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Smirnova OA, Cucinotta FA. Dynamical modeling approach to risk assessment for radiogenic leukemia among astronauts engaged in interplanetary space missions. LIFE SCIENCES IN SPACE RESEARCH 2018; 16:76-83. [PMID: 29475522 DOI: 10.1016/j.lssr.2017.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 12/19/2017] [Accepted: 12/20/2017] [Indexed: 06/08/2023]
Abstract
A recently developed biologically motivated dynamical model of the assessment of the excess relative risk (ERR) for radiogenic leukemia among acutely/continuously irradiated humans (Smirnova, 2015, 2017) is applied to estimate the ERR for radiogenic leukemia among astronauts engaged in long-term interplanetary space missions. Numerous scenarios of space radiation exposure during space missions are used in the modeling studies. The dependence of the ERR for leukemia among astronauts on several mission parameters including the dose equivalent rates of galactic cosmic rays (GCR) and large solar particle events (SPEs), the number of large SPEs, the time interval between SPEs, mission duration, the degree of astronaut's additional shielding during SPEs, the degree of their additional 12-hour's daily shielding, as well as the total mission dose equivalent, is examined. The results of the estimation of ERR for radiogenic leukemia among astronauts, which are obtained in the framework of the developed dynamical model for various scenarios of space radiation exposure, are compared with the corresponding results, computed by the commonly used linear model. It is revealed that the developed dynamical model along with the linear model can be applied to estimate ERR for radiogenic leukemia among astronauts engaged in long-term interplanetary space missions in the range of applicability of the latter. In turn, the developed dynamical model is capable of predicting the ERR for leukemia among astronauts for the irradiation regimes beyond the applicability range of the linear model in emergency cases. As a supplement to the estimations of cancer incidence and death (REIC and REID) (Cucinotta et al., 2013, 2017), the developed dynamical model for the assessment of the ERR for leukemia can be employed on the pre-mission design phase for, e.g., the optimization of the regimes of astronaut's additional shielding in the course of interplanetary space missions. The developed model can also be used on the phase of the real-time responses during the space mission to make the decisions on the operational application of appropriate countermeasures to minimize the risks of occurrences of leukemia, especially, for emergency cases.
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Affiliation(s)
- Olga A Smirnova
- Federal State Unitary Enterprise Research and Technical Center of Radiation-Chemical Safety and Hygiene, Moscow, Russian Federation
| | - Francis A Cucinotta
- Department of Health Physics and Diagnostic Sciences, University of Nevada, Las Vegas, NV, USA.
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202
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Badie C, Blachowicz A, Barjaktarovic Z, Finnon R, Michaux A, Sarioglu H, Brown N, Manning G, Benotmane MA, Tapio S, Polanska J, Bouffler SD. Transcriptomic and proteomic analysis of mouse radiation-induced acute myeloid leukaemia (AML). Oncotarget 2018; 7:40461-40480. [PMID: 27250028 PMCID: PMC5130020 DOI: 10.18632/oncotarget.9626] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/09/2016] [Indexed: 01/06/2023] Open
Abstract
A combined transcriptome and proteome analysis of mouse radiation-induced AMLs using two primary AMLs, cell lines from these primaries, another cell line and its in vivo passage is reported. Compared to haematopoietic progenitor and stem cells (HPSC), over 5000 transcriptome alterations were identified, 2600 present in all materials. 55 and 3 alterations were detected in the proteomes of the cell lines and primary/in vivo passage material respectively, with one common to all materials. In cell lines, approximately 50% of the transcriptome changes are related to adaptation to cell culture, and in the proteome this proportion was higher. An AML 'signature' of 17 genes/proteins commonly deregulated in primary AMLs and cell lines compared to HPSCs was identified and validated using human AML transcriptome data. This also distinguishes primary AMLs from cell lines and includes proteins such as Coronin 1, pontin/RUVBL1 and Myeloperoxidase commonly implicated in human AML. C-Myc was identified as having a key role in radiation leukaemogenesis. These data identify novel candidates relevant to mouse radiation AML pathogenesis, and confirm that pathways of leukaemogenesis in the mouse and human share substantial commonality.
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Affiliation(s)
- Christophe Badie
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
| | - Agnieszka Blachowicz
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Techology, Gliwice, Poland
| | - Zarko Barjaktarovic
- Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Radiation Proteomics Group, Institute of Radiation Biology, Neuherberg, Germany
| | - Rosemary Finnon
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
| | - Arlette Michaux
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK•.CEN), Mol, Belgium
| | - Hakan Sarioglu
- Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Research Unit Protein Science, Neuherberg, Germany
| | - Natalie Brown
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
| | - Grainne Manning
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
| | - M Abderrafi Benotmane
- Radiobiology Unit, Institute for Environment, Health and Safety, Belgian Nuclear Research Centre (SCK•.CEN), Mol, Belgium
| | - Soile Tapio
- Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Radiation Proteomics Group, Institute of Radiation Biology, Neuherberg, Germany
| | - Joanna Polanska
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Techology, Gliwice, Poland
| | - Simon D Bouffler
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, UK
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203
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Lee C, Morton LM, de Gonzalez AB. A NOVEL METHOD TO ESTIMATE LYMPHOCYTE DOSE AND APPLICATION TO PEDIATRIC AND YOUNG ADULT CT PATIENTS IN THE UNITED KINGDOM. RADIATION PROTECTION DOSIMETRY 2018; 178:116-121. [PMID: 28981878 PMCID: PMC5927330 DOI: 10.1093/rpd/ncx084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/09/2017] [Accepted: 07/07/2017] [Indexed: 05/28/2023]
Abstract
Despite decades of epidemiological research, it remains uncertain whether ionizing radiation can cause lymphomas. Most epidemiological studies of lymphoma risk following non-uniform exposure used dose to red bone marrow (RBM), constituting a small fraction of the lymphocytes, as a surrogate of dose to the lymphocytes. We developed a method to estimate dose to the lymphocytes using the reference distribution of lymphocytes throughout the body and Monte Carlo simulations of computational human phantoms. We applied our method to estimating lymphocyte doses for a pediatric CT patient cohort in the United Kingdom. Estimated dose to the RBM was greater than lymphocyte dose for most scan types (up to 2.6-fold higher, a 5-year-old brain scan) except abdomen scan (RBM dose was about half the lymphocyte dose, a 5-year-old abdomen scan). The lymphocyte dose in the UK cohort showed that T-spine and whole body scans delivered the highest lymphocyte doses (up to 22.4 mGy).
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Affiliation(s)
- Choonsik Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA
| | - Amy Berrington de Gonzalez
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA
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204
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Detection of de novo single nucleotide variants in offspring of atomic-bomb survivors close to the hypocenter by whole-genome sequencing. J Hum Genet 2017; 63:357-363. [DOI: 10.1038/s10038-017-0392-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 10/11/2017] [Accepted: 11/07/2017] [Indexed: 12/30/2022]
Abstract
Abstract
Ionizing radiation released by the atomic bombs at Hiroshima and Nagasaki, Japan, in 1945 caused many long-term illnesses, including increased risks of malignancies such as leukemia and solid tumours. Radiation has demonstrated genetic effects in animal models, leading to concerns over the potential hereditary effects of atomic bomb-related radiation. However, no direct analyses of whole DNA have yet been reported. We therefore investigated de novo variants in offspring of atomic-bomb survivors by whole-genome sequencing (WGS). We collected peripheral blood from three trios, each comprising a father (atomic-bomb survivor with acute radiation symptoms), a non-exposed mother, and their child, none of whom had any past history of haematological disorders. One trio of non-exposed individuals was included as a control. DNA was extracted and the numbers of de novo single nucleotide variants in the children were counted by WGS with sequencing confirmation. Gross structural variants were also analysed. Written informed consent was obtained from all participants prior to the study. There were 62, 81, and 42 de novo single nucleotide variants in the children of atomic-bomb survivors, compared with 48 in the control trio. There were no gross structural variants in any trio. These findings are in accord with previously published results that also showed no significant genetic effects of atomic-bomb radiation on second-generation survivors.
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205
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Molenaar RJ, Sidana S, Radivoyevitch T, Advani AS, Gerds AT, Carraway HE, Angelini D, Kalaycio M, Nazha A, Adelstein DJ, Nasr C, Maciejewski JP, Majhail NS, Sekeres MA, Mukherjee S. Risk of Hematologic Malignancies After Radioiodine Treatment of Well-Differentiated Thyroid Cancer. J Clin Oncol 2017; 36:1831-1839. [PMID: 29252123 DOI: 10.1200/jco.2017.75.0232] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To investigate the risk and outcomes of second hematologic malignancies (SHMs) in a population-based cohort of patients with well-differentiated thyroid cancer (WDTC) treated or not with radioactive iodine (RAI). Methods Patients with WDTC were identified from SEER registries. Competing risk regression analysis was performed to calculate the risks of SHMs that occurred after WDTC treatment and outcomes after SHM development were assessed. Results Of 148,215 patients with WDTC, 53% received surgery alone and 47% received RAI. In total, 783 patients developed an SHM after a median interval of 6.5 years (interquartile range, 3.3 to 11.2 years) from WDTC diagnosis. In multivariable analysis, compared with those undergoing thyroidectomy alone, RAI treatment was associated with an increased early risk of developing acute myeloid leukemia (AML; hazard ratio, 1.79; 95% CI, 1.13 to 2.82; P = .01) and chronic myeloid leukemia (CML; hazard ratio, 3.44; 95% CI, 1.87 to 6.36; P < .001). This increased risk of AML and CML after RAI treatment was seen even in low-risk and intermediate-risk WDTC tumors. Occurrence of AML but not CML in patients with WDTC was associated with shorter median overall survival compared with matched controls (8.0 years v 31.0 years; P = .001). In addition, AML developing after RAI trended toward inferior survival compared with matched controls with de novo AML (median overall survival, 1.2 years v 2.9 years; P = .06). Conclusion Patients with WDTC treated with RAI had an increased early risk of developing AML and CML but no other hematologic malignancies. AML that arises after RAI treatment has a poor prognosis. RAI use in patients with WDTC should be limited to patients with high-risk disease features, and patients with WDTC treated with adjuvant RAI should be monitored for myeloid malignancies as part of cancer surveillance.
