[Therapeutic approaches of hematopoietic syndrome following accidental total whole body irradiation].
Since the first radiation accidents which resulted in severe health effects in the workforce or the population, great progress has been made in the fields of diagnosis, prognosis and treatment of accidentally overexposed victims. Since then, progress has also been made in the medical management of diseases such as aplasia. Because of the relative scarcity of radiation accidents, there is a need for complementary researches, in order to take advantage of new techniques and medical approaches. After whole body overexposure, the key issue is the therapeutic decision, ie, the choice between bone marrow transplantation and other strategies. The indications of bone marrow transplantation cover only a short range of doses, provided the exposure is distributed uniformly within the body. The last accidental overexposures which happened in the world have demonstrated the possible efficiency of haematopoietic growth factors, most of them being still under clinical trials. Actions based on these various approaches are summarized, as well as the lessons which have been learned.
Thierry
D
D
Département de protection de la santé de l'homme et de dosimétrie, Institut de protection et de sûreté nucléaire (IPSN), Paris, France.
Cosset
J M
JM
Van der Meeren
A
A
Gourmelon
P
P
Nénot
J C
JC
D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D001803:Blood Transfusion; D016026:Bone Marrow Transplantation; D005260:Female; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000528:radiation effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D018788:Radioactive Hazard Release; D016896:Treatment Outcome; D014916:Whole-Body Irradiation / Q000009:adverse effects*
D016298:Hematopoietic Cell Growth Factors; D007166:Immunosuppressive Agents
Approches thérapeutiques du syndrome hématopoïétique après irradiation globale accidentelle grave.