Long-term exposure to low doses of ionizing radiation and COVID-19 pandemic: oncohematological aspects.

For more than 35 years after Chornobyl catastrophe, about 5 million people in Ukraine, Republic of Belarus and Russian Federation inhabit the territories that are residually contaminated with long-lived radionuclides such as 137Cs, 90Sr. The previous studies of the Reference Laboratory operating at RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology allowed specifying the effects of the protracted low dose irradiation on the state of the hematopoietic and lymphoid tissues resulting in the increased proportion of the B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma and acute myeloid leukemia among the patients referred from the contaminated areas of Ukraine. Since the beginning of 2020, these effects of radiation were superimposed by the factors associated with COVID-19 pandemic. SARS-CoV-2 infection is associated with the significant impact on hematopoiesis and immune system. Particular attention should be given to the role of such combined burden in the development of the immunodeficiency-associated lymphoid neoplasms. The extensive studies of the combined effects of low dose irradiation and COVID-19 within the large affected populations could be made a priority in future endeavors of epidemiologists and oncohematologists.

[State of medical care of patients with hematological malignancies in Kyïv].

In the article data are presented about morbidity by oncogematologic pathology - one of the most meaningful of social-economic problems. In Ukraine annually diagnose the to 8 thousand new cases of haemoblastosis. Indexes of morbidity on a 100 thousand population are 5,2; at illness of Hodgkin's lymphoma - 2,5, at plural myeloma - 1,6; at leukemia - 8,1. Morbidity by haematological pathology in Kyiv long time remains high: annually 250 expose patients with malignant lymphnoma, 57 - with myeloma, 190 - with leukemia, from them at 55 % is a sharp form and at 40 % - chronic. The anxiety of doctors causes circumstance that the special treatment is overcome 58,1 % patients by leukemia, 68,6 % - plural myeloma and 77,8 % patients with malignant lymphoma. World experience shows that application of complex methods of therapy allows to prolong life-span 80-90 % patients with Hodgkin's malignant lymphoma on 10, and at 95 % patients by a lymphogranulomatosis - to attain nonrecurrence survival to 5 years.

[P-glycoprotein expression in radiation-associated acute myeloid leukemia].

The article presents findings of the analysis on P-glycoprotein expression of leukemic cells in 52 acute myeloid leukemia (AML) patients. Of these, there were 20 persons exposed to ionizing radiation due to the Chernobyl accident and 32 patients with spontaneous disease. Leukemic cells in patients with radiation-associated AML compared to spontaneous cases more often were P-glycoprotein positive (12/20 vs 9/32, P<0,05). P-glycoprotein overexpression significantly correlated with resistant disease in patients with radiation-associated AML, but was not a prognostic variable for treatment outcome in terms of overall survival.

[Enterosorption and therapeutic plasmapheresis in the intensive therapy of patients with acute leukemia and of persons who were victims of the accident at the Chernobyl Atomic Electric Power Station]. / Enterosorbtsiia i lechebnyi plazmaferez v intensivnoi terapii bol'nykh ostrym leikozom i u lits, postradavshikh v rezul'tate avarii na ChAES.

The paper reports on the preliminary experience of treatment of those patients having been the victims to the reactor accident at the Chernobyl NPP as well as of those with acute and chronic leukoses, having received courses of modern cytostatic therapy. The patients were exposed to therapeutic plasmapheresis and enterosorption as part of a complex conventional treatment programme. The conclusion the authors have come to is as follows: enterosorption strikingly reduces manifestations of "cytostatic disease"; the use of plasmapheresis in those persons having been previously exposed to small dose chronic radiation, makes for improvement of clinical and laboratory values but further studies are warranted to determine indications for therapeutic plasmapheresis.