HEMOBLASTOSES AMONG LIQUIDATORS HEMOBLASTOSES AMONG LIQUIDATORS OF CONSEQUENCES OF THE CHERNOBYL OF CONSEQUENCES OF THE CHERNOBYL

ACCIDENT AND POPULATION IN THE MOST ACCIDENT AND POPULATION IN THE MOST HIGHLY CONTAMINATED TERRITORIES HIGHLY CONTAMINATED TERRITORIES

OF RUSSIA OF RUSSIA

MEDICAL RADIOLOGICAL RESEARCH CENTRE RUSSIAN ACADEMY OF MEDICAL SCIENCES DIRECTOR – ACADEMICIAN OF RAMS A. F. TSYB

29 May – 3 June 2006, Kiev, Ukraine

V.K. Ivanov, A.F. Tsyb, S.E. Khait, A.I. Gorsky, M.A. Maksioutov, N.V. Schukina

NATIONAL RADIATION AND EPIDEMIOLOGICAL REGISTRY HEAD – CORR.-MEMBER OF RAMS V. K. IVANOV

WHO Collaborating Centre of Radiation Epidemiology

Sources of the data

Primary medical documentsPrimary medical documents

1. Medical History2. Out-patient card3. Control card of dispensary follow-up4. Notification about oncological disease5. Record in the journal of KDL (text of myelogramm, cytochemical study, immunological, cytogenetics and blood cell culture study)6. The journals of oncological offices of CRH7. Pathological anatomy study (protocol of histological study) 8. Protocol of trepanobiopsy of bone marrow and biopsy of lymphatic node

Diagnostic materialsDiagnostic materials Blood smearsSmears of bone marrowHistological preparations

Health care serviceHealth care service

Rayon and municipal clinic

(oncological consulting cabinet)

Oblast clinic

Oblast oncological dispensary

Republican hematological Center

РОССИЙСКИЙ РАДИАЦИОННО- ЭПИДЕМИОЛОГИЧЕСКИЙ РЕГИСТР

АРХИВ ГИСТОЛОГИЧЕСКИХ МАТЕРИАЛОВБольной Л. Диагноз: острый миелобластный лейкоз

Structure of hemoblastoses among liquidators (1986-2006)

Leukemia 49,2%

Non-Hodgkin's lymphoma

28,9%

Lympho-granulomatosis

15,9%

Multiple myeloma

6,0%

LEUKAEMIA AND MYELOMA CASES

0

20

40

60

80

100

120

06.1986-1992 1993-06.1999 07.1999-2005

Nu

mb

er o

f ca

ses

case

died

4,7

7,98,5

Distribution of different types of leukemia

I. among the liquidators (1986-2006)

II. for males with attained age 35-69 years according to official statistical data in the Russia as a whole (1993-1998)

III. according to data of the Russian Hematological Center (1968-1978)

ALL25,0%

OAL11,0%

CLL30,0%

CML12,0%

OCL6,0%

AML16,0%

ALL14,7%

OAL6,6%

CLL30,0%

CML14,5%

OCL8,2%

AML26,0%

AL23,4%

CLL28,7%

ER14,5%

MDS4,5%

CML28,9%

Structure of leukemia in different time periods

0

5

10

15

20

25

30

AL MDS CLL CML ER MM

I - 06.1986-1992II - 1993-06.1999III - 07.1999-2005

I

II

III

ESTIMATES OF RELATIVE RISK AMONG LIQUIDATORS

0

0,5

1

1,5

2

2,5

0-150 >150 0-150 >150

Rel

ativ

e ri

sk

Dose, mSv

1986-1996 1997-2005

LEUKAEMIA CASES

0

12

34

5

67

89

10

1980-1986 1987-1992 1993-1998

Inc

ide

nc

e r

ate

p

er

10

00

00

pe

rso

n-y

ea

rs

Highlycontaminated(22.9 mSv)Lowcontaminated(7.4 mSv)Conrtol (0.4 mSv)

LEUKAEMIA CASES (children)

0

2

4

6

8

10

12

14

ALL AML CML

Nu

mb

er o

f ca

ses

I - 1980-1986II - 1987-1992III - 1993-1998 I

II

III

I

III IIIII III

LEUKAEMIA CASES (adults)

0

10

20

30

40

50

60

AL CLL CML OCL

Nu

mb

er o

f ca

ses

I - 1980-1986II - 1987-1992III - 1993-1998

III III

LEUKAEMIA CASES

010

203040

5060

7080

AL CLL CML OCL

Nu

mb

er o

f ca

ses

I - 1980-1986 (all areas) II - Highly contaminatedIII - Low contaminatedIV - Control

I

II

III IV

ESTIMATES OF RELATIVE RISK AMONG POPULATION

1

1,36 1,3

1,8

0

0,5

1

1,5

2

Relative riskSIR

Dose, mSv0 - 10 > 30

1. Potential risk group of radiogenic leukemia is defined, which contains liquidators with dose more then 150 mSv.

2. Risk of radiogenic leukaemia in the population of the highly contaminated areas of the Bryansk oblast during 1986-1998 is positive, but statistically not significant. There is trend of leukaemia incidence with the dose for the overall population.

3. In the cohort of liquidators and the population of the most contaminated with radionuclides areas following the Chernobyl accident increase of the fraction of chronic myeloleucosis in the structure of leukemias were detected.