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Blood, Vol. 111, Issue 12, 5440-5445, June 15, 2008
Radiologic and nuclear events: contingency planning for hematologists/oncologists
Blood Weinstock et al.
111: 5440
Supplemental materials for: Weinstock et al
Files in this Data Supplement:
- Table S1. Candidate medical countermeasures for acute radiation syndrome and delayed effects of acute radiation exposure (PDF, 36.1 KB) -
Medical countermeasures to mitigate the morbidity and mortality of radiation exposures are classified according to the following categories: 1) Protectants – given prior to exposure as prophylaxis against radiation injury, 2) Mitigators – given after exposure but prior to the clinical manifestation of injury, 3) Therapeutics – given after the radiation injury is manifest, 4) Decorporating agents – given to increase excretion of internalized radioisotopes, and 5) Blocking agents – given to reduce organ uptake of internalized radioisotopes. Abbreviations: ITP, idiopathic thrombocytopenic purpura; HSCT, hematopoietic stem cell transplant; PDGFR, platelet-derived growth factor receptor; ACE, angiotensin converting enzyme.
- Figure S1. Radiation Injury Treatment Network-approved conditioning protocol for allogeneic hematopoietic stem cell transplantation after radiation-induced myeloablation (JPG, 57.3 KB)
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Pre-HSCT conditioning will require sufficient immunosuppression to ensure engraftment but not myeloablation, and if possible should limit epithelial and epidermal toxicity. This protocol is a modified version of the reduced intensity conditioning regimen for severe aplastic anemia being tested in the Blood and Marrow Transplant Clinical Trials Network (BMT CTN Protocol 0301). The allograft may consist of bone marrow, peripheral blood stem cells or umbilical cord blood from a matched, mismatched, related, or unrelated donor. While radiation contingencies require prompt mobilization and application of best available care, they are also opportunities for review and evaluation of proposed practices. The RITN proposes this regimen in order to encourage uniformity of care and facilitate prospective data collection and outcome evaluation. These will be essential for future reassessment and modification. Elements of the regimen, including donor matching and selection and necessary supportive care, are outlined at www.ritn.net.
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