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Title: EFFECT OF SOMEUNFAVORABLE FACTORS OF ENVIRONMENT ON THE SURVIVAL OF CHILDREN WITH ACUTE LEUKEMIA IN A LONG6TERM PERIOD AFTER ACCIDENT ON THE CHORNOBYL NPP.
Author: Bebeshko VG, Bruslova KM, Tsvietkova NM, Lyashenko LO, Pushkareva TI, Honchar LO, Sergeeva AS, Yatsemyrskii M, Samson YM, Trihlib IV, Makovey OI.
Journal: Probl Radiac Med Radiobiol; 2018 Dec; 23():254-262. PubMed ID: 30582851.
Abstract:
OBJECTIVE: Determine of the influence of adverse environmental factors, including irradiation, on the survival ofchildren with acute leukemia in the long-term period after the Chornobyl accident (2008-2017). MATERIALS AND METHODS: Examined 74 children with acute leukemia (АL): 64 with acute lymphoblastic leukemia(ALL); 10 - acute myeloblastic leukemia (AML). The influence of negative environmental factors was assessed bythe degree of integrated pollution of the atmospheric air, surface waters and soils with pesticides, heavy metals (Pb,Cu, Ni, Cr, Mn, Zn, Fe) and cesium isotope 137Cs. These regions were ranked on a moderately polluted (1), polluted (2),very (3) and extremely (4) polluted territories. Took into account the age of children, blood test, immunophenotyp-ic of variant the acute leukemia, survival of patients and place of residence (city / village), serum ferritin level (SF). RESULTS: Exposure doses of children were in the range from 0.4 mSv to 35.0 mSv (average values were (4.25 ± 0.63 mSv)and did not affect the prognosis and variants of AL. 52 children lived in moderately and polluted territories (30 wereresidents of cities, 22 - villages). 22 patients were lived in very and extremely polluted territories (4 were residentsof cities, 18 - villages). Of 74 patients with ALL and AML 24 children died (32.4 %). The smallest number ofchildren, who died, were patients with «general type» В-ALL (18.7 %), most of all children with pro-В-ALL (8 out of10) and Т-ALL (3 of 4). Of the 52 patients, the inhabitants of moderately and polluted regions, 13 patients died (25%), while out of 22 patients, who lived in very and extremely polluted areas, 11 children died (50 % share)(rs = 0.39; p < 0.05). Of the 10 patients with AML, 4 children died. Most often, children died, who were residents ofvillages. Moreover, the level of SF was significantly higher in children over 6 years, the inhabitants of villages -(406.8 ± 40.6) ng/ml, compared to younger patients - (211.2 ± 32.1) ng/ml) and residents of of cities: up to 6years - (297.4 ± 52.3) ng/ml; over 6 years - (275.6 ± 29.8) ng/ml. CONCLUSIONS: The obtained data testify to the negative influence of environmental factors, including iron, and canbe the basis for understanding the mechanisms of potentiating influence of metals and their compounds on thedevelopment of malignant diseases of the blood system in children. Meta. Vyznachennia vplyvu nespryiatlyvykh chynnykiv dovkillia, v tomu chysli ĭ oprominennia, na vyzhyvanist' diteĭ,khvorykh na gostri leĭkemiï, u viddalenyĭ period pislia avariï na ChAES (2008-2017 rr.).Materialy i metody. Obstezheno 74 dytyny z gostrymy leĭkemiiamy (GL) (64 – z gostrymy limfoblastnymy leĭ-kemiiamy (GLL)); 10 – z gostrymy miieloblastnymy leĭkemiiamy (GML). Vplyv negatyvnykh chynnykiv navkolyshn'o-go seredovyshcha otsiniuvaly za stupenem integral'nogo zabrudnennia atmosfernogo povitria, poverkhnevykh vod iґruntiv pestytsydamy, vazhkymy metalamy (Pb, Cu, Ni, Cr, Mn, Zn, Fe) ta izotopom tseziiu 137Cs. Tsi regiony ranzhyru-valy na pomirno zabrudnenu (1), zabrudnenu (2), duzhe (3) ta nadzvychaĭno (4) zabrudnenu terytoriiu. Vrakhovu-valy vik diteĭ, pokaznyky krovi, imunofenotypovyĭ variant gostrykh leĭkemiĭ, vyzhyvanist' khvorykh i mistse pro-zhyvannia (misto/selo), riven' syrovatkovogo ferytynu (SF).Rezul'taty. Dozy oprominennia diteĭ z GL znakhodylys' v mezhakh vid 0,4 mZv do 35,0 mZv (seredni velychyny –(4,25 -#177; 0,63) mZv) i vony ne vplyvaly na prognoz perebigu ta varianty GL. 52 dytyny prozhyvaly na pomirno i za-brudnenykh terytoriiakh (30 buly zhyteliamy mist, 22 – sil). 22 khvorykh meshkaly na duzhe ta nadzvychaĭno zabrudne-nykh terytoriiakh (4 buly zhyteliamy mist, 18 – sil). Z 74 khvorykh na GLL ta GML pomerlo 24 dytyny (32,4 %). Naĭ-menshe chyslo diteĭ, iaki pomerly, buly khvorymy na «zagal'nyĭ typ» V-GLL (18,7 %), naĭbil'she – dity z pro-V-GLL(8 z 10) ta T-GLL (3 z 4). Sered 52 khvorykh, zhyteliv pomirno ta zabrudnenykh regioniv, pomerlo 13 patsiientiv (do-lia – 25 %), todi iak z 22 khvorykh, iaki zhyly na duzhe ta nadzvychaĭno zabrudnenykh terytoriiakh, pomerlo 11 diteĭ (do-lia – 50 %) (rs = 0,39; p -#060; 0,05). Sered 10 khvorykh na GML pomerlo 4 dytyny. Chastishe pomyraly dity, iaki buly zhy-teliamy sil. Prychomu, riven' SF buv dostovirno vyshchyĭ u diteĭ starshykh za 6 rokiv, zhyteliv sil – (406,8 -#177; 40,6) ng/ml,porivniano z khvorymy molodshogo viku – (211,2 -#177;32,1) ng/ml i zhyteliv mist: do 6 rokiv – (297,4-#177;52,3) ng/ml;starshi za 6 rokiv – (275,6 -#177; 29,8) ng/ml.Vysnovky. Otrymani dani svidchat' pro negatyvnyĭ vplyv chynnykiv dovkillia, v tomu chysli ĭ zaliza, i mozhut' bu-ty pidґruntiam dlia rozuminnia mekhanizmiv potentsiuiuchogo vplyvu metaliv ta ïkh spoluk na rozvytok zloiakisnykh zakh-voriuvan' systemy krovi u diteĭ.

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