Hematological aftermath of the radiation accident in Istanbul

Abstract

Purpose: The effects of radiation exposure are long-lasting. Long-term monitoring is imperative to diagnose late effects and improve our far-sightedness about possible events in the future. A radiation accident occurred in Istanbul in 1998 that resulted in mild to moderate acute radiation syndrome (ARS). In this study we aimed to investigate the changes in hematological parameters at the long-term follow-up of ARS patients.

Methods: Ten adults were hospitalized after exposure to a 60Co source. Seven were diagnosed as having ARS and had severe and symptomatic pancytopenia. All of the exposed people recovered following intensive treatment. Treatment was supportive with transfusion, granulocyte-colony stimulating factor, and anti- infective management covering antifungal agents. Patients were closely monitored. Nine years after the accident, the initial and follow-up complete blood count examinations and peripheral blood smears (PBS) were comparatively evaluated by an experienced hematologist. The hematological laboratory values of the patients on admission, after treatment, and nine years after the accident were documented and compared.

Results: Biodosimetric analysis revealed that whole-body doses ranged from 1–1.9 Gy. All subjects have shown complete recovery of the hematological laboratory values after treatment. All but one of the subjects showed complete blood cell recovery. The improvement of the blood cell count of the excepted patient stalled at a mildly reduced level and his bone marrow was still hypocellular nine years after the accident; however, no malignant changes were detected. Values at admission were significantly different compared with post treatment and present values of all patients. Post treatment and follow-up values were similar. One of the patients died of lung cancer. None of the patients developed hematological malignancy.

Conclusions: In this study, the recovery from ARS was complete after treatment. The small population, short follow-up period, and the relatively small doses resulted in no long-term adverse effects, as would be predicted.

Keywords::

• Accidents
• radiation
• hematopoiesis
• dosimetry
• follow-up
• Istanbul

Acknowledgements

We would like to thank Associate Professor Gursel Karahan for counseling on dosimetric analysis. We would also like to thank the personnel of Cekmece Nuclear Research Facility (Istanbul, Turkey), for their support in determining the estimated doses during the acute phase. We would also like to thank David Chapman for English editing.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.