Problems of Radiation Medicine and Radiobiology

V. G. Bebeshko, K. M. Bruslova, L. O. Lyashenko , N. M. Tsvietkova., L. O. Gonchar, S. G.
Galkina, A. L. Zaitseva, L. S. Reznikova, S. M. Iatsemyrskii, L. O. Tsvet

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

PROGNOSIS OF ACUTE LEUKEMIA DEPENDING ON THE IRON METABOLISM PARAMETERS IN CHILDREN AFTER CHORNOBYL NUCLEAR POWER PLANT ACCIDENT

Objective. To determine the influence of iron metabolism on the prognosis of acute lymphoblastic (ALL) and (AML) myeloblastic leukemia at the different phases of chemotherapy in children after Chоrnobyl accident.
Materials and methods. 333 children (295 – ALL, 38 – AML) were examined at the stages of chemotherapy. The comparison group included 93 children without leukemia. Acute leukemia variants, patients survival, relapses, the nature of disease (live child or died), iron methabolism (morphometric parameters of erythrocytes, SI, SF, STf, TS), manifestations of dyserythropoiesis, bone marrow sideroblast and patients radiation dose were taken into account.
Results. In 295 patients with ALL the following variants of leukemia were established: pro-B-ALL in 23, «common» type of ALL in 224, pre-B-ALL in 29, T-ALL in 19. Thirty eight patients were diagnosed with AML (11 – M1, 19 – M2, 8 – M4). Doses of radiation in patients with AL were (2.78 ± 0.10) mSv and they did not correlate with clinical and hematological parameters, disease variant. Relapse rates and shorter survival were in patients with T-ALL, pro-B-ALL and AML with SF levels > 500 ng/ml (p < 0.05). The amount of children with normochromic-normocytic anemias and manifestations of dysplasia of erythroid lineage elements was greater in the AML than in ALL. SF content in patients was elevated during chemotherapy and was lower than the initial one only in the remission period. Transferrin was reliably overloaded with iron: TS (70.2 ± 2.3) % compared with the control group (32.7 ± 2.1) %. Correlation between TS and survival of patients was detected (rs = -0.45). Direct correlation between the number of iron granules in erythrocariocytes and SF level (rs = 0.43) was established, indicating the phenomena of ineffective erythropoiesis.
Conclusions. The negative influence of iron excess in the patients body on the hemopoiesis function, manifestations of ineffective erythropoiesis and the course of acute leukemia in children have been established. Changes in ferrokinetic processes in children can be the basis of leukemоgenesis development.
Key words: acute leukemia, children, Chornobyl accident, serum iron, ferritin, transferrin, tranferrin saturation, sideroblasts, prognosis.

Problems of Radiation Medicine and Radiobiology.
2020;25:390-401. doi: 10.33145/2304-8336-2020-25-390-401

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