A nine-year cytogenetic follow-up of a patient injected with thorotrast

Summary Chromosomal abnormalities in the peripheral lymphocytes of a Thorotrast case were followed up for almost nine years during which four direct bone marrow observations were made. Chromosomal abnormalities, both Cu type (dicentrics, rings, and acentric fragments) and Cs type (reciprocal translocations, inversions, deletions, duplications, and others), were observed with an average frequency of about 7.5% and 8%, respectively. The frequency of chromosomal abnormalities showed no significant changes during the nine years. Formation of clones of cells with identical chromosomal abnormalities was observed both in bone marrow and peripheral lymphocytes. There were clones common to myeloid and lymphoid cell series, which may be regarded as evidence for the presence of pluripotent stem cells in man. One such common clone had a translocation involving chromosomes 2 and 22. Banding analysis revealed a break in chromosome 22 at the q12 or q12/13 band interface. The frequency of the clone remained fairly constant within 5% for several years and the patient showed no indication of leukemia or any other blood disease. The finding seems to suggest a genetic factor relating to the development of chronic myelocytic leukemia (CML), which generally shows the Ph¹ chromosome resulting from a translocation of chromosome 22 with the break at the q11 or q11/12 band interface. The increase in the number of cells lacking the Y chromosome was observed in our final bone marrow sample, but the phenomenon may be attributed to the age of the patient rather than to the direct effect of radiation. Results of the cytogenetic follow-up study seem to indicate the importance of studies in this direction for a better understanding of radiation effects on human beings.