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  • Title: State of erythroid, granulocyte and platelet branches of hematopoiesis on stages of chemotherapy in children with acute lymphoblastic leukemia, who were exposed to ionizing radiation after the Chornobyl NPP accident.
    Author: Bebeshko VG, Bruslova KM, Pushkareva TI, Tsvyetkova NM, Lyashenko LO, Kuznyetsova OY, Kuzmenko VF, Gonchar LO, Yaatsemyrskyy SM.
    Journal: Probl Radiac Med Radiobiol; 2016 Dec; 21():178-190. PubMed ID: 28027552.
    Abstract:
    OBJECTIVE: Evaluation of proliferation and differentiation processes of progenitor cells in bone marrow by the com position of elements of erythroid, granulocyte and platelet branches of hematopoiesis on the treatment stages in children with acute lymphoblastic leukemia (ALL), who were exposed to radiation from the Chornobyl NPP accident. MATERIALS AND METHODS: The 46 children with ALL were studied, who lived in Kyiv, Zhytomyr and Chernihiv regions. Studies were conducted before the start of chemotherapy (ChT), on the 33 day of ChT (phase I), and after the com pletion of ChT (phase II). Exposure doses of patients, hemogram and myelogram parameters both with indices of mat uration of progenitor cells were evaluated. Signs of dysplasia of hematopoietic branch elements were revewed. RESULTS: The 46 patients were studied. They have had the B ALL, namely pro B ALL (n=5), «common type» (n=36), pre B ALL (n=3), and T ALL in 2 other cases. In a debut of ALL the bone marrow was represented by lymphoblasts. Along with ChT conduction the bone marrow hematopoiesis recovered by such types, as erythroid, granulocyte, gran ulocyte whith monocytes, and uniform, when the cells number of all branches was within a normal quantity. At the phase ІІ of ChT the number of patients with hematopoiesis recovery by erythroid type decreased and number of chil dren with activation of granulocyte branch of hematopoiesis increased. In children with pro B ALL the number of erythroid elements was higher than normative at both ChT phases. A direct correlation was established between the number of myelokaryocytes (Mkc) and megakaryocytes (Mgkc) in both phase І and phase ІІ of treatment (Rs = +0.72; Rs = +0.56, respectively). There was no correlation between the radiation dose in patients (3.73 ± 0.12 mSv) and studied parameters. CONCLUSIONS: Types of bone marrow recovery were established in ALL patients after the ChT indicating to the differ ent kinetic pathways of hematopoietic progenitor cells. Evaluation of reasons of prevalence of some hematopoietic branches will allow to reveal their role in leukemogenesis and to correct the treatment programs. Meta. Vyvchyty protsesy proliferatsiï ta dyferentsiiuvannia klityn poperednykiv kistkovogo mozku za skladom elementiv erytroïdnoï, granulotsytarnoï ta trombotsytarnoï lanok gemopoezu na etapakh likuvannia ditey̆ z gostry my limfoblastnymy ley̆kemiiamy (GLL), iaki zaznaly vplyvu ionizuiuchogo vyprominiuvannia vnaslidok avariï na Chornobyl's'kiy̆ AES.Materialy i metody. Obstezheno 46 ditey̆, khvorykh na GLL, iaki prozhyvaly na terytoriiakh Kyïvs'koï, Zhytomyrs'koï ta Chernigivs'koï oblastey̆. Doslidzhennia provedeni pered pochatkom khimioterapiï (KhT), na 33 y̆ den' KhT (I etap) ta pislia zakinchennia kursu KhT (II etap). Otsiniuvaly dozy oprominennia khvorykh, pokaznyky gemogram i miielogram ta indeksy dozrivannia klityn poperednykiv. Analizuvaly oznaky dysplaziï elementiv lanok gemopoezu Rezul'taty. Obstezheno 46 khvorykh na V GLL (5 – pro V GLL, 36 – «zagal'nyy̆ typ», 3 – pre V GLL) ta 2 dytyny z T GLL. V debiuti GLL kistkovyy̆ mozok u khvorykh buv predstavlenyy̆ limfoblastamy. Pry provedenni KhT kistko vomozkove krovotvorennia vidnovliuvalos' za takymy typamy: erytroïdnym, granulotsytarnym, granulotsytar nym z monotsytamy ta rivnomirnym, koly chyslo klityn vsikh parostkiv bulo v mezhakh normatyvnykh velychyn. Na II etapi KhT zmenshuvalos' chyslo khvorykh, u iakykh vidnovlennia krovotvorennia vidbuvalosia za erytroïdnym typom ta zbil'shuvalos' chyslo ditey̆ z aktyvatsiieiu granulotsytarnoï lanky gemopoezu. Za naiavnosti u ditey̆ pro V GLL na obokh etapakh KhT erytroïdni elementy buly vyshchymy za normatyvni. Priamyy̆ koreliatsiy̆nyy̆ zv'iazok vstanovlenyy̆ mizh chyslom miielokariotsytiv ta megakariotsytiv na I ta II etapakh likuvannia (Rs = +0,72; Rs = +0,56, vidpovidno). Koreliatsiy̆nogo zv’iazku mizh dozamy oprominennia khvorykh (3,73 ± 0,12 mZv) i vyznachenymy parametramy vstanov leno ne bulo.Vysnovky. Vstanovleni typy vidnovlennia kistkovogo mozku u khvorykh na GLL pislia KhT svidchat' pro rizni me khanizmy kinetyky klityn poperednykiv gemopoezu. Vyvchennia prychyn prevaliuvannia okremykh lanok krovotvo rennia u khvorykh nadast' zmogu rozkryty ïkh rol' v ley̆kemogenezi ta koryguvaty programy terapiï.
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