Chronic myeloid leukaemia following repeated exposure to chest radiography and computed tomography in a patient with pneumothorax: A case report and literature review

Ju,Fang‑He; Gong,Xu‑Bo; Jiang,Li‑Bin; Hong,Hui‑Hua; Yang,Jun‑Chao; Xu,Ting‑Zhen; Chen,Yu; Wang,Zhen

doi:10.3892/ol.2016.4236

Chronic myeloid leukaemia following repeated exposure to chest radiography and computed tomography in a patient with pneumothorax: A case report and literature review

Authors:
- Fang‑He Ju
- Xu‑Bo Gong
- Li‑Bin Jiang
- Hui‑Hua Hong
- Jun‑Chao Yang
- Ting‑Zhen Xu
- Yu Chen
- Zhen Wang
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Affiliations: Department of Respiratory Medicine, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310006, P.R. China, Department of Clinical Laboratory, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, P.R. China
Published online on: February 17, 2016 https://doi.org/10.3892/ol.2016.4236
Pages: 2398-2402
Copyright: © Ju et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

It is well known that radioactive rays may cause damage to the human body. Progress in modern medicine has led to an increased risk of therapeutic and diagnostic radiation exposure of patients. Although clear evidence of a radiation dose‑dependent risk of chronic myeloid leukaemia, particularly for patients exposed to radiation at a young age, has been established, it is not known whether radiation exposure during diagnostic imaging also increases the risk of cancer. The present study reports the case of a patient who underwent several diagnostic imaging tests (including repeated chest radiography and computed tomography) for recurrent pneumothorax. At around one year subsequent to these tests, the patient was diagnosed with chronic myeloid leukaemia. The patient exhibited an increase in white blood cell count over time, and a bone marrow smear test showed a myeloid/erythroid ratio of 13.9:1. In addition, the qualitative breakpoint cluster region (BCR)/Abelson (ABL) gene test revealed positive results for BCR/ABL fusion (p210). Based on the data reported in the current case, research aimed at elucidating the potential risks associated with diagnostic radiation is urgently required. It is crucial that medical professionals consider the potential harmful side effects of diagnostic radiation when ordering radiation‑based diagnostic imaging examinations.

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1	Hall EJ and Giaccia AJ: Radiobiology for the Radiologist (7th). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 273–302. 2012.
2	Tsushima H, Iwanaga M and Miyazaki Y: Late effect of atomic bomb radiation on myeloid disorders: Leukemia and myelodysplastic syndromes. Int J Hematol. 95:232–238. 2012. View Article : Google Scholar : PubMed/NCBI
3	Ural AU, Beyzadeoglu M, Avcu F and Nevruz O: Chronic myeloid leukemia following radiotherapy for carcinoma of the cervix: Report of a case and brief review of the literature. Am J Hematol. 82:415–416. 2007. View Article : Google Scholar : PubMed/NCBI
4	Shimon I, Kneller A and Olchovsky D: Chronic myeloid leukaemia following 131I treatment for thyroid carcinoma: A report of two cases and review of the literature. Clin Endocrinol (Oxf). 43:651–654. 1995. View Article : Google Scholar : PubMed/NCBI
5	Aguiar RC: Therapy-related chronic myeloid leukemia: An epidemiological, clinical and pathogenetic appraisal. Leuk Lymphoma. 29:17–26. 1998. View Article : Google Scholar : PubMed/NCBI
6	Nowell PC and Hungerford DAS: A minute chromosome in human chronic granulocytic leukemia. Science. 132:1497–1501. 1960.
7	Hochhaus A: Detection and quantification of leukemia-specific rearrangements. Methods in Molecular Medicine™ Molecular Analysis of Cancer. Boultwood J and Fidler C: Humana Press. (Totowa, NJ). 67–96. 2001. View Article : Google Scholar
8	Konopka JB, Watanabe SM, Singer JW, Collins SJ and Witte ON: Cell lines and clinical isolates derived from Ph1-positive chronic myelogenous leukemia patients express c-abl proteins with a common structural alteration. Proc Natl Acad Sci USA. 82:1810–1814. 1985. View Article : Google Scholar : PubMed/NCBI
9	Davis RL, Konopka JB and Witte ON: Activation of the c-abl oncogene by viral transduction or chromosomal translocation generates altered c-abl proteins with similar in vitro kinase properties. Mol Cell Biol. 5:204–213. 1985. View Article : Google Scholar : PubMed/NCBI
10	Wang JY, Liao EY and Hu PJ: Leukemia. Internal Medicine. People's Medical Publishing House. (Bejing). 756–757. 2005.(In Chinese).
11	Hughes T, Deininger M, Hochhaus A, Branford S, Radich J, Kaeda J, Baccarani M, Cortes J, Cross NC, Druker BJ, et al: Monitoring CML patients respongding to treatment with tyrosine kinase inhibitors:review and recommendations for harmonizing current methodology for detecting BCR-ABL transcripts and kinase domain mutations and for expressing results. Blood. 108:28–37. 2006. View Article : Google Scholar : PubMed/NCBI
12	Shah NP: Front-line TKI therapy for chronic-phase CML: The luxury of choice. Oncology (Williston Park). 26:908, 910, 9122012.PubMed/NCBI
13	Au WY, Ooi GC, Ma SK, Wan TS and Kwong YL: Chronic myeloid leukemia in an adolescent with Ollier's disease after intensive X-ray exposure. Leuk Lymphoma. 45:613–616. 2004. View Article : Google Scholar : PubMed/NCBI
14	Yuasa H, Hamajima N, Ueda R, Ohno R, Asou N, Utsunomiya A, Ogura M, Takigawa N, Ueda T, Hiraoka A, et al: Case-control study of leukemia and diagnostic radiation exposure. Int J Hematol. 65:251–261. 1997. View Article : Google Scholar : PubMed/NCBI
15	Preston-Martin S, Thomas DC, Yu MC and Henderson BE: Diagnostic radiography as a risk factor for chronic myeloid and monocytic leukaemia (CML). Br J Cancer. 59:639–644. 1989. View Article : Google Scholar : PubMed/NCBI
16	United Nations Scientific Committee on the Effects of Atomic Radiation: Effects of ionizing radiation. UNSCEAR 2006 report. Report to the general assembly, with scientific annexes. Annex A: Epidemiological studies of radiation and cancer. United Nations. (New York). 13:3222006.
17	ICRP: The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann ICRP. 37(2-4)2007.
18	Evans JS, Wennberg JE and McNeil BJ: The influence of diagnostic radiography on the incidence of breast cancer and leukemia. N Eng J Med. 315:810–815. 1986. View Article : Google Scholar
19	Sodickson A, Baeyens PF, Andriole KP, Prevedello LM, Nawfel RD, Hanson R and Khorasani R: Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. Radiology. 251:175–184. 2009. View Article : Google Scholar : PubMed/NCBI
20	United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation. UNSCEAR 1993 report. Report to the general assembly, with scientific annexes. Annex F: Influence of dose and dose rate on stochastic effects of radiation. (New York). United Nations. 619–728. 1993.
21	Sigurdson AJ and Stram DO: Genetic predisposition to radiation-related cancer and potential implications for risk assessment. Ann ICRP. 41:108–116. 2012. View Article : Google Scholar : PubMed/NCBI
22	Barnett GC, West CM, Dunning AM, Elliott RM, Coles CE, Pharoah PD and Burnet NG: Normal tissue reactions to radiotherapy: Towards tailoring treatment dose by genotype. Nat Rev Cancer. 9:134–142. 2009. View Article : Google Scholar : PubMed/NCBI