Zusammenfassung
Die Ätiologie der chronischen myeloischen Leukämie (CML) ist wie die der übrigen Leukämien ungeklärt. Es gibt jedoch Hinweise darauf, daß in manchen Fällen ionisierende Strahlen als leukämogener Faktor in Frage kommen. So hat sich gezeigt, daß bei den Überlebenden der Atomexplosionen von Hiroshima und Nagasaki die Leukämierate nach 1945 dramatisch anstieg (Moloney, 1955; Heyssel et al., 1960; Brill et al., 1962; Bizzozero et al., 1966, 1967). Die Inzidenz der CML erreichte ihr Maximum in den Jahren 1950–1952, lag aber auch nach 13 Jahren noch deutlich höher als in der übrigen japanischen Bevölkerung. Am häufigsten trat die Erkrankung bei Personen auf, die sich innerhalb der 1500-m-Zone befunden hatten. Mit steigender Entfernung vom Hypozentrum nahm die Leukämierate ab, was auf eine Dosisabhängigkeit hindeutet. Tatsächlich bestand nach einer Analyse von Heyssel et al. (1960) bei Strahlendosen über 50–100 rad eine lineare Beziehung zur Leukämiehäufigkeit. Auch Cronkite et al. (1960) errechneten, daß die Leukämierate nach einer einmaligen Strahlenexposition eine annähernd lineare Abhängigkeit von der verabreichten Dosis zeigt und bei Dosen über 100 rad etwa 1–2 Erkrankungsfälle/rad/Jahr/1 Mio. Einwohner beträgt. Ferner ist nachgewiesen worden, daß in den USA Radiologen in den Jahren 1929–1948 8–10mal und in den Jahren 1949–1958 4 – 5mal häufiger an Leukämie erkrankten als nicht radiologisch tätige Ärzte (March, 1961).
Innere Universitätsklinik und Poliklinik (Tumorforschung), Klinikum der Gesamthochschule Essen; die Chromosomenuntersuchungen wurden mit Unterstützung der Deutschen Forschungsgemeinschaft durchgeführt.
Hämatologische Abteilung, Medizinische Universitätsklinik und Poliklinik, Klinikum der Gesamthochschule Essen.
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Hossfeld, D.K., Cohnen, G. (1978). Die chronische myeloische Leukämie. In: Begemann, H., et al. Blut und Blutkrankheiten. Handbuch der Inneren Medizin, vol 2 / 6. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-66388-8_8
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