Role of bone marrow transplantation as treatment for victims of nuclear accidents

  • Richard Champlin
Part of the Cancer Treatment and Research book series (CTAR, volume 50)

Abstract

The bone marrow is among the most sensitive tissues to the cytotoxic effects of ionizing irradiation. Doses exceeding 2 Gy produce both pancytopenia and immunosuppression, predisposing victims to opportunistic infections and bleeding complications. Mortality is dose dependent, but the dose/survival relationship for accidental whole body radiation exposure is poorly defined in humans due to the small number of documented cases in which an accurate determination of the absorbed dose could be made [1–3]. The LD50/60 (the lethal dose for 50% of individuals within 60 days) for total body irradiation is approximately 4.5 Gy if optimal supportive care is administered, and the LD90 has been estimated to be approximately 7 Gy [1]. At higher doses, generally exceeding 8–12 Gy, severe toxicity to the gastrointestinal tract and other organs ensue. The gastrointestinal syndrome is due to cytotoxicity to the epithelial crypt cells, the proliferative cells that maintain the bowel mucosa. Injury to these cells by high doses of radiation leads to sloughing of the bowel mucosa, massive diarrhea, and sepsis, typically resulting in death within 6–9 days of exposure. Very high doses of total body irradiation produce neurotoxicity and cardiovascular collapse, which result in death within several days. Radiation injury is dependent on a number of factors, including the type and quality of radiation, the dose and dose rate, homogeneity of the dose, and shielding.

Keywords

Toxicity Lymphoma Leukemia Anemia Radio Nuclide 

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© Kluwer Academic Publishers 1990

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  • Richard Champlin

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