Peripheral Blood Indices at Different Periods of Chronic Radiation Syndrome (Literature Review)

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.