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Affiliation(s)
- Remco J Molenaar
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Surbhi Sidana
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Tomas Radivoyevitch
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Anjali S Advani
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Aaron T Gerds
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Hetty E Carraway
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Dana Angelini
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Matt Kalaycio
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Aziz Nazha
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - David J Adelstein
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Christian Nasr
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Jaroslaw P Maciejewski
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Navneet S Majhail
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Mikkael A Sekeres
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
| | - Sudipto Mukherjee
- Remco J. Molenaar, Surbhi Sidana, Tomas Radivoyevitch, Anjali S. Advani, Aaron T. Gerds, Hetty E. Carraway, Dana Angelini, Matt Kalaycio, Aziz Nazha, David J. Adelstein, Christian Nasr, Jaroslaw P. Maciejewski, Navneet S. Majhail, Mikkael A. Sekeres, and Sudipto Mukherjee, Cleveland Clinic, Cleveland, OH; Remco J. Molenaar, University of Amsterdam, Amsterdam, the Netherlands; and Surbhi Sidana, Mayo Clinic, Rochester, MN
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206
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Gao D, Xiao Z, Li HP, Han DH, Zhang YP. The mechanism study of miR-125b in occurrence and progression of multiple myeloma. Cancer Med 2017; 7:134-145. [PMID: 29214735 PMCID: PMC5773953 DOI: 10.1002/cam4.1181] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 07/26/2017] [Accepted: 08/08/2017] [Indexed: 12/25/2022] Open
Abstract
Although many efforts have contributed to improve our knowledge of molecular pathogenesis about multiple myeloma (MM), the role and significance of microRNAs and long noncoding RNAs in MM cells, along with the core mechanism remains virtually absent. The mRNA levels of miR-125b and MALAT1 in MM cell lines were detected by qRT-PCR. The influence of Lenti-Sh-miR-125b on cell viability and the Notch-1 pathway-related proteins were assessed by MTT method and western blot, respectively. We also investigated the regulation effect between MALAT1 and Notch1 pathway. Moreover, the connection between Notch1 signaling and MM cell growth was discussed in-depth. The reverse effect of pcDNA-Notch1 on the cell viability and Notch-1 pathway proteins induced by Si-MALAT1 was also studied. Furthermore, miR-125b overexpressing MM cell lines were injected subcutaneously into nude mice. MiR-125b and MALAT1 were inversely expressed in MM cell lines. Lenti-Sh-miR-125b inhibited the expression of MALAT1 and Notch-1 protein. Binding sites were confirmed between miR-125b and MALAT1, and silencing MALAT1 did not alter the expression of Notch-1. The apoptosis rate was increased and the survival rate was decreased obviously in GSI XII (targeted cleavage of Notch-1 receptor) group, along with the inhibited Notch1 and HES1 proteins. Moreover, the decreased cell viability and Notch-1 pathway proteins induced by Si-MALAT1 could be reversed by pcDNA-Notch1. Lenti-Sh-miR-125b promoted survival and decreased Notch1 and HES1 proteins levels, while this effect was reversed by si -MALAT1. MiR-125b regulated MALAT1 expression via Notch1 signaling pathway to regulate cell growth, thus participating in the occurrence and progression of MM, which functioned as a therapeutic target for tracking MM.
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Affiliation(s)
- Da Gao
- Department of Hematology, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Zhen Xiao
- Department of Hematology, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Hui-Ping Li
- Department of Hematology, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Dong-Hai Han
- Department of Hematology, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Ya-Peng Zhang
- Department of Hematology, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
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207
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Lecca P, Sorio C. Accurate prediction of the age incidence of chronic myeloid leukemia with an improved two-mutation mathematical model. Integr Biol (Camb) 2017; 8:1261-1275. [PMID: 27801472 DOI: 10.1039/c6ib00127k] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Chronic myeloid leukemia (CML) is a malignant clonal disorder whose hallmark is a reciprocal translocation between chromosomes 9 and 22 occurring in 95% of affected patients. This translocation causes the expression of a deregulated BCR/ABL fusion oncogene and, interestingly, is detectable in healthy individuals. Based on this information we assumed that the sole presence of the BCR/ABL transcript represents a necessary but not sufficient event for the clonal expansion of CML precursors. We developed a mathematical model introducing a probability that any normal cell undergoes a first aberration, and a probability that a cell that experienced a first mutation undergoes a second mutation as well. Two variants are proposed and analyzed: in the first the probability of the first mutation is supposed to be age independent and in the second, it depends on the hemopoietic cell turnover and mass. The model parameters have been estimated by regression from the observed CML incidence curves. Our models offer a significantly improved version of existing one-step and two-steps models, as they integrate key clinical and biological data reported in the literature and accurately fit the observed incidence. Our models also estimate the increased radiation-associated mutation rate at a younger age in atomic bomb survivors. Although this work focuses on CML, the modelling approach can be applied to all types of leukemia and lymphoma.
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Affiliation(s)
- Paola Lecca
- Department of Mathematics, University of Trento, via SOmamrive, 14, 38123 Trento, Italy.
| | - Claudio Sorio
- Department of Medicine, General Pathology Division, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy
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208
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Hsieh WH, Lin IF, Ho JC, Chang PW. 30 years follow-up and increased risks of breast cancer and leukaemia after long-term low-dose-rate radiation exposure. Br J Cancer 2017; 117:1883-1887. [PMID: 28972968 PMCID: PMC5729469 DOI: 10.1038/bjc.2017.350] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 08/19/2017] [Accepted: 09/07/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The current study followed-up site-specific cancer risks in an unique cohort with 30 years' follow-up after long-term low-dose-rate radiation exposure in Taiwan. METHODS Six thousand two hundred and forty two Taiwanese people received extra exposure in residential and school buildings constructed with Co-60-contaminated steel from 1982 until informed and relocated in early 1990s. The additional doses received have been estimated. During 1983-2012, 300 cancer cases were identified through the national cancer registry in Taiwan, 247 cases with minimum latent periods from initial exposure. The hazard ratios (HR) of site-specific cancers were estimated with additional cumulative exposure estimated individually. RESULTS Dose-dependent risks were statistically significantly increased for leukaemia excluding chronic lymphocytic leukaemia (HR100mSv 1.18; 90% CI 1.04-1.28), breast cancers (HR100mSv 1.11; 90% CI 1.05-1.20), and all cancers (HR100mSv 1.05; 90% CI 1.0-1.08, P=0.04). Women with an initial age of exposure lower than 20 were shown with dose response increase in breast cancers risks (HR100mSv 1.38; 90% CI 1.14-1.60; P=0.0008). CONCLUSIONS Radiation exposure before age 20 was associated with a significantly increased risk of breast cancer at much lower radiation exposure than observed previously.
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Affiliation(s)
- Wan-Hua Hsieh
- Department of Public Health, Tzu Chi University, Hualien 970, Taiwan
| | - I-Feng Lin
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Jung-Chun Ho
- School of Oral Hygiene, Taipei Medical University, Taipei 110, Taiwan
- Department of Nursing, Kang-Ning University, Taipei 114, Taiwan
| | - Peter Wushou Chang
- Taipei Hospital, Ministry of Health and Welfare, New Taipei City 242, Taiwan
- National Health Research Institute, Miaoli 350, Taiwan
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209
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Candéias SM, Mika J, Finnon P, Verbiest T, Finnon R, Brown N, Bouffler S, Polanska J, Badie C. Low-dose radiation accelerates aging of the T-cell receptor repertoire in CBA/Ca mice. Cell Mol Life Sci 2017; 74:4339-4351. [PMID: 28667356 PMCID: PMC11107572 DOI: 10.1007/s00018-017-2581-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 06/15/2017] [Accepted: 06/26/2017] [Indexed: 11/28/2022]
Abstract
While the biological effects of high-dose-ionizing radiation on human health are well characterized, the consequences of low-dose radiation exposure remain poorly defined, even though they are of major importance for radiological protection. Lymphocytes are very radiosensitive, and radiation-induced health effects may result from immune cell loss and/or immune system impairment. To decipher the mechanisms of effects of low doses, we analyzed the modulation of the T-cell receptor gene repertoire in mice exposed to a single low (0.1 Gy) or high (1 Gy) dose of radiation. High-throughput T-cell receptor gene profiling was used to visualize T-lymphocyte dynamics over time in control and irradiated mice. Radiation exposure induces "aging-like" effects on the T-cell receptor gene repertoire, detectable as early as 1 month post-exposure and for at least 6 months. Surprisingly, these effects are more pronounced in animals exposed to 0.1 Gy than to 1 Gy, where partial correction occurs over time. Importantly, we found that low-dose radiation effects are partially due to the hematopoietic stem cell impairment. Collectively, our findings show that acute low-dose radiation exposure specifically results in long-term alterations of the T-lymphocyte repertoire.
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Affiliation(s)
- Serge M Candéias
- CEA, Fundamental Research Division, Biosciences and Biotechnologies Institute, Laboratory of Chemistry and Biology of Metals, 38054, Grenoble, France.
- Laboratory of Chemistry and Biology of Metals, CNRS, UMR5249, 38054, Grenoble, France.
- Laboratory of Chemistry and Biology of Metals, UMR5249, University of Grenoble-Alpes, 38054, Grenoble, France.
| | - Justyna Mika
- Data Mining Group, Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, Gliwice, Poland
| | - Paul Finnon
- Cancer Mechanisms and Biomarkers Group, Radiation Effects Department, CRCE, Public Health England, Didcot, UK
| | - Tom Verbiest
- Cancer Mechanisms and Biomarkers Group, Radiation Effects Department, CRCE, Public Health England, Didcot, UK
| | - Rosemary Finnon
- Cancer Mechanisms and Biomarkers Group, Radiation Effects Department, CRCE, Public Health England, Didcot, UK
| | - Natalie Brown
- Cancer Mechanisms and Biomarkers Group, Radiation Effects Department, CRCE, Public Health England, Didcot, UK
| | - Simon Bouffler
- Cancer Mechanisms and Biomarkers Group, Radiation Effects Department, CRCE, Public Health England, Didcot, UK
| | - Joanna Polanska
- Data Mining Group, Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, Gliwice, Poland
| | - Christophe Badie
- Cancer Mechanisms and Biomarkers Group, Radiation Effects Department, CRCE, Public Health England, Didcot, UK.
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210
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Samet JM, Berrington de González A, Dauer LT, Hatch M, Kosti O, Mettler FA, Satyamitra MM. Gilbert W. Beebe Symposium on 30 Years after the Chernobyl Accident: Current and Future Studies on Radiation Health Effects. Radiat Res 2017; 189:5-18. [PMID: 29136393 DOI: 10.1667/rr14791.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This commentary summarizes the presentations and discussions from the 2016 Gilbert W. Beebe symposium "30 years after the Chernobyl accident: Current and future studies on radiation health effects." The symposium was hosted by the National Academies of Sciences, Engineering, and Medicine (the National Academies). The symposium focused on the health consequences of the Chernobyl accident, looking retrospectively at what has been learned and prospectively at potential future discoveries using emerging 21st Century research methodologies.
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Affiliation(s)
- Jonathan M Samet
- a Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | | | | | - Ourania Kosti
- d National Academies of Sciences, Engineering, and Medicine, Washington, DC
| | - Fred A Mettler
- e University of New Mexico School of Medicine, Albuquerque, New Mexico
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211
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Risk of developing chronic myeloid neoplasms in well-differentiated thyroid cancer patients treated with radioactive iodine. Leukemia 2017; 32:952-959. [DOI: 10.1038/leu.2017.323] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/23/2017] [Accepted: 10/26/2017] [Indexed: 01/22/2023]
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212
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Hatch M, Cardis E. Somatic health effects of Chernobyl: 30 years on. Eur J Epidemiol 2017; 32:1047-1054. [PMID: 28929329 DOI: 10.1007/s10654-017-0303-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 08/23/2017] [Indexed: 01/01/2023]
Abstract
2016 marked the 30th anniversary of the Chernobyl Nuclear Power Plant accident. We and others wrote reviews for the 25th anniversary. Since then, additional papers have appeared and it seems timely to highlight lessons learned. To present, not a systematic review, but a commentary drawing attention to notable findings. We include not only recent reports and updates on previous results, but key findings from prior Chernobyl studies. The dose-dependent increase in Papillary Thyroid Cancer (PTC) following childhood I-131 exposure in Ukraine and Belarus has now been shown to persist for decades. Studies of post-Chernobyl PTCs have produced novel information on chromosomal rearrangements and gene fusions, critical to understanding molecular mechanisms. Studies of clean-up workers/liquidators suggest dose-related increases of thyroid cancer and hematological malignancies in adults. They also report increases in cardiovascular and cerebrovascular disease. If confirmed, these would have significant public health and radiation protection implications. The lens opacities following low to moderate doses found earlier are also a concern, particularly among interventional radiologists who may receive substantial lens doses. Finally, there is some, inconsistent, evidence for genetic effects among offspring of exposed persons. Further efforts, including improved dosimetry, collection of information on other risk factors, and continued follow-up/monitoring of established cohorts, could contribute importantly to further understand effects of low doses and dose-rates of radiation, particularly in young people, and ensure that appropriate public health and radiation protection systems are in place. This will require multinational collaborations and long-term funding.
