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December 21, 1964, Vol 190, No. 12 >
BILLINGS LECTURE | December 21, 1964

Irradiation Leukemogenesis

John S. Lawrence, MD
[+] Author Affiliations

Read as Billings Lecture before the Section on Internal Medicine at the 113th Annual Convention of the American Medical Association, San Francisco, June 23, 1964.

Reprint requests to Department of Medicine, University of California School of Medicine, Los Angeles 90024 (Dr. Lawrence).


From the Department of Medicine, University of California School of Medicine at Los Angeles.


JAMA. 1964;190(12):1049-1054. doi:10.1001/jama.1964.03070250031008
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References

Although there is no longer any question about the ability of irradiation to produce leukemia, there remains considerable confusion as to how much danger exists from exposure to irradiation in the normal course of our lives. The general public has much fear of irradiation for diagnostic and therapeutic purposes; some physicians share this fear, while others tend to disregard it. Many persons are concerned about the dangers incurred from irradiation due to fallout associated with detonation of atomic bombs, others have no fear of this type of irradiation exposure, and some are in a state of confusion about it. Still again, the question of a threshold for irradiation is debatable and subject to various interpretations. I hope to clarify a few of these problems.

Review of Incriminating Evidence  While irradiation has been strongly suspected as one possible cause for leukemia, since the report by Von Jagie et al1

REFERENCES

1 +
Von Jagie, N.; Schwartz, G.; and von Siebenbach, L.:  Blutbefunde ber Roentgenologen , Berlin Klin Wschr 48:122-123, 1911;.
2 +
Valentine, W.N.: Present Status of Study of Incidence of Leukemia Among Individuals Surviving Exposure to Atomic Bomb in Hiroshima and Nagasaki , technical report, Atomic Bomb Casualty Commission, 1951;.
3 +
Folley, J.H.; Borges, W.; and Yamawaki, T.:  Incidence of Leukemia in Survivors of Atomic Bomb in Hiroshima and Nagasaki, Japan , Amer J Med Sci 13:311-321, 1952;.
4 +
Jablon, S.; Ishida, M.: and Beebe, G.W.: Mortality in Selection I and II October 1950-September 1959 , Life-Span Study Report 2, technical report 01-63, Atomic Bomb Casualty Commission, 1963;.
5 +
Heyssel, R., et al:  Leukemia in Hiroshima Atomic Bomb Survivors , Blood 15:313-331. 1960;.
6 +
Brill, A.B., et al: Leukemia in Humans Following Exposure to Ionizing Radiation: Summary of Findings in Hiroshima and Nagasaki and Comparison With Other Human Experience , technical report 15, Atomic Bomb Casualty Commission, 1956;.
7 +
Court-Brown, W.M., and Doll, R.:  Leukemia and Aplastic Anemia in Patients Irradiated for Ankylosing Spondylitis , Med Res Counc Spec Rep , No. (295) , 1957;.
8 +
March, H.C.:  Leukemia in Radiologists in 20-Year Period , Amer J Med Sci 220:282-286 ( (Sept) ) 1950;.
9 +
March, H.C.:  Leukemia in Radiologists: Ten Years Later With Review of Pertinent Evidence for Radiation Leukemia , Amer J Med Sci 242:137-149 ( (Aug) ) 1961;.
10 +
Pochin, E.:  Leukemia Following Radioiodine Treatment of Thyrotoxicosis , Brit Med J 2:1545-1550, 1960;.
11 +
Simpson, C.L.; Hemplemann, L.H.; and Fuller, L.M.:  Neoplasia in Children Treated in Infancy for Thymic Enlargement , Radiology 64:840-845, 1955;.
12 +
Lewis, E.B.:  Leukemia and Ionizing Radiation , Science 125:965-972, 1957;.
13 +
Cronkite, E.P.; Moloney, W.: and Bond, V.P.:  Radiation Leukemogenesis , Amer J Med 28:673-682, 1960;.
14 +
Brues, A.M.:  Critique of Linear Theory of Carcinogenesis , Science 128:693-698, 1958;.
15 +
Brues A.M.: Somatic Effects, Low Level Irradiation , Washington, DC: American Association for the Advancement of Science, 1960;, p 73.
16 +
Lamerton, L.F.:  Examination of Clinical and Experimental Data Relating to Possible Hazard to Individual of Small Doses of Radiation , Brit J Radiol 31:229-239, 1958;.
17 +
Report of United Nations Scientific Committee on Effects of Atomic Radiation, suppl 16 (A/5216), official records of 17th session, United Nations General Assembly, 1962.
18 +
Estimates and Evaluation of Fallout in United States From Nuclear Weapons Testing Conducted Through 1962 , report 4, Federal Radiations Council, (May) , 1963;.
19 +
Ellis, R.E.:  Distribution of Active Bone Marrow in Adult , Phys Med Biol 5:255-258. 1961;.

