Hematopoietic recovery after 10-Gy acute total body radiation
AE Baranov, GD Selidovkin, A Butturini and RP Gale
Institute of Biophysics, Moscow, Russia.
Considerable data suggest that very high doses of acute total body
radiation destroy most hematopoietic stem cells and that recovery is
possible only after a bone marrow transplant. We review data from a
radiation accident victim exposed to about 10-Gy or more acute total body
radiation. Total dose and uniformity of distribution were confirmed by
physical measurements (paramagnetic resonance), computer simulation, and
biologic dosimetry (granulocyte kinetics and cytogenetic abnormalities).
Treatment consisted of supportive measures, transfusions, and hematopoietic
growth factors (granulocyte-macrophage colony-stimulating factor and
interleukin-3). Hematopoietic recovery occurred slowly. Granulocytes were
detectable throughout the postexposure period, exceeding 0.5 x 10(9)/L by
day 37. There was slower and incomplete recovery of red blood cells and
platelets. Increases in blood cell production were paralleled by
morphologic changes in bone marrow biopsies. Gastrointestinal toxicity was
moderate. Death from a probable radiation pneumonitis infection occurred on
day 130. These data indicate the possibility of hematopoietic recovery
after approximately 10 Gy or more acute total body radiation without a
transplant. They also suggest that lung rather than gastrointestinal
toxicity may be dose-limiting under these circumstances.
Volume 83,
Issue 2,
pp. 596-599,
01/15/1994
Copyright © 1994 by The American Society of Hematology
