Non-radiation risk factors for leukemia: A case-control study among chornobyl cleanup workers in Ukraine

Gudzenko, Nataliya; Hatch, Maureen; Bazyka, Dimitry; Dyagil, Iryna; Reiss, Robert F.; Brenner, Alina V.; Chumak, Vadim; Babkina, Nataliya; Zablotska, Lydia B.; Mabuchi, Kiyóhiko

doi:10.1016/j.envres.2015.06.019

Cited by 15 publications

(11 citation statements)

References 32 publications

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“…For example, a number of studies of farming populations now strongly suggest that pesticides and/or herbicides play a likely role in the etiology of CLL . However, in our study, occupational exposures to pesticides, solvents and benzene were not independent risk factors of CLL .…”

Section: Discussioncontrasting

confidence: 78%

Clinical characteristics of chronic lymphocytic leukemia occurring in chornobyl cleanup workers

Finch

Dyagil

Reiss

et al. 2016

Hematological Oncology

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The recently demonstrated radiation-induction of chronic lymphocytic leukemia (CLL) raises the question as to whether the amount of radiation exposure influences any of the clinical characteristics of the disease. We evaluated the relationship between bone marrow radiation doses and clinical characteristics and survival of 79 CLL cases diagnosed during 1986–2006 in a cohort of 110,645 male workers who participated in the cleanup work of the Chornobyl nuclear accident in Ukraine in 1986. All diagnoses were confirmed by an independent International Hematology Panel. Patients were followed up to the date of death or end of follow-up on October 31, 2010. The median age at diagnosis was 57 years. Median bone marrow dose was 22.6 milligray (mGy) and was not associated with time between exposure and clinical diagnosis of CLL (latent period), age, peripheral blood lymphocyte count or clinical stage of disease in univariate and multivariate analyses. A significant increase in the risk of death with increasing radiation dose was observed (P=0.03, hazard ratio=2.38, 95% confidence interval: 1.11,5.08 comparing those with doses ≥22 mGy to doses <22 mGy). After adjustment for radiation dose, survival of CLL cases was significantly shorter among those with younger age at first exposure, higher peripheral blood lymphocyte count, more advanced clinical stage of disease and older age at diagnosis (all P<0.05). This is the first study to examine association between bone marrow radiation doses from the Chornobyl accident and clinical manifestations of the CLL in Chornobyl cleanup workers. The current study provides new evidence on the association of radiation dose and younger age at first radiation exposure at Chornobyl with shorter survival after diagnosis. Future studies are necessary with more cases in order to improve the statistical power of these analyses and to determine their significance.

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Section: Discussioncontrasting

confidence: 78%

Clinical characteristics of chronic lymphocytic leukemia occurring in chornobyl cleanup workers

Finch

Dyagil

Reiss

et al. 2016

Hematological Oncology

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“…Previous analyses in the cohort of Chornobyl cleanup workers revealed significant radiation-related increased risk for all leukemia types, including chronic lymphocytic leukemia (CLL) [1][2][3]. Further study did not find additional effects of occupational and lifestyle factors on CLL risk in this radiationexposed cohort [4]. Numerous investigations emphasized the significance of genetic susceptibility to the development of tumors after exposure to carcinogens [5][6][7].…”

Section: The Distribution Of Tp53 Gene Polymorphisms In Chronic Lymphmentioning

confidence: 64%

The Distribution of Tp53 Gene Polymorphisms in Chronic Lymphocytic Leukemia Patients, Sufferers of Chornobyl Nuclear Power Plant Accident