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1 +
Von Jagie, N.; Schwartz, G.; and von Siebenbach, L.:  Blutbefunde ber Roentgenologen , Berlin Klin Wschr 48:122-123, 1911;.
2 +
Valentine, W.N.: Present Status of Study of Incidence of Leukemia Among Individuals Surviving Exposure to Atomic Bomb in Hiroshima and Nagasaki , technical report, Atomic Bomb Casualty Commission, 1951;.
3 +
Folley, J.H.; Borges, W.; and Yamawaki, T.:  Incidence of Leukemia in Survivors of Atomic Bomb in Hiroshima and Nagasaki, Japan , Amer J Med Sci 13:311-321, 1952;.
4 +
Jablon, S.; Ishida, M.: and Beebe, G.W.: Mortality in Selection I and II October 1950-September 1959 , Life-Span Study Report 2, technical report 01-63, Atomic Bomb Casualty Commission, 1963;.
5 +
Heyssel, R., et al:  Leukemia in Hiroshima Atomic Bomb Survivors , Blood 15:313-331. 1960;.
6 +
Brill, A.B., et al: Leukemia in Humans Following Exposure to Ionizing Radiation: Summary of Findings in Hiroshima and Nagasaki and Comparison With Other Human Experience , technical report 15, Atomic Bomb Casualty Commission, 1956;.
7 +
Court-Brown, W.M., and Doll, R.:  Leukemia and Aplastic Anemia in Patients Irradiated for Ankylosing Spondylitis , Med Res Counc Spec Rep , No. (295) , 1957;.
8 +
March, H.C.:  Leukemia in Radiologists in 20-Year Period , Amer J Med Sci 220:282-286 ( (Sept) ) 1950;.
9 +
March, H.C.:  Leukemia in Radiologists: Ten Years Later With Review of Pertinent Evidence for Radiation Leukemia , Amer J Med Sci 242:137-149 ( (Aug) ) 1961;.
10 +
Pochin, E.:  Leukemia Following Radioiodine Treatment of Thyrotoxicosis , Brit Med J 2:1545-1550, 1960;.
11 +
Simpson, C.L.; Hemplemann, L.H.; and Fuller, L.M.:  Neoplasia in Children Treated in Infancy for Thymic Enlargement , Radiology 64:840-845, 1955;.
12 +
Lewis, E.B.:  Leukemia and Ionizing Radiation , Science 125:965-972, 1957;.
13 +
Cronkite, E.P.; Moloney, W.: and Bond, V.P.:  Radiation Leukemogenesis , Amer J Med 28:673-682, 1960;.
14 +
Brues, A.M.:  Critique of Linear Theory of Carcinogenesis , Science 128:693-698, 1958;.
15 +
Brues A.M.: Somatic Effects, Low Level Irradiation , Washington, DC: American Association for the Advancement of Science, 1960;, p 73.
16 +
Lamerton, L.F.:  Examination of Clinical and Experimental Data Relating to Possible Hazard to Individual of Small Doses of Radiation , Brit J Radiol 31:229-239, 1958;.
17 +
Report of United Nations Scientific Committee on Effects of Atomic Radiation, suppl 16 (A/5216), official records of 17th session, United Nations General Assembly, 1962.
18 +
Estimates and Evaluation of Fallout in United States From Nuclear Weapons Testing Conducted Through 1962 , report 4, Federal Radiations Council, (May) , 1963;.
19 +
Ellis, R.E.:  Distribution of Active Bone Marrow in Adult , Phys Med Biol 5:255-258. 1961;.

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