10 20 30 40 50 60 0 Year Since 1945 (years) Increase in Deaths Years elapsed since the bombings and increase in deaths from leukemia and cancer Early Onset Late Onset Solid Cancers Phase: Thyroid, Breast, Lung, Colon, Stomach, Multiple Cancers Commonalities among young survivors 2nd Leukemia Phase (MDS/AML) 1st Leukemia Phase (AML/ALL/CML*) *CML is very rare as a therapy-related leukemia Among the surviving hibakusha, rates of leukemia increased drastically after 5 years. After reaching a peak in the 10th year, these cases diminished while other cancers started to appear and increase: thyroid cancer (10 years), breast and lung cancer (20 years), stomach and colon cancers and myeloma (30 years). The incidence of these cancers was higher the younger the hibakusha were at the time of the bombing. Myelodysplastic syndrome started to appear among elderly hibakusha 50 years after the bombing and is increasing year by year, a phenomenon described as a second epidemic of leukemia. Microgram from The Medical Effects of the Nagasaki Atomic Bombing by Atomic Bomb Disease Institute, Nagasaki University Illnesses after the Atomic Bombing The graph shows the rate of deaths from leukemia and various solid cancers and the onset of myelodysplastic syndrome in relation to the number of years since the atomic bombing. Data from Masao Tomonaga, M.D., PhD., March 2013, Oslo, Norway. Normal bone marrow, granulocytes and erythroblasts. Acute lymphoid leukemia (ALL); marked proliferation of small lymphoblasts is evident. Acute myeloid leukemia (AML); marked proliferation of large myeloblasts is evident. Chronic myeloid leukemia (CML); marked proliferation of granulocytes at various stages of maturation is evident.