Preston D L, Kusumi S, Tomonaga M, Izumi S, Ron E, Kuramoto A, Kamada N, Dohy H, Matsuo T, Matsui T [corrected to Matsuo T ]
Department of Statistics, Radiation Effects Research Foundation, Hiroshima, Japan.
Radiat Res. 1994 Feb;137(2 Suppl):S68-97.
This paper presents an analysis of data on the incidence of leukemia, lymphoma and myeloma in the Life Span Study cohort of atomic bomb survivors during the period from late 1950 through the end of 1987 (93,696 survivors accounting for 2,778,000 person-years). These analyses add 9 additional years of follow-up for leukemia and 12 for myeloma to that in the last comprehensive reports on these diseases. This is the first analysis of the lymphoma incidence data in the cohort. Using both the Leukemia Registry and the Hiroshima and Nagasaki tumor registries, a total of 290 leukemia, 229 lymphoma and 73 myeloma cases were identified. The primary analyses were restricted to first primary tumors diagnosed among residents of the cities or surrounding areas with Dosimetry System 1986 dose estimates between 0 and 4 Gy kerma (231 leukemias, 208 lymphomas and 62 myelomas). Analyses focused on time-dependent models for the excess absolute risk. Separate analyses were carried out for acute lymphocytic leukemia (ALL), acute myelogenous leukemia (AML), chronic myelocytic leukemia (CML) and adult T-cell leukemia (ATL). There were few cases of chronic lymphocytic leukemia in this population. There was strong evidence of radiation-induced risks for all subtypes except ATL, and there were significant subtype differences with respect to the effects of age at exposure and sex and in the temporal pattern of risk. The AML dose-response function was nonlinear, whereas there was no evidence against linearity for the other subtypes. When averaged over the follow-up period, the excess absolute risk (EAR) estimates (in cases per 10(4) PY Sv) for the leukemia subtypes were 0.6, 1.1 and 0.9 for ALL, AML and CML, respectively. The corresponding estimated average excess relative risks at 1 Sv are 9.1, 3.3 and 6.2 respectively. There was some evidence of an increased risk of lymphoma in males (EAR = 0.6 cases per 10(4) PY Sv) but no evidence of any excess in females. There was no evidence of an excess risk for multiple myeloma in our standard analyses.
本文对1950年末至1987年底原子弹爆炸幸存者寿命研究队列中的白血病、淋巴瘤和骨髓瘤发病率数据进行了分析（93,696名幸存者，共计2,778,000人年）。这些分析为白血病增加了9年的随访时间，为骨髓瘤增加了12年的随访时间，超过了关于这些疾病的上一份综合报告中的随访时间。这是该队列中淋巴瘤发病率数据的首次分析。利用白血病登记处以及广岛和长崎肿瘤登记处的数据，共识别出290例白血病、229例淋巴瘤和73例骨髓瘤病例。主要分析仅限于在剂量测定系统1986剂量估计在0至4戈瑞比释动能之间的城市或周边地区居民中诊断出的原发性肿瘤（231例白血病、208例淋巴瘤和62例骨髓瘤）。分析重点在于超额绝对风险的时间依赖性模型。对急性淋巴细胞白血病（ALL）、急性髓细胞白血病（AML）、慢性髓细胞白血病（CML）和成人T细胞白血病（ATL）进行了单独分析。该人群中慢性淋巴细胞白血病病例很少。除ATL外，所有亚型均有辐射诱发风险的有力证据，并且在暴露年龄、性别影响以及风险的时间模式方面存在显著的亚型差异。AML的剂量反应函数是非线性的，而其他亚型则没有证据表明其非线性。在随访期内进行平均时，白血病亚型的超额绝对风险（EAR）估计值（每10⁴人年·希沃特的病例数），ALL、AML和CML分别为0.6、1.1和0.9。在1希沃特时相应的估计平均超额相对风险分别为9.1、3.3和6.2。有证据表明男性淋巴瘤风险增加（EAR =每10⁴人年·希沃特0.6例），但没有证据表明女性有任何超额风险。在我们的标准分析中，没有证据表明多发性骨髓瘤存在超额风险。