et al. 2016

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Previous analyses in a cohort of Chornobyl cleanup workers revealed significantly increased radiation-related risk for all leukemia types, including chronic lymphocytic leukemia (CLL). Numerous investigations emphasized the significance of genetic susceptibility to the radiation carcinogenesis. The aim of the work was to study the distribution of TP53 single nucleotide polymorphisms (SNPs) in CLL patients exposed to ionizing radiation (IR) due to Chornobyl nuclear power plant accident and estimate their impact on disease development. Materials and Methods: The TP53 exonic and intronic SNPs were analyzed in 236 CLL patients by polymerase chain reaction and direct sequencing. The main group included 106 IR exposed CLL patients and the control group was composed of 130 IR non-exposed CLL patients. Results: Nineteen TP53 SNPs were found in the observed CLL cohort. No significant differences were found between the main and the control groups, but increased frequencies of T/T rs12947788 + G/G rs12951053 homozygotes and rs146340390 C/T variants were found among IR-exposed CLL patients compared with healthy Europeans (data from the 1000 Genomes Project). Rare nucleotide substitution rs146340390 (c.665C>T) was found only in the main group. These features were primarily typical for the most affected group of IR-exposed patients, namely, cleanup workers engaged in emergency works in the 2nd quarter of 1986. Conclusion: These preliminary findings don’t contradict the assumption on possible influence of IR on CLL development via the p53-dependent pathway. This article is a part of a Special Issue entitled “The Chornobyl Nuclear Accident: Thirty Years After”.

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“…After adjusting for radiation, there was found no clear association of leukemia risk with smoking or alcohol use but a two-fold elevated risk was identified for a non-CLL leukemia upon occupational exposure to petroleum (OR=2.28; 95% Confidence Interval 1.13,6.79). Risk was particularly high for the myeloid leukemia [19]. So, it can be suggested that exposure to similar confound factors has to be analyzed for MDS cases.…”

Section: Discussionmentioning

confidence: 99%

“…In the frame of mentioned above epidemiological study "The Ukrainian-American study of leukemia and related disorders among Chоrnobyl cleanup workers" a set of data on a range of non-radiation exposures was collected [19]. Potential for additional effects of occupational (including exposure to petroleum) and lifestyle (cigarette smoking and alcohol consumption) factors on leukemia risk in this radiation-exposed cohort was investigated.…”

Section: Discussionmentioning

confidence: 99%

Myelodysplastic Syndrome in Patients with Acute Radiation Syndrome Following the Chornobyl Nuclear Power Plant Accident

Liubarets¹,

Kovalenko²

2016

J Leuk

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The MDS cases (n=3) among acute radiation syndrome (ARS) survivors after the ChNPP accident were analyzed. MDS diagnoses were based on FAB (1982) and WHO classifications and included the refractory anemia (RA) (patient D. with ARS grade III), refractory anemia with ringed sideroblasts (RARS) (patient B. with ARS grade III), and unclassified MDS (MDS-U) (patient S. with ARS grade I). Clinical management of MDS in ARS patients was analyzed taking into consideration the morphological, immunological, and cytochemical peculiarities of haemopoietic cells. The ARS diagnoses were confirmed in a survey on a regular basis using standard cytogenetic method. Described MDS cases in ARS patients may be the secondary MDS variants taking into consideration possible radiation-induced injuries of hematopoietic cell genome due to the high dose of IR (1.7-5.5 Sv). The possible role of previous irradiation in a range of occupational dose limits before the ChNPP catastrophe for patients D. and B. with ARS grade III, both with possible role of such a confounding factor as petroleum exposure for patient S. (ARS grade I) for the development of MDS cannot be excluded.

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Non-radiation risk factors for leukemia: A case-control study among chornobyl cleanup workers in Ukraine

Cited by 15 publications

References 32 publications

Clinical characteristics of chronic lymphocytic leukemia occurring in chornobyl cleanup workers

Clinical characteristics of chronic lymphocytic leukemia occurring in chornobyl cleanup workers

The Distribution of Tp53 Gene Polymorphisms in Chronic Lymphocytic Leukemia Patients, Sufferers of Chornobyl Nuclear Power Plant Accident

Myelodysplastic Syndrome in Patients with Acute Radiation Syndrome Following the Chornobyl Nuclear Power Plant Accident

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