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Affiliation(s)
- Maureen Hatch
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, 20892-9778, USA
| | - Elisabeth Cardis
- Radiation Programme, Barcelona Institute for Global Health (ISGlobal), Campus Mar, Barcelona Biomedical Research Park (PRBB), Dr Aiguader 88, 08003, Barcelona, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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213
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Sollazzo A, Brzozowska B, Cheng L, Lundholm L, Haghdoost S, Scherthan H, Wojcik A. Alpha Particles and X Rays Interact in Inducing DNA Damage in U2OS Cells. Radiat Res 2017; 188:400-411. [DOI: 10.1667/rr14803.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Alice Sollazzo
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Beata Brzozowska
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Lei Cheng
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Lovisa Lundholm
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Siamak Haghdoost
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Harry Scherthan
- Bundeswehr Institute of Radiobiology, D-80937 Munich, Germany
| | - Andrzej Wojcik
- Centre for Radiation Protection Research, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
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214
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Residential exposure to ultraviolet light and risk of precursor B-cell acute lymphoblastic leukemia: assessing the role of individual risk factors, the ESCALE and ESTELLE studies. Cancer Causes Control 2017; 28:1075-1083. [DOI: 10.1007/s10552-017-0936-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 07/27/2017] [Indexed: 11/26/2022]
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215
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Talibov M, Auvinen A, Weiderpass E, Hansen J, Martinsen JI, Kjaerheim K, Tryggvadottir L, Pukkala E. Occupational solvent exposure and adult chronic lymphocytic leukemia: No risk in a population-based case-control study in four Nordic countries. Int J Cancer 2017; 141:1140-1147. [PMID: 28571111 DOI: 10.1002/ijc.30814] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/15/2017] [Accepted: 05/23/2017] [Indexed: 11/11/2022]
Abstract
The aim of this study was to assess the effect of occupational solvent exposure on the risk of adult chronic lymphocytic leukemia (CLL). The current case-control study was nested in the Nordic Occupational Cancer Study (NOCCA) cohort. 20,615 CLL cases diagnosed in 1961-2005 in Finland, Iceland, Norway, and Sweden, and 103,075 population-based controls matched by year of birth, sex, and country were included. Occupational histories for cases and controls were obtained from census records in 1960, 1970, 1980/1981, and 1990. Exposure to selected solvents was estimated by using the NOCCA job-exposure matrix (NOCCA-JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by using conditional logistic regression models. Overall, nonsignificant CLL risk elevations were observed for methylene chloride, perchloroethylene, and 1,1,1-trichloroethane. Compared to unexposed, significantly increased risks were observed for cumulative perchloroethylene exposure ≤13.3 ppm-years (OR = 1.85, 95% CI 1.16-2.96) and average life-time perchloroethylene exposure ≤2.5 ppm (1.61, 95% CI 1.01-2.56) among women, and cumulative methylene chloride exposure ≤12.5 ppm-years (OR = 1.19, 95% CI 1.01-1.41) and 12.5-74.8 ppm-years (OR = 1.23, 95% CI 1.01-1.51) among men in an analysis with 5 years lag-time, though without dose-response pattern. Decreased CLL risk was observed for aliphatic and alicyclic hydrocarbon solvents and toluene. This study did not support associations for solvent exposure and CLL. Observed weak associations for methylene chloride, perchloroethylene, 1,1,1-trichloroethane exposures, aliphatic and alicyclic hydrocarbons and toluene were not consistent across sexes, and showed no gradient with amount of exposure.
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Affiliation(s)
- Madar Talibov
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Anssi Auvinen
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.,Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Johnni Hansen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Eero Pukkala
- Faculty of Social Sciences, University of Tampere, Tampere, Finland.,Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
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216
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Boice JD. The linear nonthreshold (LNT) model as used in radiation protection: an NCRP update. Int J Radiat Biol 2017; 93:1079-1092. [DOI: 10.1080/09553002.2017.1328750] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- John D. Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA
- Department of Medicine, Division of Epidemiology, Vanderbilt University, Nashville, TN, USA
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217
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Finch SC, Dyagil I, Reiss RF, Gudzenko N, Babkina N, Lyubarets T, Bebeshko V, Romanenko A, Chumak VV, Bouville A, Hatch M, Little MP, Bazyka D, Zablotska LB. Clinical characteristics of chronic lymphocytic leukemia occurring in chornobyl cleanup workers. Hematol Oncol 2017; 35:215-224. [PMID: 26806761 PMCID: PMC5531054 DOI: 10.1002/hon.2278] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 11/23/2015] [Accepted: 12/04/2015] [Indexed: 11/06/2022]
Abstract
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 31 October 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. Latent period was significantly shorter among those older at first exposure, smokers and those with higher frequency of visits to the doctor prior to diagnosis. 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. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Stuart C. Finch
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Irina Dyagil
- National Research Center for Radiation Medicine, Kyiv, Ukraine
| | - Robert F. Reiss
- Department of Pathology and Cell Biology, and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | | | | | | | | | | | - Vadim V. Chumak
- National Research Center for Radiation Medicine, Kyiv, Ukraine
| | - Andre Bouville
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Maureen Hatch
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Mark P. Little
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine, Kyiv, Ukraine
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
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218
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Chernyavskiy P, Edmondson EF, Weil MM, Little MP. High-energy particle beam and gamma radiation exposure, familial relatedness and cancer in mice. Br J Cancer 2017; 117:41-50. [PMID: 28535153 PMCID: PMC5520205 DOI: 10.1038/bjc.2017.141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 04/12/2017] [Accepted: 04/24/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Some highly penetrant familial cancer syndromes exhibit elevated leukaemia risk, and there is evidence for familial clustering of lung cancer and other common cancers. Lung cancer and leukaemia are strongly radiogenic, but there are few indications that high-energy beam irradiation is markedly more effective than lower-energy radiation. METHODS We used a Cox model with familially structured random effects to assess 16 mortality end points in a group of 1850 mice in 47 families maintained in a circular-breeding scheme, exposed to accelerated Si or Fe ions (0.4 Gy) or 137Cs gamma rays (3 Gy). RESULTS There is periodicity in the effect of familial relatedness, which is most pronounced for pulmonary adenoma, Harderian-gland adenoma, Harderian-gland tumour, ectodermal tumour, pulmonary adenocarcinoma and hepatocellular carcinoma (P=0.0001/0.0003/0.0017/0.0035/0.0257/0.0340, respectively) with families that are 3-4 generations apart most strongly correlated; myeloid leukaemia also exhibited a striking periodic correlation structure. The relative risks of high-energy Si or Fe ions are not significantly different and are less than for 137Cs gamma-rays for most end points at the doses used. CONCLUSIONS There is periodicity in the effect of familial relatedness for various cancer sites. The effects per unit dose of high-energy charged particle beams are no higher than ninefold those of lower-energy gamma radiation.
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Affiliation(s)
- Pavel Chernyavskiy
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Elijah F Edmondson
- Colorado State University, Fort Collins, CO 80523, USA.,Frederick National Laboratory for Cancer Research, National Cancer Institute, Fort Detrick, Frederick, MD 21702, USA
| | | | - Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
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219
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Shore R, Walsh L, Azizova T, Rühm W. Risk of solid cancer in low dose-rate radiation epidemiological studies and the dose-rate effectiveness factor. Int J Radiat Biol 2017; 93:1064-1078. [DOI: 10.1080/09553002.2017.1319090] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Roy Shore
- Environmental Medicine, New York University School of Medicine, New York, U.S.A
| | - Linda Walsh
- Department of Physics, University of Zurich, Zurich, Switzerland
| | - Tamara Azizova
- Clinical Department, Southern Urals Biophysics Institute, Ozyorsk, Russia
| | - Werner Rühm
- Department of Radiation Sciences, Institute of Radiation Protection, Helmholtz Centre Munich, Neuherberg, Germany
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220
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No increased prevalence of malignancies among first-degree relatives of 800 patients with chronic myeloid leukemia: a population-based study in Sweden. Leukemia 2017; 31:1825-1827. [DOI: 10.1038/leu.2017.131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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221
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Grant EJ, Brenner A, Sugiyama H, Sakata R, Sadakane A, Utada M, Cahoon EK, Milder CM, Soda M, Cullings HM, Preston DL, Mabuchi K, Ozasa K. Solid Cancer Incidence among the Life Span Study of Atomic Bomb Survivors: 1958-2009. Radiat Res 2017; 187:513-537. [PMID: 28319463 PMCID: PMC10320812 DOI: 10.1667/rr14492.1] [Citation(s) in RCA: 278] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
This is the third analysis of solid cancer incidence among the Life Span Study (LSS) cohort of atomic bomb survivors in Hiroshima and Nagasaki, adding eleven years of follow-up data since the previously reported analysis. For this analysis, several changes and improvements were implemented, including updated dose estimates (DS02R1) and adjustment for smoking. Here, we focus on all solid cancers in aggregate. The eligible cohort included 105,444 subjects who were alive and had no known history of cancer at the start of follow-up. A total of 80,205 subjects had individual dose estimates and 25,239 were not in either city at the time of the bombings. The follow-up period was 1958-2009, providing 3,079,484 person-years of follow-up. Cases were identified by linkage with population-based Hiroshima and Nagasaki Cancer Registries. Poisson regression methods were used to elucidate the nature of the radiation-associated risks per Gy of weighted absorbed colon dose using both excess relative risk (ERR) and excess absolute risk (EAR) models adjusted for smoking. Risk estimates were reported for a person exposed at age 30 years with attained age of 70 years. In this study, 22,538 incident first primary solid cancer cases were identified, of which 992 were associated with radiation exposure. There were 5,918 cases (26%) that occurred in the 11 years (1999-2009) since the previously reported study. For females, the dose response was consistent with linearity with an estimated ERR of 0.64 per Gy (95% CI: 0.52 to 0.77). For males, significant upward curvature over the full dose range as well as restricted dose ranges was observed and therefore, a linear-quadratic model was used, which resulted in an ERR of 0.20 (95% CI: 0.12 to 0.28) at 1 Gy and an ERR of 0.010 (95% CI: -0.0003 to 0.021) at 0.1 Gy. The shape of the ERR dose response was significantly different among males and females (P = 0.02). While there was a significant decrease in the ERR with increasing attained age, this decrease was more rapid in males compared to females. The lowest dose range that showed a statistically significant dose response using the sex-averaged, linear ERR model was 0-100 mGy (P = 0.038). In conclusion, this analysis demonstrates that solid cancer risks remain elevated more than 60 years after exposure. Sex-averaged upward curvature was observed in the dose response independent of adjustment for smoking. Findings from the current analysis regarding the dose-response shape were not fully consistent with those previously reported, raising unresolved questions. At this time, uncertainties in the shape of the dose response preclude definitive conclusions to confidently guide radiation protection policies. Upcoming results from a series of analyses focusing on the radiation risks for specific organs or organ families, as well as continued follow-up are needed to fully understand the nature of radiation-related cancer risk and its public health significance. Data and analysis scripts are available for download at: http://www.rerf.or.jp .
