State Institution «National Research Center for radiation Medicine of the National Academy of medical Sciences of Ukraine», 53 Yury Illienko str., Kyiv, 04050, Ukraine.
Probl Radiac Med Radiobiol. 2020 Dec;25:443-455. doi: 10.33145/2304-8336-2020-25-443-455.
Describe and characterize the peculiarities of the chronic myeloid leukemia (CML) course and responseto treatment in patients irradiated as a result of the Chornobyl nuclear power plant (ChNPP) accident based on theassessment of clinical-laboratory and clinical parameters.
The CML patients (n = 33) exposed to ionizing radiation as a result of the ChNPP accidentwere enrolled. The comparison group consisted of CML patients (n = 725) with no history of radiation exposure. Allpatients were in the chronic phase of the disease. Clinical, hematological and molecular genetic research methodswere applied.
Patients exposed to ionizing radiation as a result of the ChNPP accident had no differences in CML manifestation, as well as in classical genetic markers at the onset of the disease compared with patients with no historyof radiation exposure. Reduction of tumor clone on imatinib therapy was significantly less effective in the patientsexposed to ionizing radiation than in cases of no history of radiation exposure. Cases of primary resistance were statistically significantly prevalent in the ChNPP accident consequences clean-up workers while in the residents ofradiologically contaminated areas a statistically significant increase in probability of loss of complete cytogeneticresponse (development of secondary resistance) to imatinib therapy was found. An association was found betweenthe radiation exposure and probability of loss of complete cytogenetic response to imatinib therapy in this group ofpatients.
The radiation exposure in the history even many years before the onset of CML is an unfavorable exogenous factor responsible for the development of resistance to imatinib therapy.
根据临床-实验室和临床参数评估，描述并阐明因切尔诺贝利核电站（ChNPP）事故而受到辐射的患者慢性髓性白血病（CML）病程和治疗反应的特点。
纳入了因 ChNPP 事故受到电离辐射的 CML 患者（n=33）。对照组由无辐射暴露史的 CML 患者（n=725）组成。所有患者均处于疾病慢性期。应用了临床、血液学和分子遗传学研究方法。
与无辐射暴露史的患者相比，因 ChNPP 事故而受到电离辐射的患者在 CML 表现以及疾病发病时的经典遗传标志物方面无差异。与无辐射暴露史的患者相比，接受伊马替尼治疗的肿瘤克隆减少明显不那么有效。在 ChNPP 事故后果清理人员中，原发性耐药的病例明显更为常见，而在放射性污染地区的居民中，伊马替尼治疗完全细胞遗传学反应丧失（继发性耐药发展）的概率显著增加。在该组患者中发现了辐射暴露与对伊马替尼治疗完全细胞遗传学反应丧失的概率之间存在关联。
即使在 CML 发病前多年有辐射暴露史，也是导致对伊马替尼治疗产生耐药性的不利外源性因素。
