The number of deaths in each interval of follow-up and 99% confidence intervals are indicated (Pr87).Īmong 14,106 patients who were followed for up to 48 years after a single course of x-ray therapy for ankylosing spondylitis, 39 deaths from leukemia were recorded versus a total of 12.29 expected cases (ratio of observed to expected deaths, 3.17) (Da87).

Relative risk of mortality from leukemia and all cancers other than leukemia in A-bomb survivors, 1950-1982, in relation to time after irradiation. The saturation of the leukemia response at high doses has been attributed to the reduced survival of potentially transformed myeloblasts in the range above 3-4 Gy (Un86). As noted below, this pattern is characteristic of the leukemia response in other irradiated populations. At bone marrow doses of 3-4 Gy, the estimated dose-response curve peaks and turns downward ( Figure 5-1). For the combined data, the rate of mortality is significantly elevated at 0.4 Gy and above but not at lesser doses. Analyzed in terms of absorbed dose to the bone marrow as estimated with the new DS86 dosimetry, the dose response for Nagasaki rises less steeply than for Hiroshima, especially in the dose range below 0.5 Gy, but the difference between the two cities is smaller with the DS86 dosimetry than with the T65D dosimetry and is no longer significant (Sh87). In the atomic-bomb survivors of the Life Span Study Cohort, a total of 202 deaths from leukemia were recorded for the period from 1950 to 1985, during which there were an estimated 2,185,335 person-years of follow-up. The most extensive human data on the dose-incidence relationship come from studies of the Japanese atomic-bomb survivors and patients treated with x rays for ankylosing spondylitis.

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