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RATIONALE TREATMENT AND PREVENTIVE MEASURES FOR CORRECTION OF BONE STRUCTURE IN CHILDREN WITH ACUTE LEUKEMIA, EXPOSED TO IONIZING RADIATION DUE TO THE CHORNOBYL ACCIDENT
V. G. Bebeshko1, K. M. Bruslova1, N. M. Tsvietkova1, T. T. Volodina2, O. V. Kopylova1,
T. O. Belingio1, S. A. Berezovski1, M. P. Petrunko1, V. G. Boyarskiy1, V. M. Polianska1,
T. I.Pushkareva1, L. P. Mishchenko1
1State Institution “National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine”, Melnykov str., 53, Kyiv, 04050, Ukraine
2A. V. Palladin Institute of Biochemistry of the National Academy of Sciences of Ukraine, Leontovych str., 9, Kyiv, Ukraine
Objective. To justify and evaluate the effectiveness of treatment and preventive measures taken to correct the biochemical and biophysical changes in the structure of bone in children exposed to ionizing radiation due to Chornobyl accident in the dynamics of leukemic process.
Materials and methods. The study involved 144 patients with acute lymphoid and myeloid leukemia. Serum calcium, total protein, alkaline phosphatase, cortisol and thyroid-stimulating hormone were investigated, as well as calcium and phosphate excretion, amino acids composition in the urine, acid-base balance and buffer systems of blood, bone density.
Results. A reduction of bone densitometry, calcium and cortisol levels and increase of serum alkaline phosphatase and urine oxyproline were found in children with acute leukemia in acute I phase and during the chemotherapy. In the period of remission the majority of patients did not differ from the comparison group. The signs of osteopenic syndrome that require monitoring of the bone structure status were revealed in 10.0 % of children of the comparison group. Radiation doses of leukemia patients were 3.66 ± 0.11 mSv. No relationship between radiation dose and indicators that reflect the state of the bone tissue structures has been established. The use of complex health care measures in children with acute leukemia in remission, contributed to the positive effect of 62.0 %. Worser effect was observed in patients with an unfavorable course of the disease.
Conclusions. Results of the study of bone tissue metabolism prove fore a change in the organic and mineral matrix in patients with acute leukemia exposed to ionizing radiation as a result of the Chonobyl NPP accident, and persons without hematologic diseases, and the need for treatment and prevention.
Key words: children, acute leukemia, ionizing radiation, bone structure, correction.
Problems of radiation medicine and radiobiology. 2014;19:192_202.
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