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This paper identifies the major challenges faced and the lessons learned in addressing them by the collaborative research groups involved in developing and conducting a large, multi-national case-control study of acute leukemia among children in areas of the former Soviet Union (FSU) that were most heavily exposed to radioactive fallout as a result of the April 1986 accident in reactor vessel #4 of the Chernobyl Nuclear Power Plant.
In this accident, a variety of radioisotopes including iodine (].
The final research team for the multinational Leukemia case-control study includes the FHCRC in collaboration with the Medical Radiological Research Center in Russia and two groups from the Roswell Park Cancer Institute (one working with the Research Institute of Radiation Medicine and Endocrinology, in Minsk, Belarus and another with the National University "Kiev-Mohyla Academy", Kiev, Ukraine).
The Bridgeport Hospital/Yale University and the Research Institute of Radiation Medicine and Endocrinology, Minsk, Belarus, joined the Consortium later.
Local teams participated in study design, as well as study management in the field and troubleshooting problems.
This required teams that were extremely knowledgeable about geopolitical boundaries, location of cities/small villages, governmental structures, and the health care delivery system.
The intent of the research project was to examine acute leukemias without specific regard to national boundaries, while recognizing the requirement to bring together investigators from these three republics in a common effort.
Acute external exposures to ionizing radiation have been etiologically linked with observed increases in the risk of all types of leukemia, except chronic lymphocytic leukemia; the risk is greatest for acute myeloid leukemia  which highlights mixed results from published studies to date (see the review article for a comprehensive overview of published studies).
Each Oblast (an Oblast is a large administrative unit – equivalent to a state in the United States) has 1–2, and in rare cases 4, large cancer treatment and diagnostic facilities (termed oncodispensaries).