Problems of Radiation Medicine and Radiobiology

V. G. Bebeshko, K. M. Bruslova, N. M. Tsvietkova, L. О. Lyashenko, T. I. Pushkareva,
L. O. Honchar, A. S. Sergeeva, S. M. Yatsemyrskii, Y. M. Samson, I. V.Trihlib, O. I. Makovey

State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine

EFFECT OF SOMEUNFAVORABLE FACTORS OF ENVIRONMENT ON THE SURVIVAL OF CHILDREN WITH ACUTE LEUKEMIA IN A LONG-TERM PERIOD AFTER ACCIDENT ON THE CHORNOBYL NPP

Objective. Determine of the influence of adverse environmental factors, including irradiation, on the survival of children 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 by the 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, immunophenotypic 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 were residents of cities, 22 – villages). 22 patients were lived in very and extremely polluted territories (4 were residents of cities, 18 – villages). Of 74 patients with ALL and AML 24 children died (32.4 %). The smallest number of children, who died, were patients with «general type» В-ALL (18.7 %), most of all children with pro-В-ALL (8 out of 10) 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 of villages. 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 6 years – (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 can be the basis for understanding the mechanisms of potentiating influence of metals and their compounds on the development of malignant diseases of the blood system in children.
Key words: children, acute leukemia, prognosis, serum ferritin, environmental factors, Chornobyl accident.

Problems of radiation medicine and radiobiology.
2018;23:254_262. doi: 10.33145/2304-8336-2018-23-254-262.

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