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Affiliation(s)
- Eric J. Grant
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Alina Brenner
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Hiromi Sugiyama
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Ritsu Sakata
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Atsuko Sadakane
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Mai Utada
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Elizabeth K. Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Caitlin M. Milder
- Department of Visiting Researcher, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Midori Soda
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Harry M. Cullings
- Department of Statistics, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | | | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Kotaro Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
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222
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Preston DL, Sokolnikov ME, Krestinina LY, Stram DO. Estimates of Radiation Effects on Cancer Risks in the Mayak Worker, Techa River and Atomic Bomb Survivor Studies. RADIATION PROTECTION DOSIMETRY 2017; 173:26-31. [PMID: 27885076 DOI: 10.1093/rpd/ncw316] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
For almost 50 y, the Life Span Study cohort of atomic bomb survivor studies has been the primary source of the quantitative estimates of cancer and non-cancer risks that form the basis of international radiation protection standards. However, the long-term follow-up and extensive individual dose reconstruction for the Russian Mayak worker cohort (MWC) and Techa River cohort (TRC) are providing quantitative information about radiation effects on cancer risks that complement the atomic bomb survivor-based risk estimates. The MWC, which includes ~26 000 men and women who began working at Mayak between 1948 and 1982, is the primary source for estimates of the effects of plutonium on cancer risks and also provides information on the effects of low-dose rate external gamma exposures. The TRC consists of ~30 000 men and women of all ages who received low-dose-rate, low-dose exposures as a consequence of Mayak's release of radioactive material into the Techa River. The TRC data are of interest because the exposures are broadly similar to those experienced by populations exposed as a consequence of nuclear accidents such as Chernobyl. In this presentation, it is described the strengths and limitations of these three cohorts, outline and compare recent solid cancer and leukemia risk estimates and discussed why information from the Mayak and Techa River studies might play a role in the development and refinement of the radiation risk estimates that form the basis for radiation protection standards.
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Affiliation(s)
- Dale L Preston
- Hirosoft International, 1335 H Street, Eureka, CA95501, USA
| | - Mikhail E Sokolnikov
- Epidemiology Laboratory Southern Urals Biophysics Institute, Ozyorskoe Schosse 19, Ozyorsk456780, Russian Federation
| | - Lyudmila Yu Krestinina
- Epidemiology Laboratory, Urals Research Center for Radiation Medicine, 68-A Vorovsky Street, Chelyabinsk454076, Russian Federation
| | - Daniel O Stram
- Division of Biostatistics and Genetic Epidemiology, University of Southern California, Room 116, 2001 N Soto Street, Los Angeles, CA90033, USA
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223
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Demoury C, Marquant F, Ielsch G, Goujon S, Debayle C, Faure L, Coste A, Laurent O, Guillevic J, Laurier D, Hémon D, Clavel J. Residential Exposure to Natural Background Radiation and Risk of Childhood Acute Leukemia in France, 1990-2009. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:714-720. [PMID: 27483500 PMCID: PMC5381982 DOI: 10.1289/ehp296] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/20/2016] [Accepted: 07/11/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND Exposures to high-dose ionizing radiation and high-dose rate ionizing radiation are established risk factors for childhood acute leukemia (AL). The risk of AL following exposure to lower doses due to natural background radiation (NBR) has yet to be conclusively determined. METHODS AL cases diagnosed over 1990-2009 (9,056 cases) were identified and their municipality of residence at diagnosis collected by the National Registry of Childhood Cancers. The Geocap study, which included the 2,763 cases in 2002-2007 and 30,000 population controls, was used for complementary analyses. NBR exposures were modeled on a fine scale (36,326 municipalities) based on measurement campaigns and geological data. The power to detect an association between AL and dose to the red bone marrow (RBM) fitting UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) predictions was 92%, 45% and 99% for exposure to natural gamma radiation, radon and total radiation, respectively. RESULTS AL risk, irrespective of subtype and age group, was not associated with the exposure of municipalities to radon or gamma radiation in terms of yearly exposure at age reached, cumulative exposure or RBM dose. There was no confounding effect of census-based socio-demographic indicators, or environmental factors (road traffic, high voltage power lines, vicinity of nuclear plants) related to AL in the Geocap study. CONCLUSIONS Our findings do not support the hypothesis that residential exposure to NBR increases the risk of AL, despite the large size of the study, fine scale exposure estimates and wide range of exposures over France. However, our results at the time of diagnosis do not rule out a slight association with gamma radiation at the time of birth, which would be more in line with the recent findings in the UK and Switzerland.
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Affiliation(s)
- Claire Demoury
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l’enfant et de l’adolescent, Paris, France
| | - Fabienne Marquant
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l’enfant et de l’adolescent, Paris, France
| | - Géraldine Ielsch
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Bureau d’étude et d’expertise du radon et de la modélisation (PRP-DGE/SEDRAN/BERAM), Fontenay aux Roses, France
| | - Stéphanie Goujon
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l’enfant et de l’adolescent, Paris, France
- French National Registry of Childhood Hematological Malignancies, Villejuif, France
| | - Christophe Debayle
- IRSN, Laboratoire de surveillance atmosphérique et d’alerte (PRP-ENV/SESURE/LS2A), Le Vésinet, France
| | - Laure Faure
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l’enfant et de l’adolescent, Paris, France
- French National Registry of Childhood Hematological Malignancies, Villejuif, France
| | - Astrid Coste
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l’enfant et de l’adolescent, Paris, France
| | - Olivier Laurent
- IRSN, Laboratoire d’épidémiologie des rayonnements ionisants (PRP-HOM/SRBE/LEPID), Fontenay aux Roses, France
| | - Jérôme Guillevic
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Bureau d’étude et d’expertise du radon et de la modélisation (PRP-DGE/SEDRAN/BERAM), Fontenay aux Roses, France
| | - Dominique Laurier
- IRSN, Laboratoire d’épidémiologie des rayonnements ionisants (PRP-HOM/SRBE/LEPID), Fontenay aux Roses, France
| | - Denis Hémon
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l’enfant et de l’adolescent, Paris, France
| | - Jacqueline Clavel
- INSERM, Université Paris-Descartes, Université Sorbonne-Paris-Cité, CRESS-EPICEA Epidémiologie des cancers de l’enfant et de l’adolescent, Paris, France
- French National Registry of Childhood Hematological Malignancies, Villejuif, France
- Address correspondence to J. Clavel, CRESS–INSERM U1153, 16 Avenue Paul Vaillant-Couturier, F-94807 Villejuif Cedex, France. Telephone: 33 (01) 45 59 50 38.
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Wang R, Zeidan A, Yu JB, Soulos PR, Davidoff AJ, Gore SD, Huntington S, Gross CP, Ma X. Myelodysplastic Syndromes and Acute Myeloid Leukemia After Radiotherapy for Prostate Cancer: A Population-Based Study. Prostate 2017; 77:437-445. [PMID: 27868212 PMCID: PMC5785924 DOI: 10.1002/pros.23281] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 11/04/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND To understand the impact of radiotherapy on the development of myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) among elderly prostate cancer patients. METHODS We performed a retrospective cohort study of elderly prostate cancer patients diagnosed during 1999-2011 by using the National Cancer Institute's Surveillance, Epidemiology and End Results-Medicare linked database. Competing risk analyses adjusting for patient characteristics were conducted to assess the impact of radiotherapy on the development of subsequent MDS/AML, compared with surgery. RESULTS Of 32,112 prostate cancer patients, 14,672 underwent radiotherapy, and 17,440 received surgery only. The median follow-up was 4.68 years. A total of 157 (0.47%) prostate cancer patients developed subsequent MDS or AML, and the median time to develop MDS/AML was 3.30 (range: 0.16-9.48) years. Compared with prostate cancer patients who received surgery only, patients who underwent radiotherapy had a significantly increased risk of developing MDS/AML (hazard ratio [HR] =1.51, 95% confidence interval [CI]: 1.07-2.13). When radiotherapy was further categorized by modalities (brachytherapy, conventional conformal radiotherapy, and intensity-modulated radiotherapy [IMRT]), increased risk of second MDS/AML was only observed in the IMRT group (HR = 1.66, 95% CI: 1.09-2.54). CONCLUSIONS Our findings suggest that radiotherapy for prostate cancer increases the risk of MDS/AML, and the impact may differ by modality. Additional studies with longer follow-up are needed to further clarify the role of radiotherapy in the development of subsequent myeloid malignancies. A better understanding may help patients, physicians, and other stakeholders make more informed treatment decisions. Prostate 77:437-445, 2017. © 2016 Wiley Periodicals, Inc.
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MESH Headings
- Aged
- Aged, 80 and over
- Cohort Studies
- Follow-Up Studies
- Humans
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/epidemiology
- Leukemia, Myeloid, Acute/etiology
- Leukemia, Radiation-Induced/diagnosis
- Leukemia, Radiation-Induced/epidemiology
- Leukemia, Radiation-Induced/etiology
- Male
- Myelodysplastic Syndromes/diagnosis
- Myelodysplastic Syndromes/epidemiology
- Myelodysplastic Syndromes/etiology
- Population Surveillance/methods
- Prostatic Neoplasms/diagnosis
- Prostatic Neoplasms/epidemiology
- Prostatic Neoplasms/radiotherapy
- Radiotherapy, Intensity-Modulated/adverse effects
- Retrospective Studies
- Risk Factors
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Affiliation(s)
- Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health
- Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale University
| | - Amer Zeidan
- Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale University
- Department of Internal Medicine, Yale School of Medicine
| | - James B. Yu
- Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale University
- Department of Therapeutic Radiology, Yale School of Medicine
| | - Pamela R. Soulos
- Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale University
- Department of Internal Medicine, Yale School of Medicine
| | - Amy J. Davidoff
- Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale University
- Department of Health Policy and Management, Yale School of Public Health
| | - Steven D. Gore
- Department of Internal Medicine, Yale School of Medicine
| | - Scott Huntington
- Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale University
- Department of Internal Medicine, Yale School of Medicine
| | - Cary P. Gross
- Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale University
- Department of Internal Medicine, Yale School of Medicine
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health
- Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale University
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Daniels RD, Bertke SJ, Richardson DB, Cardis E, Gillies M, O'Hagan JA, Haylock R, Laurier D, Leuraud K, Moissonnier M, Thierry-Chef I, Kesminiene A, Schubauer-Berigan MK. Examining temporal effects on cancer risk in the international nuclear workers' study. Int J Cancer 2017; 140:1260-1269. [PMID: 27914102 PMCID: PMC5286034 DOI: 10.1002/ijc.30544] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/16/2016] [Indexed: 11/12/2022]
Abstract
The paper continues the series of publications from the International Nuclear Workers Study cohort that comprises 308,297 workers from France, the United Kingdom and the United States, providing 8.2 million person-years of observation from a combined follow-up period (at earliest 1944 to at latest 2005). These workers' external radiation exposures were primarily to photons, resulting in an estimated average career absorbed dose to the colon of 17.4 milligray. The association between cumulative ionizing radiation dose and cancer mortality was evaluated in general relative risk models that describe modification of the excess relative risk (ERR) per gray (Gy) by time since exposure and age at exposure. Methods analogous to a nested-case control study using conditional logistic regression of sampled risks sets were used. Outcomes included: all solid cancers, lung cancer, leukemias excluding chronic lymphocytic, acute myeloid leukemia, chronic myeloid leukemia, multiple myeloma, Hodgkin lymphoma and non-Hodgkin lymphoma. Significant risk heterogeneity was evident in chronic myeloid leukemia with time since exposure, where we observed increased ERR per Gy estimates shortly after exposure (2-10 year) and again later (20-30 years). We observed delayed effects for acute myeloid leukemia although estimates were not statistically significant. Solid cancer excess risk was restricted to exposure at age 35+ years and also diminished for exposure 30 years prior to attained age. Persistent or late effects suggest additional follow-up may inform on lifetime risks. However, cautious interpretation of results is needed due to analytical limitations and a lack of confirmatory results from other studies.
