Biology of Blood and Marrow Transplantation
Volume 12, Issue 6 , Pages 672-682 , June 2006

Acute Radiation Injury: Contingency Planning for Triage, Supportive Care, and Transplantation

Presented in part at a workshop held at the Tandem BMT Meetings; Keystone, Colorado; February 2005.

  • Daniel Weisdorf

      Affiliations

    • University of Minnesota, Minneapolis, Minnesota
    • Corresponding Author InformationCorrespondence and reprint requests: Daniel Weisdorf, MD, Department of Medicine, University of Minnesota, 420 Delaware Street, SE, MMC, 480, Minneapolis, MN 55455
  • ,
  • Nelson Chao

      Affiliations

    • Duke University Medical Center, Durham, North Carolina
  • ,
  • Jamie K. Waselenko

      Affiliations

    • Sarah Cannon Research Institute, Nashville, Tennessee
  • ,
  • Nicholas Dainiak

      Affiliations

    • Department of Medicine, Bridgeport Hospital and Yale University School of Medicine, New Haven, Connecticut
  • ,
  • James O. Armitage

      Affiliations

    • Division of Hematology/Oncology, University of Nebraska, Omaha, Nebraska
  • ,
  • Ian McNiece

      Affiliations

    • Division of Biomedical Sciences John Hopkins Singapore, Singapore, Singapore
  • ,
  • Dennis Confer

      Affiliations

    • National Marrow Donor Program, Minneapolis, Minnesota

Received 4 January 2006 ,Accepted 7 February 2006.

