Medical Radiology and Radiation Safety. 2025. Vol. 70. № 5
DOI:10.33266/1024-6177-2025-70-5-75-81
I.A. Galstyan, A.Yu. Bushmanov, M.V. Konchalovsky,
V.Yu. Nugis, N.A. Metlyaeva, O.V. Shcherbatykh, L.A. Yunanova
Peripheral Blood Indices at Different Periods of Chronic Radiation Syndrome (Literature Review)
A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia
Contact person: I.A. Galstyan, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
The article reviews literature data on the state of peripheral blood in different periods of chronic radiation syndrome (CRS). In the period of disease formation in workers of the Mayak Production Association when working under high dose rate irradiation conditions, the time of development of clinical manifestations was determined by the rate of accumulation of the threshold dose value and ranged from 1–2 to 5–8 years. Patients showed moderate leukopenia (2.6–4.0 × 109/l with normal values of 5.0–8.0 × 109/l), thrombocytopenia (70.0-160.0 × 109/l with the normal values of 200.0–300.0 × 109/l). In more severe cases, mainly at high dose rates (more than 1.0 Gy/year), anemic syndrome developed. Damage to hematopoiesis in most cases (except for 2 patients) did not reach the degree of aplastic anemia.
The population of the Techa River basin was more heterogeneous in age and health at the time of the onset of radiation exposure, which predetermined the characteristics of the clinical manifestations of CRS. A shortening of the latent period of CRS in children was noted. There were no cases of CRS of grade III severity. Anemic syndrome of radiation genesis was not observed. All identified anemias were associated with iron deficiency.
After the cessation of contact with gamma radiation, blood counts were restored, reaching physiological levels in the near future. The concentration of platelets reached the normal value, as a rule, within the next 5 years after withdrawal from production conditions. Leukopenia persisted for up to 25 years, especially in patients with CRS of grade III severity.
The reaction of the hematopoietic system to chronic intake of radionuclides is determined by the patterns of their distribution in the body. In the presence of incorporated osteotropic radionuclides, signs of incomplete hematopoiesis regeneration persisted in patients after cessation of irradiation.
Keywords: chronic radiation syndrome, peripheral blood, accumulated dose, dose rate, osteotropic radionuclides, leukopenia, thrombocytopenia, anemia
For citation: Galstyan IA, Bushmanov AYu, Konchalovsky MV, Nugis VYu, Metlyaeva NA, Shcherbatykh OV, Yunanova LA. Peripheral Blood Indices at Different Periods of Chronic Radiation Syndrome (Literature Review). Medical Radiology and Radiation Safety. 2025;70(5):75–81. (In Russian). DOI:10.33266/1024-6177-2025-70-5-75-81
References
1. Okladnikova N.D. Chronic Radiation Sickness in Humans Caused by External or Predominantly External Gamma Irradiation. Radiatsionnaya Meditsina = Radiation Medicine. Vol. 2. Moscow, IzdAT Publ., 2001. P. 253-274 (In Russ.).
2. Gus’kova A.K., Baysogolov G.D. Luchevaya Bolezn’ Cheloveka = Human Radiation Sickness. Moscow, Meditsina Publ., 1971. 384 p. (In Russ.).
3. Gus’kova A.K. Chronic Radiation Sickness from Uniform Irradiation. Radiatsionnyye Porazheniya Cheloveka = Radiation Injuries to Humans / Barabanova A.V., Baranov A.Ye., Bushmanov A.Yu., et al. Moscow, Slovo Publ., 2007. P. 85-102 (In Russ.).
4. Legeza V.I., Ushakov I.B., Grebenyuk A.N., et al. Radiobiologiya, Radiatsionnaya Fiziologiya i Meditsina = Radiobiology, Radiation Physiology and Medicine. Dictionary-Reference Book. St. Petersburg, Foliant, 2017. 175 p. (In Russ.).
5. Medical Management of Radiation Injuries. SRS N101. IAEA, 2020. 98 p.
6. Galstyan I.A., Bushmanov A.Yu., Metlyayeva N.A., et al. Chronic Radiation Sickness of Subacute Course from External Uneven Irradiation Upon Contact with a Lost Source. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2021;66;4:62-69 (In Russ.).
7. Gus’kova A.K. Radiation Pathology of Man. Radiatsionnaya Meditsina = Radiation Medicine. Vol. 1. Moscow, IzdAT Publ., 2001. P. 90-121 (In Russ.).
8. Muksinova K.N., Mushkacheva G.S. Kletochnyye i Molekulyarnyye Osnovy Perestroyki Krovetvoreniya pri Dlitel’nom Radiatsionnom Vozdeystvii = Cellular and Molecular Bases of Hematopoiesis Restructuring during Prolonged Radiation Exposure. Moscow, Energoatomizdat Publ., 1990. 160 p. (In Russ.).
9. Moskalev Yu.I. Otdalennyye Posledstviya Vozdeystviya Ioniziruyushchikh Izlucheniy = Remote Consequences of Exposure to Ionizing Radiation. Moscow, Meditsina Publ., 1991. 462 p. (In Russ.).
10. Yegorov A.P., Bochkarev V.V. Krovetvoreniye i Ioniziruyushchaya Radiatsiya = Hematopoiesis and Ionizing Radiation. Moscow, Medgiz Publ., 1954. 259 p. (In Russ.).
11. Kurshakov N.A., Kirillov S.A. Chronic Radiation Sickness as a Consequence of External Irradiation. Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the “Bulletin of Radiation Medicine”. Vol. 2. Moscow, FMBC im. A.I.Burnazyana FMBA Rossii Publ., 2016. P. 215-230 (In Russ.).