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Affiliation(s)
- Robert D. Daniels
- National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USA
| | - Stephen J. Bertke
- National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USA
| | - David B. Richardson
- Department of Epidemiology. University of North Carolina. Chapel Hill, NC, USA
| | - Elisabeth Cardis
- ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Michael Gillies
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, UK
| | - Jacqueline A. O'Hagan
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, UK
| | - Richard Haylock
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, UK
| | - Dominique Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN). Fontenay-aux-Roses, France
| | - Klervi Leuraud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN). Fontenay-aux-Roses, France
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226
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Gale RP, Opelz G. Is there immune surveillance against chronic myeloid leukaemia? Possibly, but not much. Leuk Res 2017; 57:109-111. [PMID: 28359029 DOI: 10.1016/j.leukres.2017.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/28/2017] [Accepted: 03/02/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Robert Peter Gale
- Haematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK.
| | - Gerhard Opelz
- Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Heidelberg, Germany
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227
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Who Has Therapy-Related AML? Mediterr J Hematol Infect Dis 2017; 9:e2017025. [PMID: 28293413 PMCID: PMC5333730 DOI: 10.4084/mjhid.2017.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/23/2017] [Indexed: 12/03/2022] Open
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Linet MS, Kitahara CM, Ntowe E, Kleinerman RA, Gilbert ES, Naito N, Lipner RS, Miller DL, Berrington de Gonzalez A. Mortality in U.S. Physicians Likely to Perform Fluoroscopy-guided Interventional Procedures Compared with Psychiatrists, 1979 to 2008. Radiology 2017; 284:482-494. [PMID: 28234559 DOI: 10.1148/radiol.2017161306] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose To compare total and cause-specific mortality rates between physicians likely to have performed fluoroscopy-guided interventional (FGI) procedures (referred to as FGI MDs) and psychiatrists to determine if any differences are consistent with known radiation risks. Materials and Methods Mortality risks were compared in nationwide cohorts of 45 634 FGI MDs and 64 401 psychiatrists. Cause of death was ascertained from the National Death Index. Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for FGI MDs versus psychiatrists, with adjustment (via stratification) for year of birth and attained age. Results During follow-up (1979-2008), 3506 FGI MDs (86 women) and 7814 psychiatrists (507 women) died. Compared with psychiatrists, FGI MDs had lower total (men: RR, 0.80 [95% CI: 0.77, 0.83]; women: RR, 0.80 [95% CI: 0.63, 1.00]) and cancer (men: RR, 0.92 [95% CI: 0.85, 0.99]; women: RR, 0.83 [95% CI: 0.58, 1.18]) mortality. Mortality because of specific types of cancer, total and specific types of circulatory diseases, and other causes were not elevated in FGI MDs compared with psychiatrists. On the basis of small numbers, leukemia mortality was elevated among male FGI MDs who graduated from medical school before 1940 (RR, 3.86; 95% CI: 1.21, 12.3). Conclusion Overall, total deaths and deaths from specific causes were not elevated in FGI MDs compared with psychiatrists. These findings require confirmation in large cohort studies with individual doses, detailed work histories, and extended follow-up of the subjects to substantially older median age at exit. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Martha S Linet
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
| | - Cari M Kitahara
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
| | - Estelle Ntowe
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
| | - Ruth A Kleinerman
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
| | - Ethel S Gilbert
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
| | - Neal Naito
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
| | - Rebecca S Lipner
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
| | - Donald L Miller
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
| | - Amy Berrington de Gonzalez
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
| | -
- From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end
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Kipps TJ, Stevenson FK, Wu CJ, Croce CM, Packham G, Wierda WG, O'Brien S, Gribben J, Rai K. Chronic lymphocytic leukaemia. Nat Rev Dis Primers 2017; 3:16096. [PMID: 28102226 PMCID: PMC5336551 DOI: 10.1038/nrdp.2016.96] [Citation(s) in RCA: 314] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chronic lymphocytic leukaemia (CLL) is a malignancy of CD5+ B cells that is characterized by the accumulation of small, mature-appearing lymphocytes in the blood, marrow and lymphoid tissues. Signalling via surface immunoglobulin, which constitutes the major part of the B cell receptor, and several genetic alterations play a part in CLL pathogenesis, in addition to interactions between CLL cells and other cell types, such as stromal cells, T cells and nurse-like cells in the lymph nodes. The clinical progression of CLL is heterogeneous and ranges from patients who require treatment soon after diagnosis to others who do not require therapy for many years, if at all. Several factors, including the immunoglobulin heavy-chain variable region gene (IGHV) mutational status, genomic changes, patient age and the presence of comorbidities, should be considered when defining the optimal management strategies, which include chemotherapy, chemoimmunotherapy and/or drugs targeting B cell receptor signalling or inhibitors of apoptosis, such as BCL-2. Research on the biology of CLL has profoundly enhanced our ability to identify patients who are at higher risk for disease progression and our capacity to treat patients with drugs that selectively target distinctive phenotypic or physiological features of CLL. How these and other advances have shaped our current understanding and treatment of patients with CLL is the subject of this Primer.
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Affiliation(s)
- Thomas J Kipps
- Division of Hematology-Oncology, Department of Medicine, Moores Cancer Centre, University of California, San Diego, 3855 Health Sciences Drive M/C 0820, La Jolla, California 92093, USA
| | - Freda K Stevenson
- Southampton Cancer Research UK Centre, Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Catherine J Wu
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Carlo M Croce
- Department of Molecular Virology, Immunology and Medical Genetics, Ohio State University, Columbus, Ohio, USA
| | - Graham Packham
- Southampton Cancer Research UK Centre, Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - William G Wierda
- Department of Hematology, MD Anderson Cancer Centre, Houston, Texas, USA
| | - Susan O'Brien
- Division of Hematology, Department of Medicine, University of California, Irvine, California, USA
| | - John Gribben
- Department of Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Kanti Rai
- CLL Research and Treatment Program, Feinstein Institute for Medical Research, Northwell Health, New Hyde Park, New York, USA
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Journy NMY, Lee C, Harbron RW, McHugh K, Pearce MS, Berrington de González A. Projected cancer risks potentially related to past, current, and future practices in paediatric CT in the United Kingdom, 1990-2020. Br J Cancer 2017; 116:109-116. [PMID: 27824812 PMCID: PMC5220140 DOI: 10.1038/bjc.2016.351] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/12/2016] [Accepted: 09/25/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND To project risks of developing cancer and the number of cases potentially induced by past, current, and future computed tomography (CT) scans performed in the United Kingdom in individuals aged <20 years. METHODS Organ doses were estimated from surveys of individual scan parameters and CT protocols used in the United Kingdom. Frequencies of scans were estimated from the NHS Diagnostic Imaging Dataset. Excess lifetime risks (ELRs) of radiation-related cancer were calculated as cumulative lifetime risks, accounting for survival probabilities, using the RadRAT risk assessment tool. RESULTS In 2000-2008, ELRs ranged from 0.3 to 1 per 1000 head scans and 1 to 5 per 1000 non-head scans. ELRs per scan were reduced by 50-70% in 2000-2008 compared with 1990-1995, subsequent to dose reduction over time. The 130 750 scans performed in 2015 in the United Kingdom were projected to induce 64 (90% uncertainty interval (UI): 38-113) future cancers. Current practices would lead to about 300 (90% UI: 230-680) future cancers induced by scans performed in 2016-2020. CONCLUSIONS Absolute excess risks from single exposures would be low compared with background risks, but even small increases in annual CT rates over the next years would substantially increase the number of potential subsequent cancers.
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Affiliation(s)
- Neige M Y Journy
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, MSC 9776, Bethesda, Maryland 20892, USA
| | - Choonsik Lee
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, MSC 9776, Bethesda, Maryland 20892, USA
| | - Richard W Harbron
- Institute of Health & Society, Newcastle University, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne NE1 4LP, UK
- NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle-upon-Tyne, UK
| | - Kieran McHugh
- Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Mark S Pearce
- Institute of Health & Society, Newcastle University, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne NE1 4LP, UK
- NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, Newcastle-upon-Tyne, UK
| | - Amy Berrington de González
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, MSC 9776, Bethesda, Maryland 20892, USA
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Geyer AM, Schwarz BC, Hobbs RF, Sgouros G, Bolch WE. Quantitative impact of changes in marrow cellularity, skeletal size, and bone mineral density on active marrow dosimetry based upon a reference model. Med Phys 2017; 44:272-283. [PMID: 28102950 PMCID: PMC6385860 DOI: 10.1002/mp.12002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/14/2016] [Accepted: 10/30/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The hematopoietically active tissues of skeletal bone marrow are a prime target for computational dosimetry given potential risks of leukemia and, at higher dose levels, acute marrow toxicity. The complex three-dimensional geometry of trabecular spongiosa, however, complicates schema for dose assessment in such a way that only a few reference skeletal models have been developed to date, and which are based upon microimaging of a limited number of cadaveric bone spongiosa cores. The question then arises as to what degree of accuracy is achievable from reference skeletal dose models when applied to individual patients or specific exposed populations? METHODS Patient variability in marrow dosimetry were quantified for three skeletal sites - the ribs, lumbar vertebrae, and cranium - for the beta-emitters 45 Ca, 153 Sm, and 90 Y, and the alpha-particle emitters 223 Ra, 219 Rn, and 215 Po, the latter two being the immediate progeny of the former. For each radionuclide and bone site, three patient parameters were altered from their values in the reference model: (1) bone size as a surrogate for patient stature, (2) marrow cellularity as a surrogate for age- or disease-related changes in marrow adiposity, and (3) the trabecular bone volume fraction as a surrogate for bone mineral density. Marrow dose variability is expressed as percent differences in the radionuclide S value given by the reference model and the patient-parameterized model. The impact of radionuclide biokinetics on marrow dosimetry was not considered. RESULTS Variations in overall bone size play a very minor role in active marrow dose variability. Marrow cellularity is a significant factor in dose variability for active marrow self-irradiation, but it plays no role for radionuclides localized to the trabecular bone matrix. Variations in trabecular bone volume fractions impact the active marrow dose variability for short-range particle emitters 45 Ca, 223 Ra, 219 Rn, and 215 Po in the vertebrae and ribs, skeletal sites with small spongiosa proportions of trabecular bone. In the cranium, with its relative high proportion of trabecular bone, significant differences in marrow dosimetry from the reference model were noted for all radionuclides. CONCLUSIONS Skeletal models of active marrow dosimetry should be more fully parameterized to permit closer matching to patient bone density and marrow cellularity, particularly when considering short-range particle emitters localized to either the bone trabeculae or active marrow, respectively.
