人受照射或放化疗后造血系统残留效应的观察

本文通过观察(1)4例急性放射病第24年随访,(2)3例亚急性放射病2～5年随访,(3)3例急性白血病经放、化疗后获长期自下而上的资料,以及(4)6例慢粒经放、化疗后生存期超过5年的资料,发现其表现有:造血功能恢复不全,以巨核—血小板系统恢复不全为突出;造血功能处于正常低水平,代偿和储备能力不足以及发生肿瘤等后果。本资料病例死亡4例:1例因连续照射后发生造血组织异常增生综合征,因严重贫血和感染死亡;1例为慢粒照射、化疗后于第五年后有巨脾、严重贫血、骨髓纤维化而死亡,此2例与照射或化疗有关;1例急性放射病后死于车祸;另例为慢粒急变后贫血出血致死。文章还对造血系统残留效应的机理作初步讨论。

STUDIES OF RESIDUAL EFFECTS IN HEMATOPOIESIS FROM ACCIDENTAL RADIATION EXPOSURE OR RADIO-CHEMOTHERAPY.

After chinical study of (1) 24th year follow-up of four cases with acute radiation sickness, (2) 2nd to 5th year follow-up of three cases with subacute radiation sickness, (3) long-term survival in three cases of acute leukemia and (4) clinical observations of six cases with CML, who survived for more than five years, we found 3 categories of residual hematopoietic effects: (1) Incomplete recovery of hematopoiesis, especially in the megakaryocyte-platelet series. (2)Deficiency of hematopoiesis capability both in compensation and storage,and(3)malignancy transformation. Four cases in this study died: one died of myelodysplastic syndromes complicated by anemia and lung infection; one of myelofibrosis as a result of long-term radio-chemotherapy; the third on-; of anemia and hemorrhage during CML in blast crisis and the fourth from irrelevant carcinoma. The mechanism of residual hematopoietic effect was discussesed.