Alternative Title長崎において原爆放射線に被ばくした骨髄異形成症候群患者の臨床的特徴と予後
Degree grantor/typeNagasaki University (長崎大学)
Note (General)There is evidence that radiation exposure is a causative factor of myelodysplastic syndromes (MDS). However, little is known about whether radiation exposure is also a prognostic factor of MDS. We investigated the impact of radiation exposure on the prognosis of MDS in Nagasaki atomic bomb survivors using the International Prognostic Scoring System (IPSS) and the revised version (IPSS-R). Subjects were 140 patients with primary MDS diagnosed between 1985 and 2011 and evaluable for IPSS, IPSS-R, and exposure distance. Of those, 31 were exposed at <1.5 km, 35 at 1.5?2.99 km, and 74 at ?3.0 km. By the end of March 2014, 47 patients (34%) progressed to overt leukemia and 106 (75.7%) died. By comparing with patients exposed at ?3.0 km, those exposed at <1.5 km had significantly higher frequencies of abnormal chromosome (P = 0.02), intermediate/poor IPSS, and intermediate/poor/very poor IPSS-R cytogenetic category (P = 0.0001, and P < 0.0001, respectively). As with de novo MDS, multivariate Cox regression analyses revealed that cytogenetic abnormalities, IPSS karyotype, and IPSS-R cytogenetics were significantly associated with poor survival, and cumulative incidence of leukemic transformation in MDS among atomic bomb survivors, but exposure distance was not associated with any poor outcomes. These suggest that exposure to the greater dose of atomic bomb radiation is associated with developing poor cytogenetic abnormalities in MDS, which might consequently lead to overt leukemia among atomic bomb survivors.
長崎大学学位論文 学位記番号:博(医歯薬)甲第982号 学位授与年月日:平成29年6月7日
Author: Masatoshi Matsuo, Masako Iwanaga, Hisayoshi Kondo, Midori Soda, Tatsuro Jo, Kensuke Horio, Yumi Takasaki, Yasuhisa Kawaguchi, Hideki Tsushima, Yoshitaka Imaizumi, Daisuke Imanishi, Jun Taguchi, Yasushi Sawayama, Tomoko Hata and Yasushi Miyazaki
Citation: Cancer Science, 107(10), pp.1484-1491; 2016
Nagasaki University (長崎大学), 博士(医学) (2017-06-07)
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2017-07-03T04:10:06+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション