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Title: CHRONIC MYELOID LEUKEMIA COURSE IN PERSONS EXPOSED TO IONIZING RADIATION AS A RESULT OF THE CHORNOBYL ACCIDENT.
Author: Dyagil IS, Dmytrenko IV, Sholoiko VV, Fedorenko VG, Shlyakhtichenko TY, Petrusha OO, Martina ZV, Tovstogan AO, Silayev YO, Stupakova ZV, Minchenko ZM.
Journal: Probl Radiac Med Radiobiol; 2020 Dec; 25():443-455. PubMed ID: 33361853.
Abstract:
OBJECTIVE: Describe and characterize the peculiarities of the chronic myeloid leukemia (CML) course and responseto treatment in patients irradiated as a result of the Chornobyl nuclear power plant (ChNPP) accident based on theassessment of clinical-laboratory and clinical parameters. MATERIALS AND METHODS: The CML patients (n = 33) exposed to ionizing radiation as a result of the ChNPP accidentwere enrolled. The comparison group consisted of CML patients (n = 725) with no history of radiation exposure. Allpatients were in the chronic phase of the disease. Clinical, hematological and molecular genetic research methodswere applied. RESULTS: Patients exposed to ionizing radiation as a result of the ChNPP accident had no differences in CML manifestation, as well as in classical genetic markers at the onset of the disease compared with patients with no historyof radiation exposure. Reduction of tumor clone on imatinib therapy was significantly less effective in the patientsexposed to ionizing radiation than in cases of no history of radiation exposure. Cases of primary resistance were statistically significantly prevalent in the ChNPP accident consequences clean-up workers while in the residents ofradiologically contaminated areas a statistically significant increase in probability of loss of complete cytogeneticresponse (development of secondary resistance) to imatinib therapy was found. An association was found betweenthe radiation exposure and probability of loss of complete cytogenetic response to imatinib therapy in this group ofpatients. CONCLUSION: The radiation exposure in the history even many years before the onset of CML is an unfavorable exogenous factor responsible for the development of resistance to imatinib therapy. Meta: nadaty kharakterystyku osoblyvostiam perebigu khronichnoï miieloïdnoï leĭkemiï (KhML) ta vidpovidi na likuvannia sered oprominenykh vnaslidok avariï na Chornobyl's'kiĭ atomniĭ elektrostantsiï (ChAES) patsiientiv na osnovi otsinky kliniko-laboratornykh ta klinichnykh parametriv.Materialy i metody. Obstezheno 33 osoby iz KhML, iaki zaznaly diï ionizuiuchogo vyprominiuvannia vnaslidok avariïna ChAES. Grupu porivniannia sklaly 725 patsiientiv iz KhML bez radiatsiĭnogo anamnezu. Usi patsiienty znakhodylysia vkhronichniĭ fazi zakhvoriuvannia. Vykorystovuvaly kliniko-gematologichni ta molekuliarno-genetychni metody doslidzhennia.Rezul'taty. Patsiienty, iaki zaznaly vplyvu radiatsiĭnogo vyprominiuvannia, ne vidriznialys' osoblyvostiamymanifestatsiï KhML, porivniano z patsiientamy bez radiatsiĭnogo anamnezu, prote dlia nykh vyznachalasia nyz'ka efektyvnist' do terapiï imatynibom. U grupi uchasnykiv likvidatsiï naslidkiv avariï na ChAES statystychno znachushche perevazhaly vypadky rozvytku pervynnoï rezystentnosti, porivniano z grupoiu zhyteliv radiatsiĭno zabrudnenykh terytoriĭ ta grupoiu porivniannia. Vyiavleno statystychno znachushche pidvyshchennia chastoty vtraty dosiagnutoï povnoï tsytogenetychnoï vidpovidi na terapiiu imatynibom u patsiientiv, iaki buly evakuĭovani abo prozhyvaly na radiatsiĭno kontaminovanykh terytoriiakh, porivniano z patsiientamy bez radiatsiĭnogo anamnezu. Vyznacheno asotsiatyvnyĭ zv’iazokmizh vplyvom radiatsiĭnogo faktoru ta virogidnistiu vtraty dosiagnutoï povnoï tsytogenetychnoï vidpovidi na terapiiu imatynibom v tsiĭ grupi patsiientiv.Vysnovky. Naiavnist' radiatsiĭnogo oprominennia v anamnezi navit' za bagato rokiv do debiutu KhML, ie nespryiatlyvym seredovyshchnym faktorom, iakyĭ obumovliuie rozvytok rezystentnosti do terapiï imatynibom.

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