12. Kudryavtseva V.N., Shalaginov V.A. The State of Peripheral Blood and Bone Marrow Hematopoiesis in Patients with Chronic Radiation Sickness in the Late Stages (After 17-20 Years). Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the “Bulletin of Radiation Medicine”. Vol.1. Moscow, FMBC im. A.I. Burnazyana FMBA Rossii Publ., 2016. P. 283-292 (In Russ.).
13. Baysogolov G.D. Dynamics of Peripheral Blood Indices in Patients with Chronic Radiation Sickness after Cessation of Radiation Exposure. Radiatsiya i Risk = Radiation and Risk. 2000;Special Issue:29-31 (In Russ.).
14. Akleyev A.V. Khronicheskiy Luchevoy Sindrom u Zhiteley Pribrezhnykh Sel Reki Techa = Chronic Radiation Syndrome in Residents of Coastal Villages of the Techa River. Chelyabinsk, Kniga Publ., 2012. 464 p. (In Russ.).
15. Baysogolov G.D., Doshchenko V.N., Yurkov N.N., et al. Late Manifestations of Chronic Radiation Sickness in Humans. Radiatsiya i Risk = Radiation and Risk. 1997;9:107-110 (In Russ.).
16. Pesternikova V.S. Hematopoiesis Status in Patients with Chronic Radiation Sickness 25-30 Years after Diagnosis of the Disease. Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the “Bulletin of Radiation Medicine”. Vol. 2. Moscow, FMBC im. A.I.Burnazyana FMBA Rossii Publ., 2016. P. 436-444 (In Russ.).
17. Vyalova N.A., Suvorova L.A., Gavrilova K.P., et al. Results of the Study of the Dependence of Hematological Changes in the Late Period of Chronic Radiation Sickness on the Dose of External Gamma Irradiation and Incorporation of Plutonium-239. Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the “Bulletin of Radiation Medicine”. Vol. 2. Moscow, FMBC im. A.I.Burnazyana FMBA Rossii Publ., 2016. P. 388-398 (In Russ.).
18. Doshchenko V.N. Structure of Causes of Death of Patients with Chronic Radiation Sickness and Persons Exposed to Chronic External and Internal Irradiation in Doses Exceeding Maximum Permissible. Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the “Bulletin of Radiation Medicine”. Vol.1. Moscow, FMBC im. A.I.Burnazyana FMBA Rossii Publ., 2016. P. 799-804 (In Russ.).
19. Shakhmatov V.I., Gavrilova K.P., Vorob’yev A.I., et al. Analysis of the Causes of Death of Persons Exposed to Chronic Occupational Irradiation at Nuclear Industry Enterprises (Clinical and Statistical Data). Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the “Bulletin of Radiation Medicine”. Vol.1. Moscow, FMBC im. A.I.Burnazyana FMBA Rossii Publ., 2016. P. 766-776
(In Russ.).
20. Kuznetsova I.S. Zabolevayemost’ i Smertnost’ ot Leykoza Sredi Personala PO “Mayak” i Ostal’nogo Naseleniya Goroda Ozerska = Morbidity and Mortality from Leukemia among the Personnel of the Mayak Production Association and the Rest of the Population of the City of Ozersk. Extended Abstract of Candidate’s Thesis (Biol.). Ozersk Publ, 2004. 25 p. (In Russ.).
21. Vyalova N.A., Suvorova L.A., Ivanova T.A., et al. Peculiarities of Hematopoiesis in Late Periods in Patients with Chronic Radiation Sickness. Izbrannyye Materialy «Byulletenya Radiatsionnoy Meditsiny» = Selected Materials of the “Bulletin of Radiation Medicine”. Vol. 2. Moscow, FMBC im. A.I.Burnazyana FMBA Rossii Publ., 2016. P. 408-421 (In Russ.).
22. Soldatova V.A., Solodova R.A., Gus’kova A.K. Clinical Characteristics of Chronic Radiation Sickness in the Recovery Period. Otdalennyye Posledstviya Luchevykh Porazheniy = Remote Consequences of Radiation Injuries. Moscow, Atomizdat Publ., 1971. P. 62-70
(In Russ.).
23. Okladnikova N.D., Gus’kova A.K., Khokhryakov V.F., et al. Working with Plutonium Compounds. Rukovodstvo po Organizatsii Meditsinskogo Obsluzhivaniya Lits, Podvergshikhsya Deystviyu Ioniziruyushchego Izlucheniya = Guidelines for Organizing Medical Care for Individuals Exposed to Ionizing Radiation. Moscow, Energoatomizdat Publ., 1985. P. 117-137 (In Russ.).
24. Okladnikova N.D., Pesternikova V.S., Sumina M.V., et al. Clinical Effects of 239Pu. Chronic Radiation Exposure: Risk of Remote Effects. Proceedings of the 1st International Symposium. Chelyabinsk, January 9-13, 1996. Chelyabinsk Publ., 1996. P. 110-112 (In Russ.).
25. Suvorova L.A., Nugis V.Yu., Gasteva G.N., et al. The State of Bone Marrow Hematopoiesis and Bone Tissue in Plutonium-239 Carriers. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost’ = Medical Radiology and Radiation Safety. 2007;52;5:13-19 (In Russ.).
26. Baysogolov G.D. Some Issues of Pathogenesis of Clinical Syndrome Developing in Individuals in Contact with Plutonium-239 Compounds. BRM. 1969;1:10-17 (In Russ.).
27. Buldakov L.A., Lyubchanskiy E.R., Moskalev Yu.M., et al. Problema Toksikologicheskogo Plutoniya = Problems of Plutonium Toxicology. Moscow, Atomizdat Publ., 1969. 367 p. (In Russ.).
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Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.05.2025. Accepted for publication: 25.06.2025.