E-Book Overview
Acute radiation injury in man has been amply reviewed in the past decades (1-8). Information for those reviews was mainly derived from the Hiroshima and Nagasaki experience (3), from radiation accidents as a con sequence of testing nuclear weapons and the application of nuclear energy (9-13) and from the intentional irradiation of patients, mostly for the treatment of malignancies and/or as conditioning for transplantation (14-20). Further, a large body of data derived from animal experimentation has led to cautious extrapolations to the human situation (14). An elaborate review dealing with early somatic effects of radiation in a man was published by UNSCEAR ) in 1962 (2). It was supplemented in 1969 with a similar document dealing mostly with radiation-induced chromosome aberra tions, the effects of radiation on the nervous system and, radio-active contamination of the environment by nuclear testing (21). In a more recent UNSCEAR report (1972) the main topics were genetic effects, carcinogenesis and effects of radiation on the immune response (22). The early effects of radiation in man were also expertly and comprehensively reviewed in a report by the United States National Research Council in 1967 (23).
E-Book Content
Bone Marrow Transplantation and Other Treatment after Radiation Injury
Bone Marrow Transplantation and Other Treatment after Radiation Injury A review prepared for the Commission of the European Communities, Directorate-General Research, Science and Education (Biology-Medical Research)
H. BaIner M.D.
Martinus Nijhoff Medical Division - The Hague 1977 for The Commission of the European Communities
Publication arranged by Commission of the European Communities, Directorate-General Scientific and Technical Information and Information Management, Luxembourg
EUR 5884e © ECSC, EEC, EAEC, Brussels-Luxembourg, 1977
LEGAL NOTICE Neither the Commission of the European Communities nor any person acting on behalf of the Commission is responsible for the use which might be made of the following information. No part of this book may be reproduced in any form, by print, photoprint, microfilm or any other means without written permission from the publisher. ISBN 13: 978-90-247-2056-9 DOl: 10.1007/978-94-010-1113-6
e-ISBN-13: 978-94-010-1113-6
Abstract
This review deals mainly with current concepts about bone marrow transplantation as therapy for serious radiation injury. Such injury can be classified according to the following broadly defined dose ranges: (1) the supralethal range, leading mainly to the cerebral and intestinal syndromes; (2) the potentially lethal or therapeutic range which causes the bone marrow syndrome, and (3) the sublethal range which rarely leads to injury requiring therapy. The bone marrow syndrome of man and animals is discussed in detail. The optimal therapy for this syndrome is bone marrow transplantation in conjunction with conventional supportive treatment. The principal complications of such therapy are Graft versus Host Disease and a slow recovery of the recipient's immune system. Concerted research activities in a number of institutions have led to considerable progress in the field of bone marrow transplantation. Improved donor selection, new techniques for stem-cell separation and preservation, as well as effective barrier-nursing and antibiotic decontamination, have made bone marrow transplantation an accepted therapy for marrow depression, including the aplasia caused by excessive exposure to radiation. The review also contains a number of guidelines for the handling of serious radiation accidents.
Dr. H. BaIner is a staff member of the Commission of the European Communities, Directorate - General Research, Science and Education (Biology - Medical Research). He is at present Director of the Primat