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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.