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Affiliation(s)
- Amy M. Geyer
- J Crayton Pruitt Family Department of Biomedical EngineeringUniversity of FloridaGainesvilleFL32611‐6131USA
| | - Bryan C. Schwarz
- J Crayton Pruitt Family Department of Biomedical EngineeringUniversity of FloridaGainesvilleFL32611‐6131USA
| | - Robert F. Hobbs
- Department of Radiation OncologyJohns Hopkins University School of MedicineBaltimoreMD21231USA
| | - George Sgouros
- Department of RadiologyJohns Hopkins University School of MedicineBaltimoreMD21231USA
| | - Wesley E. Bolch
- J Crayton Pruitt Family Department of Biomedical EngineeringUniversity of FloridaGainesvilleFL32611‐6131USA
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Kreuzer M, Sobotzki C, Fenske N, Marsh JW, Schnelzer M. Leukaemia mortality and low-dose ionising radiation in the WISMUT uranium miner cohort (1946–2013). Occup Environ Med 2016; 74:252-258. [DOI: 10.1136/oemed-2016-103795] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/08/2016] [Accepted: 10/08/2016] [Indexed: 12/30/2022]
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Radiation Risks of Leukemia, Lymphoma and Multiple Myeloma Incidence in the Mayak Cohort: 1948-2004. PLoS One 2016; 11:e0162710. [PMID: 27631102 PMCID: PMC5025099 DOI: 10.1371/journal.pone.0162710] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 08/27/2016] [Indexed: 11/30/2022] Open
Abstract
Incidence of all types of lymphatic and hematopoietic cancers, including Hodgkin’s lymphoma, non-Hodgkin's lymphoma, multiple myeloma, acute and chronic myeloid leukemia (AML and CML respectively), chronic lymphocytic leukemia (CLL) and other forms of leukemia have been studied in a cohort of 22,373 workers employed at the Mayak Production Association (PA) main facilities during 536,126 person-years of follow-up from the start of employment between 1948 and 1982 to the end of 2004. Risk assessment was performed for both external gamma-radiation and internal alpha-exposure of red bone marrow due to incorporated Pu-239 using Mayak Workers Dosimetry System 2008 taking into account non-radiation factors. The incidence of leukemia excluding CLL showed a non-linear dose response relationship for external gamma exposure with exponential effect modifiers based on time since exposure and age at exposure. Among the major subtypes of leukemia, the excess risk of AML was the highest within the first 2–5 years of external exposure (ERR per Gy: 38.40; 90% CI: 13.92–121.4) and decreased substantially thereafter, but the risks remained statistically significant (ERR per Gy: 2.63; 90% CI: 0.07–12.55). In comparison, excess CML first occurred 5 years after exposure and decreased about 10 years after exposure, although the association was not statistically significant (ERR per Gy: 1.39; 90% CI: -0.22–7.32). The study found no evidence of an association between leukemia and occupational exposure to internal plutonium ERR per Gy 2.13; 90% CI: <0–9.45). There was also no indication of any relationship with either external gamma or internal plutonium radiation exposure for either incidence of Hodgkin or non-Hodgkin lymphoma or multiple myeloma.
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Niwa O, Barcellos-Hoff MH, Globus RK, Harrison JD, Hendry JH, Jacob P, Martin MT, Seed TM, Shay JW, Story MD, Suzuki K, Yamashita S. ICRP Publication 131: Stem Cell Biology with Respect to Carcinogenesis Aspects of Radiological Protection. Ann ICRP 2016; 44:7-357. [PMID: 26637346 DOI: 10.1177/0146645315595585] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This report provides a review of stem cells/progenitor cells and their responses to ionising radiation in relation to issues relevant to stochastic effects of radiation that form a major part of the International Commission on Radiological Protection's system of radiological protection. Current information on stem cell characteristics, maintenance and renewal, evolution with age, location in stem cell 'niches', and radiosensitivity to acute and protracted exposures is presented in a series of substantial reviews as annexes concerning haematopoietic tissue, mammary gland, thyroid, digestive tract, lung, skin, and bone. This foundation of knowledge of stem cells is used in the main text of the report to provide a biological insight into issues such as the linear-no-threshold (LNT) model, cancer risk among tissues, dose-rate effects, and changes in the risk of radiation carcinogenesis by age at exposure and attained age. Knowledge of the biology and associated radiation biology of stem cells and progenitor cells is more developed in tissues that renew fairly rapidly, such as haematopoietic tissue, intestinal mucosa, and epidermis, although all the tissues considered here possess stem cell populations. Important features of stem cell maintenance, renewal, and response are the microenvironmental signals operating in the niche residence, for which a well-defined spatial location has been identified in some tissues. The identity of the target cell for carcinogenesis continues to point to the more primitive stem cell population that is mostly quiescent, and hence able to accumulate the protracted sequence of mutations necessary to result in malignancy. In addition, there is some potential for daughter progenitor cells to be target cells in particular cases, such as in haematopoietic tissue and in skin. Several biological processes could contribute to protecting stem cells from mutation accumulation: (a) accurate DNA repair; (b) rapidly induced death of injured stem cells; (c) retention of the DNA parental template strand during divisions in some tissue systems, so that mutations are passed to the daughter differentiating cells and not retained in the parental cell; and (d) stem cell competition, whereby undamaged stem cells outcompete damaged stem cells for residence in the niche. DNA repair mainly occurs within a few days of irradiation, while stem cell competition requires weeks or many months depending on the tissue type. The aforementioned processes may contribute to the differences in carcinogenic radiation risk values between tissues, and may help to explain why a rapidly replicating tissue such as small intestine is less prone to such risk. The processes also provide a mechanistic insight relevant to the LNT model, and the relative and absolute risk models. The radiobiological knowledge also provides a scientific insight into discussions of the dose and dose-rate effectiveness factor currently used in radiological protection guidelines. In addition, the biological information contributes potential reasons for the age-dependent sensitivity to radiation carcinogenesis, including the effects of in-utero exposure.
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235
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Matsuo M, Iwanaga M, Kondo H, Soda M, Jo T, Horio K, Takasaki Y, Kawaguchi Y, Tsushima H, Imaizumi Y, Imanishi D, Taguchi J, Sawayama Y, Hata T, Miyazaki Y. Clinical features and prognosis of patients with myelodysplastic syndromes who were exposed to atomic bomb radiation in Nagasaki. Cancer Sci 2016; 107:1484-1491. [PMID: 27487572 PMCID: PMC5084675 DOI: 10.1111/cas.13025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/19/2016] [Accepted: 07/27/2016] [Indexed: 01/19/2023] Open
Abstract
There is evidence that radiation exposure is a causative factor of myelodysplastic syndromes (MDS). However, little is known about whether radiation exposure is also a prognostic factor of MDS. We investigated the impact of radiation exposure on the prognosis of MDS in Nagasaki atomic bomb survivors using the International Prognostic Scoring System (IPSS) and the revised version (IPSS‐R). Subjects were 140 patients with primary MDS diagnosed between 1985 and 2011 and evaluable for IPSS, IPSS‐R, and exposure distance. Of those, 31 were exposed at <1.5 km, 35 at 1.5–2.99 km, and 74 at ≥3.0 km. By the end of March 2014, 47 patients (34%) progressed to overt leukemia and 106 (75.7%) died. By comparing with patients exposed at ≥3.0 km, those exposed at <1.5 km had significantly higher frequencies of abnormal chromosome (P = 0.02), intermediate/poor IPSS, and intermediate/poor/very poor IPSS‐R cytogenetic category (P = 0.0001, and P < 0.0001, respectively). As with de novo MDS, multivariate Cox regression analyses revealed that cytogenetic abnormalities, IPSS karyotype, and IPSS‐R cytogenetics were significantly associated with poor survival, and cumulative incidence of leukemic transformation in MDS among atomic bomb survivors, but exposure distance was not associated with any poor outcomes. These suggest that exposure to the greater dose of atomic bomb radiation is associated with developing poor cytogenetic abnormalities in MDS, which might consequently lead to overt leukemia among atomic bomb survivors.
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Affiliation(s)
- Masatoshi Matsuo
- Department of Hematology, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masako Iwanaga
- Department of Frontier Life Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Hisayoshi Kondo
- Division of Scientific Data Registry, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Midori Soda
- Nagasaki Prefectural Cancer Registry, Nagasaki, Japan.,Department of Epidemiology, Radiation Effects Research Foundation, Nagasaki, Japan
| | - Tatsuro Jo
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kensuke Horio
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Yumi Takasaki
- Department of Internal Medicine, St. Francis Hospital, Nagasaki, Japan
| | - Yasuhisa Kawaguchi
- Department of Internal Medicine, Nagasaki Harbor Medical Center City Hospital, Nagasaki, Japan
| | - Hideki Tsushima
- Department of Internal Medicine, Nagasaki Harbor Medical Center City Hospital, Nagasaki, Japan
| | | | - Daisuke Imanishi
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Jun Taguchi
- Department of Hematology, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasushi Sawayama
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan. .,Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. .,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan.
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236
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Caldwell GG, Zack MM, Mumma MT, Falk H, Heath CW, Till JE, Chen H, Boice JD. Mortality among military participants at the 1957 PLUMBBOB nuclear weapons test series and from leukemia among participants at the SMOKY test. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2016; 36:474-489. [PMID: 27355245 PMCID: PMC5115961 DOI: 10.1088/0952-4746/36/3/474] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Health effects following low doses of ionizing radiation are uncertain. Military veterans at the Nevada test site (NTS) during the SMOKY atmospheric nuclear weapons test in 1957 were reported to be at increased risk for leukemia in 1979, but this increase was not evaluated with respect to radiation dose. The SMOKY test was one of 30 tests in 1957 within the PLUMBBOB test series. These early studies led to public laws where atomic veterans could qualify for compensation for presumptive radiogenic diseases. A retrospective cohort study was conducted of 12219 veterans at the PLUMBBOB test series, including 3020 at the SMOKY nuclear test. Mortality follow-up was through 2010 and observed causes of death were compared with expected causes based on general population rates. Radiation dose to red bone marrow was based on individual dose reconstructions, and Cox proportional hazards models were used to evaluate dose response for all leukemias other than chronic lymphocytic leukemia (non-CLL leukemia). Vital status was determined for 95.3% of the 12 219 veterans. The dose to red bone marrow was low (mean 3.2 mGy, maximum 500 mGy). Military participants at the PLUMBBOB nuclear test series remained relatively healthy after 53 years and died at a lower rate than the general population. In contrast, and in comparison with national rates, the SMOKY participants showed significant increases in all causes of death, respiratory cancer, leukemia, nephritis and nephrosis, and accidents, possibly related in part to lifestyle factors common to enlisted men who made up 81% of the SMOKY cohort. Compared with national rates, a statistically significant excess of non-CLL leukemia was observed among SMOKY participants (Standardized Mortality Ratio = 1.89, 95% 1.24-2.75, n = 27) but not among PLUMBBOB participants after excluding SMOKY (SMR = 0.87, 95% 0.64-1.51, n = 47). Leukemia risk, initially reported to be significantly increased among SMOKY participants, remained elevated, but this risk diminished over time. Despite an intense dose reconstruction, the risk for leukemia was not found to increase with increasing levels of radiation dose to the red bone marrow. Based on a linear model, the estimated excess relative risk per mGy is -0.05 (95% CI -0.14, 0.04). An explanation for the observed excess of leukemia remains unresolved but conceivably could be related to chance due to small numbers, subtle biases in the study design and/or high tobacco use among enlisted men. Larger studies should elucidate further the possible relationship between fallout radiation, leukemia and cancer among atomic veterans.
