymphoid tissues. IARC press, Lyon, pp 124–126
Tsushima H, Iwanaga M, Miyazaki Y (2012) Late effect of atomic bomb radiation on myeloid disorders: leukemia and myelodysplastic syndromes. Int J Hematol 95(3):232–238
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gluzman, D.F., Sklyarenko, L.M., Koval, S.V. et al. Myelodysplastic syndromes in Chernobyl clean-up workers. Ann Hematol 94, 1639–1643 (2015). https://doi.org/10.1007/s00277-015-2441-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00277-015-2441-9