Risk of Myelodysplastic Syndromes in People Exposed to Ionizing Radiation: A Retrospective Cohort Study of Nagasaki Atomic Bomb Survivors

2011 ◽  
Vol 29 (4) ◽  
pp. 428-434 ◽  
Author(s):  
Masako Iwanaga ◽  
Wan-Ling Hsu ◽  
Midori Soda ◽  
Yumi Takasaki ◽  
Masayuki Tawara ◽  
...  
Keyword(s):  
Cohort Study ◽  
Radiation Dose ◽  
Ionizing Radiation ◽  
Dose Response ◽  
Myelodysplastic Syndromes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Radiation Effects ◽  
Atomic Bomb ◽  
Atomic Bomb Survivors

Purpose The risk of myelodysplastic syndromes (MDS) has not been fully investigated among people exposed to ionizing radiation. We investigate MDS risk and radiation dose-response in Japanese atomic bomb survivors. Patients and Methods We conducted a retrospective cohort study by using two databases of Nagasaki atomic bomb survivors: 64,026 people with known exposure distance in the database of Nagasaki University Atomic-Bomb Disease Institute (ABDI) and 22,245 people with estimated radiation dose in the Radiation Effects Research Foundation Life Span Study (LSS). Patients with MDS diagnosed from 1985 to 2004 were identified by record linkage between the cohorts and the Nagasaki Prefecture Cancer Registry. Cox and Poisson regression models were used to estimate relationships between exposure distance or dose and MDS risk. Results There were 151 patients with MDS in the ABDI cohort and 47 patients with MDS in the LSS cohort. MDS rate increased inversely with exposure distance, with an excess relative risk (ERR) decay per km of 1.2 (95% CI, 0.4 to 3.0; P < .001) for ABDI. MDS risk also showed a significant linear response to exposure dose level (P < .001) with an ERR per Gy of 4.3 (95% CI, 1.6 to 9.5; P < .001). After adjustment for sex, attained age, and birth year, the MDS risk was significantly greater in those exposed when young. Conclusion A significant linear radiation dose-response for MDS exists in atomic bomb survivors 40 to 60 years after radiation exposure. Clinicians should perform careful long-term follow-up of irradiated people to detect MDS as early as possible.

scholarly journals Occupational radiation and haematopoietic malignancy mortality in the retrospective cohort study of US radiologic technologists, 1983–2012

2020 ◽  
Vol 77 (12) ◽  
pp. 822-831
Author(s):  
Martha S Linet ◽  
Mark P Little ◽  
Cari M Kitahara ◽  
Elizabeth K Cahoon ◽  
Michele M Doody ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cohort Study ◽  
Radiation Dose ◽  
Dose Response ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Radiologic Technologists ◽  
Mortality Risks ◽  
Baseline Questionnaire ◽  
Occupational Radiation

ObjectivesTo evaluate cumulative occupational radiation dose response and haematopoietic malignancy mortality risks in the US radiologic technologist cohort.MethodsAmong 110 297 radiologic technologists (83 655 women, 26 642 men) who completed a baseline questionnaire sometime during 1983–1998, a retrospective cohort study was undertaken to assess cumulative, low-to-moderate occupational radiation dose and haematopoietic malignancy mortality risks during 1983–2012. Cumulative bone marrow dose (mean 8.5 mGy, range 0–430 mGy) was estimated based on 921 134 badge monitoring measurements during 1960–1997, work histories and historical data; 35.4% of estimated doses were based on badge measurements. Poisson regression was used to estimate excess relative risk of haematopoietic cancers per 100 milligray (ERR/100 mGy) bone-marrow absorbed dose, adjusting for attained age, sex and birth year.ResultsDeaths from baseline questionnaire completion through 2012 included 133 myeloid neoplasms, 381 lymphoid neoplasms and 155 leukaemias excluding chronic lymphocytic leukaemia (CLL). Based on a linear dose-response, no significant ERR/100 mGy occurred for acute myeloid leukaemia (ERR=0.0002, 95% CI <−0.02 to 0.24, p-trend>0.5, 85 cases) or leukaemia excluding CLL (ERR=0.05, 95% CI <−0.09 to 0.24, p-trend=0.21, 155 cases). No significant dose-response trends were observed overall for CLL (ERR<−0.023, 95% CI <−0.025 to 0.18, p-trend=0.45, 32 cases), non-Hodgkin lymphoma (ERR=0.03, 95% CI <−0.2 to 0.18, p-trend=0.4, 201 cases) or multiple myeloma (ERR=0.003, 95% CI −0.02 to 0.16, p-trend>0.5, 112 cases). Findings did not differ significantly by demographic factors, smoking or specific radiological procedures performed.ConclusionAfter follow-up averaging 22 years, there was little evidence of a relationship between occupational radiation exposure and myeloid or lymphoid haematopoietic neoplasms.

Incidence of lymphoid neoplasms among atomic bomb survivors by histological subtype: 1950-1994

Blood ◽  
2021 ◽  
Author(s):  
Megumu Fujihara ◽  
Ritsu Sakata ◽  
Noriaki Yoshida ◽  
Kotaro Ozasa ◽  
Dale L Preston ◽  
...  
Keyword(s):  
T Cell ◽  
Radiation Dose ◽  
B Cell ◽  
Dose Response ◽  
Atomic Bomb ◽  
Nk Cell ◽  
Precursor Cell ◽  
Atomic Bomb Survivors ◽  
Lymphoid Neoplasms ◽  
The Relationship

Epidemiological data have provided limited and inconsistent evidence on the relationship between radiation exposure and lymphoid neoplasms. We classified 553 lymphoid neoplasm cases diagnosed between 1950 and 1994 in the Life Span Study (LSS) cohort of atomic bomb survivors into WHO subtypes. Mature B-cell neoplasms represented 58%, mature T-cell and NK-cell neoplasms 20%; precursor cell neoplasms, 5%, and Hodgkin lymphoma, 3%; with the remaining 15% classified as non-Hodgkin lymphoid neoplasms or lymphoid neoplasms, not otherwise specified. We used Poisson regression methods to assess the relationship between radiation exposure and the more common subtypes. As in earlier reports, a significant dose response for non-Hodgkin lymphoid neoplasms as a group was seen for males but not females. However, subtype analyses showed that radiation dose was strongly associated with increased precursor cell neoplasms rates, with an estimated excess relative risk per Gy of 16 (95% Confidence interval: 7.0, &gt;533) at age 50. The current data based primarily of tissue-based diagnoses suggest that the association between radiation dose and lymphoid neoplasms as a group is largely driven by the radiation effect on precursor cell neoplasms while presenting no evidence of a radiation dose response for major categories of mature cell neoplasms, either B- or T-/NK-cell, or more specific disease entities (diffuse large B-cell lymphoma, plasma cell myeloma, adult T-cell leukemia/lymphoma) or Hodgkin lymphoma.

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