Refractory anemia occurring in survivors of the atomic bombing in Nagasaki, Japan.

EFRACTORY anemia was omie of the first pathologic effects noted as a result of exposure to radioactive agents. Since the original description, published over forty-five years ago, a number of reports have appeared in the literature describing the occurrence of refractory anemia as a late effect of repeated exposures to x-rays or various radioactive materials.’ ‘ 2 , 3 The susceptibility of the hematopoietic tissues to irradiation is well known and the severe effects on the bone marrow accompanying acute radiatiomi injury have been described by a number of observers.4 6 However, to date refractory anemia has not been described as a late manifestation of radiation injury among survivors of the atomic bombings. The present paper is a report on six cases of refractory anemia occurring imi Nagasaki survivors four to seven years after the atomic bombing. Autopsy findings are presented in five of the six cases.