Epidemiology of Myelodysplastic Syndromes in Atomic Bomb Survivors

原子弹爆炸幸存者骨髓增生异常综合征的流行病学

基本信息

批准号：
17590545
负责人：
IWANAGA Masako
金额：
$ 2.24万
依托单位：
Nagasaki University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-17590545/
关键词：
Myelodysplastic Syndromes Atomic Bomb Survivors Radiation Exposure Epidemiology Pre-Leukemia Cancer Registry Database

项目摘要

[Background] Myelodysplastic syndromes (MDS) are acquired clonal stem cell disorders characterized by ineffective hematopoiesis and a high risk of progression to leukemia. Etiologies of MDS are still unknown. So far, there is no large-scale epidemiological study for population exposed to radiation.[Aim] To investigate the association between radiation exposure and a risk of MDS in Atomic bomb survivors.[Methods] Overall MDS cases were retrospectively accumulated from five hospitals in Nagasaki City and then identified Atomic bomb survivors by linkage with the Database of Nagasaki Atomic Bomb Survivors in the Scientific Data Center at Nagasaki University. Disease confirmation was conducted with the microscopic examination of bone marrow smear and clinical data. In retrospective cohort analyses, we set a retrospective cohort of Atomic bomb survivors who were alive at 1980.1.1 but no MDS. In age-adjusted population analyses, we used official prefecture population statistics and then compared MDS incidence between Atomic bomb survivors and Non-Atomic bomb survivors.[Results] Up to now, we accumulated approximately 600 MDS cases diagnosed during 1970' to 2004, and identified around 200 cases who were Atomic bomb survivors. In retrospective cohort analyses, 162 MDS were identified among a cohort of 87496 survivors during 1980 to 2004 (crude incidence rate: 10.7 per 103 PY). Risk of MDS was high in male than female (RR=1.7), in survivors exposed within 1.5km from hypocenter than those over 3.0km (RR=4.3). Risk of subtypes of RAEB ＆ RAEB-t was high compared with subtypes of RA ＆ RARS among survivors exposed within 1.5km. In age-adjusted population analyses, crude incidence rate of MDS was higher in Atomic bomb survivors than Non-Atomic bomb survivors (crude incidence rate: 10.0 vs. 6.49 per 106 PY, RR=1.5).[Discussion] Results suggest a clear association between radiation exposure and a risk of MDS. Radiation dose analysis is needed to confirm this association.

[背景] 骨髓增生异常综合征（MDS）是一种获得性克隆干细胞疾病，其特征是造血功能低下，且进展为白血病的风险较高，迄今为止，尚无针对辐射暴露人群的大规模流行病学研究。 [目的] 调查原子弹幸存者中辐射暴露与 MDS 风险之间的关系。 [方法] 回顾性收集长崎市 5 家医院的总体 MDS 病例然后，通过与长崎大学科学数据中心的长崎原子弹幸存者数据库联系，通过骨髓涂片显微镜检查和临床数据进行疾病确认，并进行回顾性队列分析。 1980年1月1日时还活着但没有MDS的原子弹幸存者队列在年龄调整人口分析中，我们使用官方的县人口统计数据，然后比较了原子弹幸存者和MDS之间的MDS发生率。非原子弹幸存者。[结果] 迄今为止，我们在1970年至2004年期间累计诊断出约600例MDS，并确定了约200例原子弹幸存者。在回顾性队列分析中，在一组队列中确定了162例MDS。 1980 年至 2004 年期间有 87496 名幸存者（粗发病率：每 103 PY 10.7 例）。男性高于女性（RR=1.7），距震源1.5km以内的幸存者高于3.0km以上的幸存者（RR=4.3），RAEB和RAEB-t亚型的风险高于RA和RARS亚型。在1.5公里范围内暴露的人口分析中，原子弹幸存者的MDS粗发病率高于非原子弹幸存者（粗发病率： 10.0 vs. 6.49 每 106 PY，RR=1.5)。[讨论]结果表明辐射暴露与 MDS 风险之间存在明确的关联，需要进行辐射剂量分析来证实这种关联。