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Blood, 15 June 2008, Vol. 111, No. 12, pp. 5440-5445.
Prepublished online as a Blood First Edition Paper on February 20, 2008; DOI 10.1182/blood-2008-01-134817.
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Submitted January 29, 2008
Accepted February 16, 2008
Radiological and nuclear events: contingency planning for hematologist/oncologists
David M Weinstock*, Cullen Case Jr., Judith L Bader, Nelson J Chao, C Norman Coleman, Richard J Hatchett, Daniel J Weisdorf, and Dennis L Confer
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
National Marrow Donor Program, Minneapolis, MN, United States
Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services (DHHS), Washington, DC, United States
Adult Bone Marrow and Stem Cell Transplantation Program, Duke University Medical Center, Durham, NC, United States
Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States
Department of Medicine, University of Minnesota Blood and Marrow Transplant Program, Minneapolis, MN, United States
* Corresponding author; email: davidm_weinstock{at}dfci.harvard.edu.
Untoward events involving radioactive material, either accidental or intentional, are potentially devastating. Hematologists and oncologists are uniquely suited to help manage radiation victims, as myelosuppression is a frequent complication of radiation exposure. In the aftermath of a large event like a nuclear detonation, there may be a national call for surge capacity that involves hematologists/oncologists across the country in the disaster response. In preparation, the National Marrow Donor Program and American Society for Blood and Marrow Transplantation have established the Radiation Injury Treatment Network (RITN), a voluntary consortium of transplant centers, donor centers and umbilical cord blood banks. RITN is partnered with the Office of the Assistant Secretary for Preparedness and Response in the US Department of Health and Human Services, to develop treatment guidelines, educate healthcare professionals, coordinate situation response and provide comprehensive evaluation and care for radiation injury victims. We outline the current plans for event response and describe scenarios, including catastrophic events that would require extensive support from hematologists/oncologists across the country. In addition, we highlight important reference resources and discuss current efforts to develop medical countermeasures against radiation toxicity. Practitioners and institutions across the country are encouraged to become involved and participate in the planning.
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