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Affiliation(s)
- Glyn G. Caldwell
- University of Kentucky, College of Public Health, Department of Epidemiology, Lexington, Kentucky
| | - Matthew M. Zack
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Atlanta, Georgia
| | | | - Henry Falk
- Consultant to Office of Non-Communicable Disease, Injury and Environmental Health, Centers for Disease Control, Atlanta, Georgia
| | | | - John E. Till
- Risk Assessment Corporation, Neeses, South Carolina
| | - Heidi Chen
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee
| | - John D. Boice
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee
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237
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Brooks AL, Hoel DG, Preston RJ. The role of dose rate in radiation cancer risk: evaluating the effect of dose rate at the molecular, cellular and tissue levels using key events in critical pathways following exposure to low LET radiation. Int J Radiat Biol 2016; 92:405-26. [PMID: 27266588 PMCID: PMC4975094 DOI: 10.1080/09553002.2016.1186301] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/14/2016] [Accepted: 05/02/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE This review evaluates the role of dose rate on cell and molecular responses. It focuses on the influence of dose rate on key events in critical pathways in the development of cancer. This approach is similar to that used by the U.S. EPA and others to evaluate risk from chemicals. It provides a mechanistic method to account for the influence of the dose rate from low-LET radiation, especially in the low-dose region on cancer risk assessment. Molecular, cellular, and tissues changes are observed in many key events and change as a function of dose rate. The magnitude and direction of change can be used to help establish an appropriate dose rate effectiveness factor (DREF). CONCLUSIONS Extensive data on key events suggest that exposure to low dose-rates are less effective in producing changes than high dose rates. Most of these data at the molecular and cellular level support a large (2-30) DREF. In addition, some evidence suggests that doses delivered at a low dose rate decrease damage to levels below that observed in the controls. However, there are some data human and mechanistic data that support a dose-rate effectiveness factor of 1. In summary, a review of the available molecular, cellular and tissue data indicates that not only is dose rate an important variable in understanding radiation risk but it also supports the selection of a DREF greater than one as currently recommended by ICRP ( 2007 ) and BEIR VII (NRC/NAS 2006 ).
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Affiliation(s)
- Antone L. Brooks
- Retired Professor, Environmental Science, Washington State University,
Richland,
Washington,
USA
| | - David G. Hoel
- Medical University of South Carolina, Epidemiology,
Charleston South Carolina,
USA
| | - R. Julian Preston
- US Environmental Protection Agency, National Health and Environmental Effects Research Laboratory (NHEERL) (MD B105-01), RTP,
USA
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238
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Bazyka D, Gudzenko N, Dyagil I, Goroh E, Polyschuk O, Trotsuk N, Babkina N, Romanenko A. Chronic Lymphocytic Leukemia in Chornobyl Cleanup Workers. HEALTH PHYSICS 2016; 111:186-191. [PMID: 27356063 DOI: 10.1097/hp.0000000000000440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This paper describes the chronic lymphocytic leukemia (CLL) incidence in a cohort of 110,645 (enlarged later to 152,520) male Ukrainian cleanup workers of the Chornobyl (Chernobyl) accident who were exposed to a range of radiation doses over the 1986-1990 time period. The standardized incidence rates are presented for a 27-y period after the exposure. For 2007-2012 period, the authors have identified the incident CLL cases in an enlarged cohort of 152,520 persons by linkage of the cohort file with the Ukrainian National Cancer Registry (NCRU). CLL data for the previous period (1987-2006) were identified in a frame of the Ukrainian-American leukemia study in the original cohort of 110,645 male clean-up workers. A significant CLL incidence excess was shown for the entire study period 1987-2012, with more prominent levels for the earliest years (1987-1996) when the standardized incidence rate (SIR) value was estimated to be 3.61 with 95% confidence interval from 2.32 to 4.91. In 2007-2012, the CLL incidence decreased substantially but still exceeded the national level although not significantly. In parallel, the several studies were performed at the National Research Center for Radiation Medicine (NRCRM) to explore if any clinical and cytogenetic features of CLL existed in the clean-up workers. The clinical study included 80 exposed and 70 unexposed CLL cases. Among the major clinical differences of the CLL course in the clean-up workers were a shorter period of white blood cells (WBC) doubling (10.7 vs. 18.0; p<0.001), frequent infectious episodes, lymphoadenopathy and hepatosplenomegaly (37 vs. 16), higher expression for CD38, and lower expression for ZAP-70 antigen.
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Affiliation(s)
- Dimitry Bazyka
- *National Research Center for Radiation Medicine, Ukraine (RCRM); †National Cancer Registry of Ukraine (NCRU)
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239
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Ozasa K. Epidemiological research on radiation-induced cancer in atomic bomb survivors. JOURNAL OF RADIATION RESEARCH 2016; 57 Suppl 1:i112-i117. [PMID: 26976124 PMCID: PMC4990102 DOI: 10.1093/jrr/rrw005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/11/2015] [Indexed: 05/13/2023]
Abstract
The late effects of exposure to atomic bomb radiation on cancer occurrence have been evaluated by epidemiological studies on three cohorts: a cohort of atomic bomb survivors (Life Span Study; LSS), survivors exposed IN UTERO : , and children of atomic bomb survivors (F1). The risk of leukemia among the survivors increased remarkably in the early period after the bombings, especially among children. Increased risks of solid cancers have been evident since around 10 years after the bombings and are still present today. The LSS has clarified the dose-response relationships of radiation exposure and risk of various cancers, taking into account important risk modifiers such as sex, age at exposure, and attained age. Confounding by conventional risk factors including lifestyle differences is not considered substantial because people were non-selectively exposed to the atomic bomb radiation. Uncertainty in risk estimates at low-dose levels is thought to be derived from various sources, including different estimates of risk at background levels, uncertainty in dose estimates, residual confounding and interaction, strong risk factors, and exposure to residual radiation and/or medical radiation. The risk of cancer in subjects exposed IN UTERO : is similar to that in LSS subjects who were exposed in childhood. Regarding hereditary effects of radiation exposure, no increased risk of cancers associated with parental exposure to radiation have been observed in the F1 cohort to date. In addition to biological and pathogenetic interpretations of the present results, epidemiological investigations using advanced technology should be used to further analyze these cohorts.
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Affiliation(s)
- Kotaro Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, 5-2 Hjiyama-koen, Minami-ku, Hiroshima, 732-0815, Japan
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240
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Nikkilä A, Erme S, Arvela H, Holmgren O, Raitanen J, Lohi O, Auvinen A. Background radiation and childhood leukemia: A nationwide register-based case-control study. Int J Cancer 2016; 139:1975-82. [DOI: 10.1002/ijc.30264] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 06/06/2016] [Accepted: 06/15/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Atte Nikkilä
- School of Medicine; University of Tampere; Tampere Finland
| | - Sini Erme
- Tampere Center for Child Health Research, Tampere University Hospital and University of Tampere; Tampere Finland
| | - Hannu Arvela
- STUK-Radiation and Nuclear Safety Authority; Environmental Surveillance; Helsinki Finland
| | - Olli Holmgren
- STUK-Radiation and Nuclear Safety Authority; Environmental Surveillance; Helsinki Finland
| | - Jani Raitanen
- School of Health Sciences; University of Tampere; Tampere Finland
- UKK Institute for Health Promotion; Tampere Finland
| | - Olli Lohi
- Tampere Center for Child Health Research, Tampere University Hospital and University of Tampere; Tampere Finland
| | - Anssi Auvinen
- Tampere Center for Child Health Research, Tampere University Hospital and University of Tampere; Tampere Finland
- STUK-Radiation and Nuclear Safety Authority; Environmental Surveillance; Helsinki Finland
- School of Health Sciences; University of Tampere; Tampere Finland
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241
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Berrington de González A, Ntowe E, Kitahara CM, Gilbert E, Miller DL, Kleinerman RA, Linet MS. Long-term Mortality in 43 763 U.S. Radiologists Compared with 64 990 U.S. Psychiatrists. Radiology 2016; 281:847-857. [PMID: 27440487 DOI: 10.1148/radiol.2016152472] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To compare mortality rates from all causes, specific causes, total cancers, and specific cancers to assess whether differences between radiologists and psychiatrists are consistent with known risks of radiation exposure and the changes in radiation exposure to radiologists over time. Materials and Methods The authors used the American Medical Association Physician Masterfile to construct a cohort of 43 763 radiologists (20% women) and 64 990 psychiatrists (27% women) (comparison group) who graduated from medical school in 1916-2006. Vital status was obtained from record linkages with the Social Security Administration and commercial databases, and cause of death was obtained from the National Death Index. Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for all causes and specific causes of death. Results During the follow-up period (1979-2008), 4260 male radiologists and 7815 male psychiatrists died. The male radiologists had lower death rates (all causes) compared with the psychiatrists (RR = 0.94; 95% CI: 0.90, 0.97), similar cancer death rates overall (RR = 1.00; 95% CI: 0.93, 1.07), but increased acute myeloid leukemia and/or myelodysplastic syndrome death rates (RR = 1.62; 95% CI: 1.05, 2.50); these rates were driven by those who graduated before 1940 (RR = 4.68; 95% CI: 0.91, 24.18). In these earliest workers (before 1940) there were also increased death rates from melanoma (RR = 8.75; 95% CI: 1.89, 40.53), non-Hodgkin lymphoma (NHL) (RR = 2.69; 95% CI: 1.33, 5.45), and cerebrovascular disease (RR = 1.49; 95% CI: 1.11, 2.01). The 208 deaths in female radiologists precluded detailed investigation, and the number of female radiologists who graduated before 1940 was very small (n = 47). Conclusion The excess risk of acute myeloid leukemia and/or myelodysplastic syndrome mortality in radiologists who graduated before 1940 is likely due to occupational radiation exposure. The melanoma, NHL, and cerebrovascular disease mortality risks are possibly due to radiation. The authors found no evidence of excess mortality in radiologists who graduated more recently, possibly because of increased radiation protection and/or lifestyle changes. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Amy Berrington de González
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.)
| | - Estelle Ntowe
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.)
| | - Cari M Kitahara
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.)
| | - Ethel Gilbert
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.)
| | - Donald L Miller
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.)
| | - Ruth A Kleinerman
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.)
| | - Martha S Linet
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (A.B.d.G., E.N., C.M.K., E.G., R.A.K., M.S.L.); and FDA Office of In Vitro Diagnostics and Radiological Health, White Oak Campus, Silver Spring, Md (D.L.M.)
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External radiation dose and cancer mortality among French nuclear workers: considering potential confounding by internal radiation exposure. Int Arch Occup Environ Health 2016; 89:1183-1191. [PMID: 27383840 DOI: 10.1007/s00420-016-1152-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 06/24/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVES French nuclear workers have detailed records of their occupational exposure to external radiation that have been used to examine associations with subsequent cancer mortality. However, some workers were also exposed to internal contamination by radionuclides. This study aims to assess the potential for bias due to confounding by internal contamination of estimates of associations between external radiation exposure and cancer mortality. METHODS A cohort of 59,004 workers employed for at least 1 year between 1950 and 1994 by CEA (Commissariat à l'Energie Atomique), AREVA NC, or EDF (Electricité de France) and badge-monitored for external radiation exposure were followed through 2004 to assess vital status and cause of death. A flag based on a workstation-exposure matrix defined four levels of potential for internal contamination. Standardized mortality ratios were assessed for each level of the internal contamination indicator. Poisson regression was used to quantify associations between external radiation exposure and cancer mortality, adjusting for potential internal contamination. RESULTS For solid cancer, the mortality deficit tended to decrease as the levels of potential for internal contamination increased. For solid cancer and leukemia excluding chronic lymphocytic leukemia, adjusting the dose-response analysis on the internal contamination indicator did not markedly change the excess relative risk per Sievert of external radiation dose. CONCLUSIONS This study suggests that in this cohort, neglecting information on internal dosimetry while studying the association between external dose and cancer mortality does not generate a substantial bias. To investigate more specifically the health effects of internal contamination, an effort is underway to estimate organ doses due to internal contamination.
