Acute myelocytic leukemia after exposure to asbestos

Our plain-English summary of Acute myelocytic leukemia after exposure to asbestos, by T. Kishimoto, T. Ono, K. Okada (Cancer, 1988).

The study

• Authors: T. Kishimoto, T. Ono, K. Okada
• Journal: Cancer
• Published: 1988;62(4):787-90
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000919).

Abstract

While the carcinogenicity of asbestos has been established in malignant mesotheliomas and lung cancers, and has recently been suspected in several other types of cancer, asbestos has not been implicated in the pathogenesis of acute leukemias. This article includes two cases of acute myelocytic leukemia in individuals with a long history of exposure to asbestos. Significant numbers of asbestos bodies were detected in specimens of their lungs and bone marrow. In addition, the kind of asbestos in both organs was crocidolite, which is implicated in carcinogenesis. No asbestos bodies were detected in the bone marrow specimens from a control group consisting of ten patients with lung cancer with similar occupational histories. The role of asbestos exposure in the development of leukemia requires further study.

In plain English

This article reported two cases from Kure Kyosai Hospital in Japan. Two men, aged 59 and 76, had each worked 40 years in shipyards, as an arc welder and a ship builder. Both developed acute myelocytic leukemia (AML) and died. Both had calcified pleural plaques on chest radiographs, confirmed at autopsy in the first man. Autopsy of the first man also found a liver cholangioma and a renal cell carcinoma. The authors counted asbestos bodies in 5-gram samples of lung and of bone marrow from a vertebra. They compared these with ten lung cancer patients with comparable occupational histories of asbestos exposure. Lung counts were 39,800 and 15,800 per 5 g, comparable to the controls. The two AML patients had 28 and 20 asbestos bodies per 5 g of bone marrow. No asbestos bodies were found in the bone marrow of the controls. The authors examined 20 asbestos bodies from each lung and bone marrow specimen and reported that almost all (19 of 20) were crocidolite. The authors concluded that asbestos may have been involved in causing AML and called for more studies.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Report of two cases (case reports), with asbestos body counts compared against a control group of ten lung cancer patients
• Who was studied: Two men, aged 59 and 76, with acute myelocytic leukemia (FAB M1), seen at Kure Kyosai Hospital, Kure, Japan. The controls were ten patients with lung cancer and without bone marrow involvement, seen during the same period, with comparable occupational histories of asbestos exposure.
• Exposure: Occupational exposure in shipyards. Patient 1 was an arc welder in a shipyard for 40 years. Patient 2 was a ship builder from 1926 to 1945 in a Japanese naval shipyard and from 1951 to 1975 in another shipyard, 40 years in total. The asbestos bodies found were identified as crocidolite.
• Main results:
  • Asbestos bodies in the lung were 39,800 per 5 g of tissue in Patient 1 and 15,800 per 5 g in Patient 2. The authors described these as comparable to the ten lung cancer controls.
  • Asbestos bodies in the bone marrow of the two AML patients were 28 and 20 per 5 g of bone marrow, respectively. The bone marrow specimen was a 5-gram sample.
  • No asbestos bodies were detected in the bone marrow specimens of the ten lung cancer controls.
  • Twenty asbestos bodies from each lung and bone marrow specimen were examined by scanning electron microscope and radiograph analyzer. The authors reported that almost all of the asbestos bodies (19 of 20) detected in the lung and bone marrow specimens of the two AML patients were crocidolite.
  • Both AML patients had pleural plaques with calcification on chest radiographs. In Patient 1 the plaques were confirmed at autopsy. In Patient 2, calcification of the upper diaphragm was confirmed at autopsy.
  • At autopsy, Patient 1 also had a cholangioma of the liver and a renal cell carcinoma (clear cell type).
• The authors' conclusion: The authors wrote that the bone marrow findings suggested that asbestos may have been involved in the development of AML, and that this possibility calls for more studies of asbestos exposure and AML.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Crocidolite.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Lung Cancer, Asbestos Bodies, Crocidolite, Carcinogenesis, Asbestos Exposure.

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