Medical Radiology and Radiation Safety. 2025. Vol. 70. № 6
DOI:10.33266/1024-6177-2025-70-6-97-101
A. Zherniakova1, V. Yudina1, O. Krysiuk1, 2
Leukopenia of Undetermined Significance in a Person with Long-term Exposure to Ionizing Radiation: a Perspective on Clonal Hematopoiesis (Clinical Case)
1 Russian Research Institute of Hematology and Transfusiolog, Saint Petersburg, Russia
2 Saint Petersburg State University, Saint Petersburg, Russia
Contact person: A. Zherniakova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Relevance: The phenomenon of clonal hematopoiesis (CH) is usually considered as a biological condition that precedes the development of a number of diseases and pathological processes, primarily haematological malignancies (HM). The concept of CH includes a number of conditions, among which is idiopathic cytopenia of undetermined significance (ICUS), which is defined in the presence of persistent cytopenia in more than one hematopoietic germ and the absence of criteria for myeloid neoplasm and other HM. CH is preceded by the occurrence of genomic instability and the appearance of genetic defects at various levels. The study of factors that can contribute to the transformation of CH into a pathological process is the field of particular interest is. It has been established that low doses of ionizing radiation (IR) is capable of inducing damage at the genetic and epigenetic levels. The dependence of the IR effect on the radiation dose is non-monotonic and polymodal. Recently, data has emerged that the action of small doses of IR can lead to genomic instability, and therefore may cause CH.
Purpose: The aim of this study was to present a clinical case for further discussion of the optimal medical tactics for treatment of a patient with leukopenia of undetermined significance and a history of prolonged contact with IR.
Material and methods: A patient, who had almost 40 years of contact with IR that did not exceed the maximum permissible annual dose (20 mSv per year), underwent a comprehensive examination and observation for two years. All diagnostic and therapeutic measures were performed according to the current National Clinical Guidelines of the Russian Federation, as well as International Standards and Protocols.
Results: The program of examination and monitoring of various parameters in a patient with leukopenia of undetermined significance and a long-term contact with IR is presented and discussed. It included both routine examinations and highly specific hematological and other studies in order to conduct a comprehensive assessment of the patient’s condition and the risks of various pathological conditions. Conclusion: The study of the effect of radiation-induced genetic instability on the clonal expansion is relevant for health monitoring and preventive diagnostics of HM and somatic pathology in individuals with long-term contact with IR in small doses.
Keywords: ionising radiation, professional exposure, clonal hematopoiesis, leukopenia of undetermined significance
For citation: Zherniakova A, Yudina V, Krysiuk O. Leukopenia of Undetermined Significance in a Person with Long-term Exposure to Ionizing Radiation: a Perspective on Clonal Hematopoiesis (Clinical Case). Medical Radiology and Radiation Safety. 2025;70(6):97–101. (In Russian). DOI:10.33266/1024-6177-2025-70-6-97-101
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PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Araticle was prepared with equal participation of the authors.
Editing of the manuscript: O.B. Krysyuk.
Article received: 20.07.2025. Accepted for publication: 25.08.2025.