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243
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Vandevoorde C, Vral A, Vandekerckhove B, Philippé J, Thierens H. Radiation Sensitivity of Human CD34+Cells Versus Peripheral Blood T Lymphocytes of Newborns and Adults: DNA Repair and Mutagenic Effects. Radiat Res 2016; 185:580-90. [DOI: 10.1667/rr14109.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Relationship between spontaneous γH2AX foci formation and progenitor functions in circulating hematopoietic stem and progenitor cells among atomic-bomb survivors. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2016; 802:59-65. [PMID: 27169377 DOI: 10.1016/j.mrgentox.2016.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 01/04/2023]
Abstract
Accumulated DNA damage in hematopoietic stem cells is a primary mechanism of aging-associated dysfunction in human hematopoiesis. About 70 years ago, atomic-bomb (A-bomb) radiation induced DNA damage and functional decreases in the hematopoietic system of A-bomb survivors in a radiation dose-dependent manner. The peripheral blood cell populations then recovered to a normal range, but accompanying cells derived from hematopoietic stem cells still remain that bear molecular changes possibly caused by past radiation exposure and aging. In the present study, we evaluated radiation-related changes in the frequency of phosphorylated (Ser-139) H2AX (γH2AX) foci formation in circulating CD34-positive/lineage marker-negative (CD34+Lin-) hematopoietic stem and progenitor cells (HSPCs) among 226Hiroshima A-bomb survivors. An association between the frequency of γH2AX foci formation in HSPCs and the radiation dose was observed, but the γH2AX foci frequency was not significantly elevated by past radiation. We found a negative correlation between the frequency of γH2AX foci formation and the length of granulocyte telomeres. A negative interaction effect between the radiation dose and the frequency of γH2AX foci was suggested in a proportion of a subset of HSPCs as assessed by the cobblestone area-forming cell assay (CAFC), indicating that the self-renewability of HSPCs may decrease in survivors who were exposed to a higher radiation dose and who had more DNA damage in their HSPCs. Thus, although many years after radiation exposure and with advancing age, the effect of DNA damage on the self-renewability of HSPCs may be modified by A-bomb radiation exposure.
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245
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Ionizing radiation exposures in treatments of solid neoplasms are not associated with subsequent increased risks of chronic lymphocytic leukemia. Leuk Res 2016; 43:9-12. [DOI: 10.1016/j.leukres.2016.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/14/2016] [Accepted: 02/17/2016] [Indexed: 01/30/2023]
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246
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Commentary: How do haematopoietic cell transplants cure leukaemia? Int J Hematol 2016; 103:396-8. [PMID: 26980218 DOI: 10.1007/s12185-016-1969-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 10/22/2022]
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247
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Rühm W, Azizova TV, Bouffler SD, Little MP, Shore RE, Walsh L, Woloschak GE. Dose-rate effects in radiation biology and radiation protection. Ann ICRP 2016; 45:262-279. [PMID: 26960819 DOI: 10.1177/0146645316629336] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Quantification of biological effects (cancer, other diseases, and cell damage) associated with exposure to ionising radiation has been a major issue for the International Commission on Radiological Protection (ICRP) since its foundation in 1928. While there is a wealth of information on the effects on human health for whole-body doses above approximately 100 mGy, the effects associated with doses below 100 mGy are still being investigated and debated intensively. The current radiological protection approach, proposed by ICRP for workers and the public, is largely based on risks obtained from high-dose and high-dose-rate studies, such as the Japanese Life Span Study on atomic bomb survivors. The risk coefficients obtained from these studies can be reduced by the dose and dose-rate effectiveness factor (DDREF) to account for the assumed lower effectiveness of low-dose and low-dose-rate exposures. The 2007 ICRP Recommendations continue to propose a value of 2 for DDREF, while other international organisations suggest either application of different values or abandonment of the factor. This paper summarises the current status of discussions, and highlights issues that are relevant to reassessing the magnitude and application of DDREF.
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Affiliation(s)
- W Rühm
- a Helmholtz Centre Munich, German Research Centre for Environmental Health, Department for Radiation Sciences, Institute of Radiation Protection, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
| | - T V Azizova
- b Southern Urals Biophysics Institute, Russian Federation
| | - S D Bouffler
- c Centre for Radiation, Chemical and Environmental Hazards, Public Health England, UK
| | - M P Little
- d Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, USA
| | - R E Shore
- e New York University School of Medicine, USA
| | - L Walsh
- f Federal Office for Radiation Protection, Germany
| | - G E Woloschak
- g Department of Radiation Oncology, Northwestern University, Feinberg School of Medicine, USA
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248
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Gunnarsson N, Höglund M, Stenke L, Wållberg-Jonsson S, Sandin F, Björkholm M, Dreimane A, Lambe M, Markevärn B, Olsson-Strömberg U, Wadenvik H, Richter J, Själander A. Increased prevalence of prior malignancies and autoimmune diseases in patients diagnosed with chronic myeloid leukemia. Leukemia 2016; 30:1562-7. [PMID: 27080811 DOI: 10.1038/leu.2016.59] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 02/11/2016] [Accepted: 02/19/2016] [Indexed: 02/03/2023]
Abstract
We recently reported an increased incidence of second malignancies in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKI). To elucidate whether this increase may be linked, not to TKI but rather to a hereditary or acquired susceptibility to develop cancer, we estimated the prevalence of malignancies, autoimmune disease (AD) and chronic inflammatory disease (CID) in CML patients prior to their CML diagnosis. Nationwide population-based registers were used to identify patients diagnosed with CML in Sweden 2002-2012 and to estimate the prevalence of other malignancies, AD and CID prior to their CML diagnosis. For each patient with CML, five matched controls were selected from the general population. Conditional logistic regression was used to calculate odds ratios (OR). Nine hundred and eighty-four CML patients were assessed, representing more than 45 000 person-years of follow-up. Compared with matched controls, the prevalence of prior malignancies and AD was elevated in CML patients: OR 1.47 (95% confidence interval (CI) 1.20-1.82) and 1.55 (95% CI 1.21-1.98), respectively. No associations were detected between CML and previous CID. An increased prevalence of other malignancies and AD prior to the diagnosis of CML suggest that a hereditary or acquired predisposition to cancer and/or autoimmunity is involved in the pathogenesis of CML.
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Affiliation(s)
- N Gunnarsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - M Höglund
- Department of Medical Science and Division of Hematology, University Hospital, Uppsala, Sweden
| | - L Stenke
- Department of Hematology, Karolinska University Hospital and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - S Wållberg-Jonsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - F Sandin
- Regional Cancer Centre, Uppsala-Örebro, Sweden
| | - M Björkholm
- Department of Hematology, Karolinska University Hospital and Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - A Dreimane
- Department of Hematology, University Hospital, Linköping, Sweden
| | - M Lambe
- Regional Cancer Centre, Uppsala-Örebro, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - B Markevärn
- Department of Hematology, University Hospital, Umeå, Sweden
| | - U Olsson-Strömberg
- Department of Medical Science and Division of Hematology, University Hospital, Uppsala, Sweden
| | - H Wadenvik
- Department of Hematology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - J Richter
- Department of Hematology and Vascular Disorders, Skåne University Hospital, Lund, Sweden
| | - A Själander
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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249
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Wei KC, Lin HY, Hung SK, Huang YT, Lee MS, Wang WH, Wu CS, Su YC, Shen BJ, Tsai SJ, Tsai WT, Chen LC, Li CY, Chiou WY. Leukemia Risk After Cardiac Fluoroscopic Interventions Stratified by Procedure Number, Exposure Latent Time, and Sex: A Nationwide Population-Based Case-Control Study. Medicine (Baltimore) 2016; 95:e2953. [PMID: 26962795 PMCID: PMC4998876 DOI: 10.1097/md.0000000000002953] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A number of cardiac fluoroscopic interventions have increased rapidly worldwide over the past decade. Percutaneous transluminal coronary angioplasty (PTCA) and stent implantation have become increasingly popular, and these advancements have allowed patients to receive repetitive treatments for restenosis. However, these advancements also significantly increase radiation exposure that may lead to higher cumulative doses of radiation. In the present study, a nationwide population-based case-controlled study was used to explore the risk of leukemia after cardiac angiographic fluoroscopic intervention.A total of 5026 patients with leukemia and 100,520 control patients matched for age and sex (1:20) by a propensity score method without any cancer history were enrolled using the Registry Data for Catastrophic Illness and the National Health Insurance Research Database (NHIRD) of Taiwan between 2008 and 2010. All subjects were retrospectively surveyed (from year 2000) to determine receipt of cardiac fluoroscopic interventions. Data were analyzed using conditional logistic regression models, and estimated crude and adjusted odds ratios (95% confidence interval).After adjusting for age, gender, and comorbidities, PTCA was found to be associated with an increased risk of leukemia with an adjusted OR of 1.566 (95% CI, 1.282-1.912), whereas coronary angiography alone without PTCA and cardiac electrophysiologic study were not. Our results also showed that an increased frequency of PTCA and coronary angiography was associated with a higher risk of leukemia (adjusted OR: 1.326 to 1.530 [all P < 0.05]). Gender subgroup analyses demonstrated that men were associated with a higher risk of leukemia compared with women.These results provide additional data in the quantification of the long-term health effects of radiation exposure derived from the cardiac fluoroscopic diagnostic and therapeutic intervention. PTCA alone or PTCA with coronary angiography was associated with an elevated risk of leukemia. Continued follow-up of existing cohorts will be valuable to help assess lifetime risks of cancer.
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Affiliation(s)
- Kai-Che Wei
- From the Department of Dermatology (K-CW, C-SW), Kaohsiung Veterans General Hospital, Kaohsiung; Institute of Clinical Medicine (K-CW), College of Medicine, National Cheng Kung University, Tainan; Faculty of Yuhing Junior College of Health Care and Management (K-CW), Kaohsiung; Department of Radiation Oncology (H-YL, S-KH, M-SL, BJS, S-JT, W-TT, L-CC, W-YC), Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi; School of Medicine (H-YL, S-KH, M-SL, B-JS, Y-CS, W-YC), Tzu Chi University, Hualien; Master Degree Program in Aging and Long-Term Care (Y-TH), College of Nursing, Kaohsiung Medical University; Department of Cardiology (W-HW), Kaohsiung Veterans General Hospital, Kaohsiung; Division of Hematology Oncology (Y-CS), Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi; Department of Biomedical Imaging and Radiological Sciences (W-TT), National Yang-Ming University, Taipei; Department of Public Health (C-YL, W-YC), College of Medicine, National Cheng Kung University, Tainan; and Department of Public Health (C-YL), China Medical University, Taichung, Taiwan
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Is cure for chronic myeloid leukemia possible in the tyrosine kinase inhibitors era? Curr Opin Hematol 2016; 23:115-20. [DOI: 10.1097/moh.0000000000000224] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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