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Chronic myelogenous leukemia and exposure to ionizing radiation — a retrospective study of 443 patients

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Abstract

Exposure to ionizing radiations (Rx) has been implicated as a causative factor of chronic myelogenous leukemia (CML). We performed a retrospective study of 443 consecutive CML patients, looking for a history of significant exposure to Rx, and evaluated the clinical and hematological characteristics in order to find any difference between radiation-related CML patients and those with de novo CML. We identified 406 patients without known exposure to mutagens (group I) and 37 patients with prior significant exposure to Rx (group II). In comparison to patients of group I, those of group II showed particular clinical and hematological features: significantly lower incidence of bulky splenomegaly (p<0.05) and hyperleukocytosis (WBC>100×109/l;p<0.05); significantly higher incidence of anemia (Hb<10 g/dl;p<0.01). Patients with radiation-related CML had a significantly better survival than those with de novo CML (median survival 61 months vs 42 months;p<0.05). In conclusion, this study of a large cohort of CML patients indicates that the subgroup of patients with a history of significant exposure to ionizing radiation has particular clinical and hematological features at onset (lower tumor burden, higher frequency of anemia) and a better survival.

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References

  1. Antoku S, Russell WJ (1971) Dose to the active bone marrow, gonads and skin from roentgenography and fluoroscopy. Radiology 101:669–678

    PubMed  Google Scholar 

  2. Beebe GW, Kato H, Land CE (1978) Studies of the mortality of A-bomb survivors. 6. Mortality and radiation dose, 1950–74. Radiat Res 75:138–201

    PubMed  Google Scholar 

  3. Boice JD, M Land CE (1982) Ionizing radiation. In: Schottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. WB Saunders, Philadelphia, pp 231–253

    Google Scholar 

  4. Boice JR Jr, Morin MM, Glass AG et al (1990) Diagnostic X-rays and risk of leukemia, lymphoma and multiple myeloma. JAMA 265:1290–1294

    Google Scholar 

  5. Bottura C, Ferrari I (1960) A simplified method for the study of chromosomes in man. Nature 186:904–905

    PubMed  Google Scholar 

  6. Calicchia A, Mazzei F, Dobici F, Paganini Fioratti M, Indovina PL (1991) Esposizione del paziente nella radiodiagnostica. Radiol Med 81:910–917

    Google Scholar 

  7. Cartwright RA (1992) Leukemia epidemiology and radiation risks. Blood Rev 6:10–14

    PubMed  Google Scholar 

  8. Darby SC, Doll R, Gill SK, Smith PG (1987) Long-term mortality after a single treatment course with X-rays in patients treated for ankylosing spondylitis. Br J Cancer 55:179–190

    PubMed  Google Scholar 

  9. Dutrillaux B, Viegas-Pequignot E, Prod'Homme M, Sportes M (1985) Distribution of the various radiation-induced chromosomal rearrangements in relation to the dose and the sampling time. Mutat Res 152:197–203

    PubMed  Google Scholar 

  10. Gehan E (1965) A generalized Wilcoxon test for comparing arbitrarily singly censored samples. Biometrika 52:203–224

    PubMed  Google Scholar 

  11. Haas JF, Kittelmann B, Mehnert WH, Staneczek W, Mohner M, Kaldor JM, Day NE (1987) Risk of leukemia in ovarian tumor and breast cancer patients following treatment by cyclophosphamide. Br J Cancer 55:213–218

    PubMed  Google Scholar 

  12. Hellman S, Moloney WC, Melssner WA (1982) Paradoxical effect of radiation on tumor incidence in the rat: implication for radiation therapy. Cancer Res 42:433–436

    PubMed  Google Scholar 

  13. Holmberg M (1992) Is the primary event in radiation-induced chronic myelogenous leukemia the induction of the t(9;22) translocation? Leuk Res 16:333–336

    PubMed  Google Scholar 

  14. Inskip PD, Monson RR, Wagoner JK, Stovall M, Davis FG, Kleinerman RA, Boice JD (1990) Leukemia following radiotherapy for uterine bleeding. Radiat Res 122:107–119

    PubMed  Google Scholar 

  15. Iurlo A, Foa P, Maiolo AT, Polli EE (1989) Chronic myelogenous leukemia following radiation therapy for testicular seminoma. Blut 59:503–504

