Cuzick J
N Engl J Med. 1981 Jan 22;304(4):204-10. doi: 10.1056/NEJM198101223040404.
It is well known that radiation can cause myeloid leukemia. However, no excess of chronic lymphocytic leukemia has been observed. Myelomatosis, like chronic lymphocytic leukemia, is a tumor of B lymphocytes. To determine whether this disease has a radiogenic origin, we surveyed all cohorts of persons exposed to radiation for which data on cancer-related mortality are available. An excess of myeloma was found in most cohorts. However, a striking deficit was found in two groups irradiated intensely for uterine neoplasms (three cases observed, 10.71 expected; P = 0.012). All other groups combined had a highly significant excess (50 observed, 22.21 expected; P = 2 X 10(-7)). The largest relative risk appeared among persons receiving internal doses of alpha-particles (14 observed, 3.24 expected; P = 2 X 10(-5)), but a significant excess (13 observed, 6.33 expected; P = 0.026) was also found in patients receiving only therapeutic or diagnostic gamma-rays or x-rays. Most cases occurred 15 to 25 years after exposure.
众所周知，辐射可导致髓细胞白血病。然而，未观察到慢性淋巴细胞白血病的过量发生。骨髓瘤与慢性淋巴细胞白血病一样，是B淋巴细胞的肿瘤。为了确定这种疾病是否有辐射源，我们调查了所有有癌症相关死亡率数据的受辐射人群队列。在大多数队列中发现骨髓瘤过量。然而，在两组因子宫肿瘤而接受高强度照射的人群中发现了显著不足（观察到3例，预期10.71例；P = 0.012）。所有其他组合并起来有高度显著的过量（观察到50例，预期22.21例；P = 2×10⁻⁷）。最大的相对风险出现在接受α粒子内照射的人群中（观察到14例，预期3.24例；P = 2×10⁻⁵），但在仅接受治疗性或诊断性γ射线或X射线的患者中也发现了显著过量（观察到13例，预期6.33例；P = 0.026）。大多数病例发生在接触后15至25年。
