Nuclear terrorism: the role of hematology in coping with its health consequences.
OBJECTIVE
This review reports on a novel approach to use blood cell change patterns after accidental whole body radiation exposure (to be expected as a consequence of nuclear terrorism) as reliable indicators of effect and as an aid to plan therapeutic measures.


RESULTS
There is growing concern about the potential of nuclear terrorism. Several scenarios are being discussed. In all of them one finds elements that mimic the experience gained in assessing and treating humans who were exposed to ionizing radiation in radiation accidents. This experience leads to diagnostic and therapeutic measures laid down in a recently published Manual on the Acute Radiation Syndrome. The European Bone Marrow Transplantation Group (EBMT) together with the Institut de Radioprotection et de Sûreté Nucléaire (IRSN) in Paris and the University of Ulm published a consensus paper to use 'response categories' based on organ-specific gradings of severity as indicators of the severity of health impairments.


CONCLUSIONS
The implication of this review is obvious: the medical staff confronted suddenly with the challenge of clinically managing an irradiated person will find all scientifically based recommendations in order to cope with the evolving problems on a scientific-pathophysiology driven approach.
Fliedner
Theodor M
TM
Radiation Medicine Research Group, University of Ulm, Faculty of Medicine, Helmholtzstrasse 20, D-89081 Ulm, Germany. theodor.fliedner@uni-ulm.de
D004189:Disaster Planning; D004307:Dose-Response Relationship, Radiation; D005060:Europe; D017408:Guidelines as Topic; D006405:Hematology / Q000639:trends*; D006410:Hematopoiesis / Q000187:drug effects / Q000502:physiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006412:Hematopoietic Stem Cells / Q000502:physiology; D006801:Humans; D011832:Radiation Injuries / Q000175:diagnosis / Q000628:therapy*; D018788:Radioactive Hazard Release; D023481:Terrorism