title: Impact of Nagasaki atomic bomb exposure on myelodysplastic syndrome patients who are treated with azacitidine.
abstract: OBJECTIVE
  High-dose radiation exposure greatly increases the risk of myelodysplastic syndromes (MDS), however the clinical characteristics of MDS among atomic bomb survivors have not been thoroughly investigated to date. We designed this study to identify these characteristics.
  
  
  METHODS
  We retrospectively evaluated data from 13 atomic bomb survivors with MDS and 15 elderly patients with de novo MDS who were diagnosed between April 2011 and April 2013 at the Nagasaki Genbaku Hospital. All patients were treated with azacitidine (AZA; a hypomethylating agent) and overall survival rates were estimated.
  
  
  RESULTS
  No clear difference was observed in the clinical response to AZA between the two groups. However, atomic bomb survivors had a survival disadvantage, independent of their karyotype.
  
  
  CONCLUSIONS
  Minute genetic alterations caused by exposure to atomic radiation can adversely affect the response to AZA, even 66 years after the exposure. Further studies are required to clarify the mechanisms underlying this phenomenon.
authors.affiliation: Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan firetj@nagasaki-med.jrc.or.jp.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Jo
authors.affiliation: Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Horio
authors.affiliation: Department of Pathology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Shigematsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001374:Azacitidine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000473:pathology; D009381:Neoplasms, Radiation-Induced / Q000188:drug therapy* / Q000473:pathology; D054043:Nuclear Weapons; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001374:Azacitidine
keywords: Atomic bomb; azacitidine; high-dose radiation exposure; hypomethylating agents; myelodysplastic syndrome