Ghani Fay, Zubair Abba C
Center for Regenerative Biotherapeutics and Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA.
Leukemia. 2025 Apr 24. doi: 10.1038/s41375-025-02624-4.
With the advent of deep space exploration and ambitious plans to return humans to the Moon and journey onward to Mars, humans will face exposure to ionizing radiation beyond Earth's atmosphere and magnetosphere. This is particularly concerning for the hematopoietic system that is sensitive to galactic cosmic rays (GCRs) during interplanetary missions. Epidemiological studies and animal studies implicate that exposure to ionizing radiation can cause leukemias, with recent consensus showing that almost all types of leukemias, even chronic lymphocytic leukemia, can be caused by ionizing radiation despite previous controversies. The possible deleterious effects of deep space travel on the formation, development, etiology, and pathophysiology of hematologic malignancies, specifically leukemias, remain largely unclear. The mechanism(s) by which ionizing radiations cause leukemia differs for different leukemia types and is poorly understood in the spaceflight environment, posing a serious health risk for future astronauts. This paper provides a comprehensive review of the various studies and evidence available on Earth and in space assessing the relationship between ionizing radiation and increased risk of leukemia. We also discuss the unique characteristics of leukemia in space, ethical considerations, risk assessments and potential challenges this may bring to astronauts and healthcare professionals as humanity continues to explore the cosmos.
随着深空探索的出现以及将人类送回月球并继续前往火星的宏伟计划，人类将面临地球大气层和磁层之外的电离辐射。这对于造血系统而言尤其令人担忧，因为在行星际任务期间，造血系统对银河宇宙射线（GCRs）敏感。流行病学研究和动物研究表明，暴露于电离辐射会引发白血病，最近的共识显示，几乎所有类型的白血病，甚至慢性淋巴细胞白血病，尽管此前存在争议，但都可能由电离辐射引起。深空旅行对血液系统恶性肿瘤，特别是白血病的形成、发展、病因和病理生理学可能产生的有害影响，在很大程度上仍不清楚。电离辐射导致白血病的机制因白血病类型而异，并且在太空飞行环境中了解甚少，这给未来的宇航员带来了严重的健康风险。本文全面综述了地球上和太空中关于评估电离辐射与白血病风险增加之间关系的各种研究和证据。我们还讨论了太空白血病的独特特征、伦理考量、风险评估以及随着人类继续探索宇宙这可能给宇航员和医疗保健专业人员带来的潜在挑战。