References 

  1. Dainiak N . The evolving role of hematopoietic cell transplantation in radiation injury (potentials and limitations) . Br J Radiol . 2005;27:169–174
  2. Nagayama H , Ooi J , Tomonari A , et al.   Severe immune dysfunction after lethal neutron irradiation in a JCO nuclear facility accident victim . Int J Hematol . 2002;76:157–164
  3. Waselenko JK , MacVittie TJ , Blakely WF , et al.   Medical management of the acute radiation syndrome (recommendations of the Strategic National Stockpile Radiation Working Group) . Ann Intern Med . 2004;140:1037–1051
  4. Baranov A , Gale RP , Guskova A , et al.   Bone marrow transplantation after the Chernobyl nuclear accident . N Eng J Med . 1989;321:205–212
  5. Fliedner TM , Dorr HD , Meineke V . Multi-organ involvement as a pathogenetic principle of the radiation syndromes (a study involving 110 case histories documented in SEARCH and classified as the bases of haematopoietic indicators of effect) . Br J Radiol . 2005;78:1–8
  6. Dainiak N . Hematologic consequences of exposure to ionizing radiation . Exp Hematol . 2002;30;:513–528
  7. Cerveny TJ , MacVittie TJ , Young RW . Acute radiation syndrome in humans . In:  Cerveny TJ editors. Medical Consequences of Nuclear Warfare . Bethesda, MD: Armed Forces Radiobiology Research Institute; 1989; Alexandria, VA: Defense Nuclear Agency/Falls Church, VA: TMM Publications, Office of the Surgeon General
  8. Hall EJ . Acute effects of total-body irradiation . In:  Hall EJ editors. Radiobiology for the Radiologist . Philadelphia: Lippincott Williams & Wilkins; 2000;p. 124–135
  9. Vorobiev AI . Acute radiation disease and biological dosimetry in 1993 . Stem Cells . 1997;15:269–274
  10. Hughes WT , Armstrong D , Bodey GP , et al.   2002 Guidelines for the use of antimicrobial agents in neutropenic patients with cancer . Clin Infect Dis . 2002;34:730–751
  11. Barabanova AV . Acute radiation syndrome with cutaneous syndrome . In:  Ricks RC ,  Berger ME ,  O’Hara F editor. The Medical Basis for Radiation Accident Preparedness (The Clinical Care of Victims) . Boca Raton, FL: Parthenon Publishing Group; 2002;p. 217–224
  12. van Bekkum D . Radiation sensitivity of the hematopoietic stem cell . Radiat Res . 1991;128:4–9
  13. Inoue T , Hirabayashai Y , Mitsui H , et al.   Survival of spleen colony-forming units (CFU-S) of irradiated bone marrow cells in mice (evidence for the existence of a radiosensitive subfraction) . Exp Hematol . 1995;23:1296–1300
  14. Dainiak N , Waselenko JK , Armitage JO , MacVittie TJ , Farese AM . The hematologist and radiation casualties . Hematology (Am Soc Hematol Educ Program) . 2003;473–496
  15. Waselenko JK , Armitage JO , Dainiak N . Treatment of radiation injury in the adult . UpToDate . 2005;
  16. Elliott TB , Brook I , Stiefel SM . Quantitative study of wound infection in irradiated mice . Int J Radiat Biol . 1990;58:341–350
  17. Kaplan HS , Speck RS , Jawetz E . Impairment of antimicrobial defense following total body irradiation of mice . J Lab Clin Med . 1952;40:682–691
  18. Brook I , Ledney GE . Quinolone therapy in the prevention of endogenous and exogenous infection after irradiation . J Antimicrob Chemother . 1994;33:777–784
  19. Brook I , Elliott TB , Ledney GD . Quinolone therapy of Klebsiella pneumoniae sepsis following irradiation (comparison of pefloxacin, ciprofloxacin, and ofloxacin) . Radiat Res . 1990;122:215–217
  20. Brook I , Elliott TB , Ledney GD , Knudson GB . Management of postirradiation sepsis . Mil Med . 2002;167:105–106
  21. Cruciani M , Malena M , Bosco O , Nardi S , Serpelloni G , Mengoli C . Reappraisal with meta-analysis of the addition of Gram-positive prophylaxis to fluoroquinolone in neutropenic patients . J Clin Oncol . 2003;21:4127–4137
  22. Engels EA , Lau J , Barza M . Efficacy of quinolone prophylaxis in neutropenic cancer patients (a meta-analysis) . J Clin Oncol . 1998;16:1179–1187
  23. Slavin MA , Osborne B , Adams R , et al.   Efficacy and safety of fluconazole prophylaxis for fungal infections after marrow transplantation—a prospective, randomized, double-blind study . J Infect Dis . 1995;171:1545–1552
  24. Goodman JL , Winston DJ , Greenfield RA , et al.   A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation . N Engl J Med . 1992;326:845–851
  25. Hughes WT . Use of antimicrobial agents for treatment of infection in the neutropenic immunocompromised patient . In:  Ricks RC ,  Berger ME ,  O’Hara F editor. The Medical Basis for Radiation Accident Preparedness (The Clinical Care of Victims) . Boca Raton, FL: Parthenon Publishing Group; 2002;p. 117–129
  26. Densow D , Kindler H , Baranov AE , Tibken B , Hofer EP , Fliedner TM . Criteria for the selection of radiation accident victims for stem cell transplantation . Stem Cells . 1997;15:287–297
  27. Maekawa K . Overview of medical care for highly exposed victims in the Tokaimura Accident . In:  Ricks RC ,  Berger ME ,  O’Hara F editor. The Medical Basis for Radiation Accident Preparedness (The Clinical Care of Victims) . Boca Raton, FL: Parthenon Publishing Group; 2002;p. 313–318
  28. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Biol Blood Marrow Transplant. 2000;6:659-733.
  29. Tanikawa S , Nose M , Aoki Y , Tsuneoka K , Shikita M , Nara N . Effects of recombinant human granulocyte colony-stimulating factor on the hematologic recovery and survival of irradiated mice . Blood . 1990;76:445–449
  30. Hosoi Y , Kurishita A , Ono T , Sakamoto K . Effect of recombinant human granulocyte colony-stimulating factor on survival of lethally irradiated mice . Acta Oncol . 1992;31:59–63
  31. Nothdurft W , Kreja L , Selig C . Acceleration of hemopoietic recovery in dogs after treatment extended-field partial-body irradiation by treatment with colony-stimulating factors (rhG-CSF and rhGM-CSF) . Int J Radiat Oncol Biol Phys . 1997;37:1145–1154
  32. Farese AM , Hunt P , Grab LB , MacVittie TJ . Combined administration of recombinant human megakaryocyte growth and development factor and granulocyte colony-stimulating factor enhances multilineage hematopoietic reconstitution in nonhuman primates after radiation-induced marrow aplasia . J Clin Invest . 1996;97:2145–2151
  33. Hao J , Sun L , Huang H , et al.   Effects of recombinant human interleukin 11 on thrombocytopenia and neutropenia in irradiated rhesus monkeys . Radiat Res . 2004;162:157–163
  34. Shibuya K , Akahori H , Takahashi K , Tahara E , Kato T , Miyazaki  . Multilineage hematopoietic recovery by a single injection of pegylated recombinant human megakaryocyte growth and development factor in myelosuppressed mice . Blood . 1998;91:37–45
  35. Zsebo KM , Smith KA , Hartley CA , et al.   Radioprotection of mice by recombinant stem cells factor . Proc Natl Acad Sci USA . 1992;89:9464–9468
  36. Neta R , Oppenheim JJ , Douches SD . Interdependence of the radioprotective effects of human recombinant IL-1, TNF, G-CSF and murine recombinant GM-CSF . J Immunol . 1998;140:108–111
  37. Neta R , Oppenheim JJ , Wang JM , Snapper CM , Moorman MA , Dubois CM . Synergy of IL-1 and stem cell factor in radioprotection of mice is associated with IL-1 up-regulation of mRNA and protein expression for c-kit on bone marrow cells . J Immunol . 1994;153:1536–1543
  38. Waddick KG , Song CW , Souza L , Uchun FM . Comparative analysis of the in vivo radioprotective effects of recombinant granulocyte colony-stimulating factor (G-CSF), recombinant granulocyte-macrophage CSF, and their combination . Blood . 1991;77:2364–2471
  39. Cairo MS , Plunkett JM , Nguyen A , Schendel P , van de Ven C . Effect of interleukin-11 with and without granulocyte colony-stimulating factor on in vivo neonatal rat hematopoiesis (induction of neonatal thrombocytosis by interleukin-11 and synergistic enhancement of neutropenia by interleukin-11 + granulocyte colony-stimulating factor) . Pediatr Res . 1993;34:56–61
  40. Herodin F , Drouet M . Cytokine-based treatment of accidentally irradiated victims and new approaches . Exp Hematol . 2005;33:1071–1080

PII: S1083-8791(06)00162-5

doi: 10.1016/j.bbmt.2006.02.006

Biology of Blood and Marrow Transplantation
Volume 12, Issue 6 , Pages 672-682 , June 2006