Corso A, Lazzarino M, Morra E, Merante S, Astori C, Bernasconi P, Boni M, Bernasconi C
Institute of Hematology, University of Pavia, Division of Hematology, Policlinico San Matteo, Italy.
Ann Hematol. 1995 Feb;70(2):79-82. doi: 10.1007/BF01834384.
Exposure to ionizing radiations (Rx) has been implicated as a causative factor of chronic myelogenous leukemia (CML). We performed a retrospective study of 443 consecutive CML patients, looking for a history of significant exposure to Rx, and evaluated the clinical and hematological characteristics in order to find any difference between radiation-related CML patients and those with de novo CML. We identified 406 patients without known exposure to mutagens (group I) and 37 patients with prior significant exposure to Rx (group II). In comparison to patients of group I, those of group II showed particular clinical and hematological features: significantly lower incidence of bulky splenomegaly (p < 0.05) and hyperleukocytosis (WBC > 100 x 10(9)/l; p < 0.05); significantly higher incidence of anemia (Hb < 10 g/dl; p < 0.01). Patients with radiation-related CML had a significantly better survival than those with de novo CML (median survival 61 months vs 42 months; p < 0.05). In conclusion, this study of a large cohort of CML patients indicates that the subgroup of patients with a history of significant exposure to ionizing radiation has particular clinical and hematological features at onset (lower tumor burden, higher frequency of anemia) and a better survival.
暴露于电离辐射（Rx）被认为是慢性粒细胞白血病（CML）的一个致病因素。我们对443例连续性CML患者进行了一项回顾性研究，寻找显著暴露于Rx的病史，并评估临床和血液学特征，以发现辐射相关CML患者与原发性CML患者之间的任何差异。我们确定了406例无已知诱变剂暴露的患者（I组）和37例既往有显著Rx暴露的患者（II组）。与I组患者相比，II组患者表现出特定的临床和血液学特征：巨脾肿大（p < 0.05）和白细胞增多症（白细胞> 100×10⁹/L；p < 0.05）的发生率显著更低；贫血（血红蛋白< 10 g/dl；p < 0.01）的发生率显著更高。辐射相关CML患者的生存率明显高于原发性CML患者（中位生存期61个月对42个月；p < 0.05）。总之，这项对大量CML患者的研究表明，有显著电离辐射暴露史的患者亚组在发病时具有特定的临床和血液学特征（肿瘤负荷较低、贫血频率较高）且生存率更高。