    PubMed  Google Scholar 

  16. Kaldor JM, Day NE, Clarke EA et al (1990) Leukemia following Hodgkin's disease. N Engl J Med 322:7–13

    PubMed  Google Scholar 

  17. Kaldor JM, Day NE, Pettersson F et al (1990) Leukemia following chemotherapy for ovarian cancer. N Engl J Med 322:1–6

    PubMed  Google Scholar 

  18. Kaplan E, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

    Google Scholar 

  19. Moloney WC (1987) Radiogenic leukemia revisited. Blood 70:905–908

    PubMed  Google Scholar 

  20. Nandakumar A, Davis S, Moolgavkar S, Witherspoon RP, Schwartz SM (1991) Myeloid leukemia following therapy for a first primary cancer. Br J Cancer 63:782–788

    PubMed  Google Scholar 

  21. Naparstek E, Fitzgerald TJ, Sakakeeny MT, Klassen V, Pierce JM, Woda BH, Falco J, Fitzgerald S, Nizin P, Greeberger JS (1986) Induction of growth alterations in factor-dependent hematopoietic progenitor cell lines by co-cultivation with irradiated bone marrow stromal cell. Blood 67:1395–1399

    PubMed  Google Scholar 

  22. National Academy of Sciences (1980) The effect on population of exposure to low levels of ionising radiation: report of the advisory committee on the biological effects of ionising radiation (BEIR). Division of Medical Sciences, National Academy of Sciences, National Research Council, Washington, D.C.

    Google Scholar 

  23. Pedersen-Bjergaard J (1992) Radiotherapy and chemotherapy induced myelodysplasia and acute myeloid leukemia. A review. Leuk Res 16:61–65

    PubMed  Google Scholar 

  24. Pedersen-Bjergaard J, Ersboll J, Sorensen HM, Keiding N, Larsen SO, Philip P, Larsen MS, Schultz H, Nissen NI (1985) Risk of acute nonlymphocytic leukemia and preleukemia in patients treated with cyclophosphamide for non-Hodgkin's lymphomas. Ann Intern Med 103:195–199

    PubMed  Google Scholar 

  25. Pedersen-Bjergaard J, Philip P, Larsen SO, Jensen G, Byrstin K (1990) Chromosome aberrations and prognostic factors in therapy-related myelodysplasia and acute nonlymphocytic leukemia. Blood 76:1083–1091

    PubMed  Google Scholar 

  26. Preston DL, Kato H, Kopecky KJ, Fujita S (1987) Studies of the mortality of A-bomb survivors. Radiat Res 111:151–178

    PubMed  Google Scholar 

  27. Ritch PS, Anderson T, Hanson GA, Pisciotta AV (1982) Chronic granulocytic leukemia following radiation therapy for Hodgkin's disease. Cancer 52:462–464

    Google Scholar 

  28. Shapiro B, Fig LM, Carey JE (1992) Medical management of radiation accidents. Adria Medica 3:7–26

    Google Scholar 

  29. Siegel S (1956) Nonparametric statistics for the behavioral sciences. McGraw-Hill, New York

    Google Scholar 

  30. Smith PG (1977) Leukemia and other cancers following radiation treatment of pelvic disease. Cancer 39:1901–1905

    PubMed  Google Scholar 

  31. Von Jagic N, Schwartz G, von Siebenrock L (1911) Blutbefunde bei Roentgenlogen. Berl Klin Wochenschr XL 48:1220

    Google Scholar 

  32. Whang-peng J, Young RC, Lee EC, Longo DL, Schechter GP, De Vita VT (1988) Cytogenetic studies in patients with secondary leukemia/dysmyelopoietic syndrome after different treatment modalities. Blood 71:403–414

    PubMed  Google Scholar 

  33. Yunis JJ (1981) New chromosome techniques in the study of human neoplasia. Hum Pathol 12:540–549

    PubMed  Google Scholar 

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Corso, A., Lazzarino, M., Morra, E. et al. Chronic myelogenous leukemia and exposure to ionizing radiation — a retrospective study of 443 patients. Ann Hematol 70, 79–82 (1995). https://doi.org/10.1007/BF01834384

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  • DOI: https://doi.org/10.1007/BF01834384

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