CLINICAL CHARACTERISTICS OF ACUTE MYELOID LEUKEMIA PATIENTS FROM REGIONS CONTAMINATED BY DEPLETED URANIUM: 20 YEAR ANALYSIS
Author(s): ,
Lejla Mehinovic
Affiliations:
Pathology, Cytology, and Human Genetics,Clinical Center of the University of Sarajevo,Sarajevo,Bosnia and Herzegovina
,
Amina Kozaric
Affiliations:
Pathology, Cytology, and Human Genetics,Clinical Center of the University of Sarajevo,Sarajevo,Bosnia and Herzegovina
,
Aida Dizdarevic
Affiliations:
Hematology,Clinical Center of the University of Sarajevo,Sarajevo,Bosnia and Herzegovina
Sabira Kurtovic
Affiliations:
Hematology,Clinical Center of the University of Sarajevo,Sarajevo,Bosnia and Herzegovina
EHA Library. Kozaric A. Jun 9, 2016; 132490; E941
Assoc. Prof. Amina Kozaric
Assoc. Prof. Amina Kozaric
Contributions
Abstract
Abstract: E941

Type: Eposter Presentation

Background
During the war in Bosnia (1992-1995), ammunition with depleted uranium was used in several regions, including the town of Hadzici, where the United Nations have measured high concentrations of depleted uranium several years after the war. Depleted uranium (DU), a radioactive heavy metal, is used in military ammunition. Studies have shown the potential health risks of contamination by DU by wounding, ingestion, and inhalation. In vivo and in vitro experiments showed the carcinogenic potential of DU by neoplastic transformation of human and mouse cells, leading to the development of myeloid neoplasms. It is assumed that the DU exposure induces genomic stability leading to carcinogenesis. 

Aims
Increased numbers of patients with blood cancers in DU stricken area was noted by hematologists, so we systematically analyzed hematological patients from this region in the last 20 years, from 01.01.1996. – 31.12.2015. 

Methods
We systematically analyzed hematological patients from two region in the last 20 years, from 01.01.1996. – 31.12.2015. One region had high concentrations of DU (Hadzici) and the other region (ilijas) was used as a control. Both regions have the same population size and same access to tertiary health care. Patient data was collected including age at diagnosis, sex, address, blood parameters, cytogenetics, therapy, and survival. 

Results
In the 20 year analyzed period from 01.01.1996–31.12.2015, we found 717 patients with hematological conditions (437 from DU-stricken town vs. 280 from control town). There were 74 patients with myeloid malignancies (54 vs. 20), 55 patients with non Hodgkin lymphoma (26 vs. 29), 21 patients with Hodgkin lymphoma (9 vs. 12), and 6 patients with ALL (4 vs. 2).  Among the myeloid neoplasms, CML showed 6 fold increase in DU-stricken area and AML showed 3 fold increase. The median age at diagnosis for AML patients was 41 vs. 73,  and for CML patients was 62 vs. 53. Male to female ratio was for AML 0.5 vs. 1, and for CML 1 vs. 7. For AML patients, 22% vs 67% of patients achived complete remission after first treatment. The median duration of remission was 10.5 v 17.5 months. OS at 24 months was 22% vs 50%. 

Conclusion
Clinical parameters showed more severe course of acute myeloid leukemia patients in DU stricken area compared to the control and international data. Further investigation is needed to elucidate the possible causes of stark increase in myeloid neoplasms in Hadzici area.

Session topic: E-poster

Keyword(s): Acute myeloid leukemia, Clinical outcome, Radiation

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