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Radiation-induced myelomatosis

J Cuzick

    The New England Journal of Medicine
    |January 22, 1981
    PubMed
    Summary

    Radiation exposure is linked to increased myeloma risk, particularly from alpha-particles. However, intense radiation for uterine neoplasms showed a deficit, suggesting complex radiation effects on B-cell tumors.

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    Clinical oncology (Royal College of Radiologists (Great Britain))·2015

    Area of Science:

    • Oncology
    • Radiation Epidemiology
    • Hematology

    Background:

    • Radiation exposure is a known cause of myeloid leukemia.
    • No increased risk of chronic lymphocytic leukemia (CLL) has been observed post-radiation.
    • Myelomatosis, a B-lymphocyte tumor, shares cellular origins with CLL, prompting investigation into its radiogenic potential.

    Purpose of the Study:

    • To investigate the potential radiogenic origin of myelomatosis.
    • To analyze cancer mortality data in cohorts exposed to radiation.

    Main Methods:

    • Surveyed multiple cohorts with available cancer-related mortality data following radiation exposure.
    • Compared observed myelomatosis cases against expected numbers based on general population rates.
    • Analyzed risks associated with different radiation types (alpha-particles, gamma rays, X-rays) and exposure durations.

    Main Results:

    • A significant overall excess of myelomatosis was observed in most irradiated cohorts (50 observed vs. 22.21 expected; P < 2 X 10(-7)).
    • Highest relative risk was associated with internal alpha-particle exposure (14 observed vs. 3.24 expected; P < 2 X 10(-5)).
    • A significant excess was also noted for therapeutic/diagnostic gamma and X-ray exposure (13 observed vs. 6.33 expected; P = 0.026), with most cases appearing 15-25 years post-exposure.

    Conclusions:

    • Radiation exposure, particularly from alpha-particles and therapeutic/diagnostic X-rays, significantly increases the risk of developing myelomatosis.
    • The latency period for radiation-induced myelomatosis appears to be 15-25 years.
    • A notable deficit in myelomatosis cases was observed in two groups intensely irradiated for uterine neoplasms, warranting further investigation.

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