Skip to main content
SpringerLink
Log in

Role of bone marrow transplantation as treatment for victims of nuclear accidents

  • Chapter
Bone Marrow Transplantation

Part of the book series: Cancer Treatment and Research ((CTAR,volume 50))

Abstract

The bone marrow is among the most sensitive tissues to the cytotoxic effects of ionizing irradiation. Doses exceeding 2 Gy produce both pancytopenia and immunosuppression, predisposing victims to opportunistic infections and bleeding complications. Mortality is dose dependent, but the dose/survival relationship for accidental whole body radiation exposure is poorly defined in humans due to the small number of documented cases in which an accurate determination of the absorbed dose could be made [1–3]. The LD50/60 (the lethal dose for 50% of individuals within 60 days) for total body irradiation is approximately 4.5 Gy if optimal supportive care is administered, and the LD90 has been estimated to be approximately 7 Gy [1]. At higher doses, generally exceeding 8–12 Gy, severe toxicity to the gastrointestinal tract and other organs ensue. The gastrointestinal syndrome is due to cytotoxicity to the epithelial crypt cells, the proliferative cells that maintain the bowel mucosa. Injury to these cells by high doses of radiation leads to sloughing of the bowel mucosa, massive diarrhea, and sepsis, typically resulting in death within 6–9 days of exposure. Very high doses of total body irradiation produce neurotoxicity and cardiovascular collapse, which result in death within several days. Radiation injury is dependent on a number of factors, including the type and quality of radiation, the dose and dose rate, homogeneity of the dose, and shielding.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Proceedings of the 35th Session of the United Nations Scientific Committee on the Effects of Atomic Radiation, 1985.

    Google Scholar 

  2. Fleidner TM, Nothdurft W, Steinbach KH. Blood cell changes after radiation exposure as an indicator for hemopoietic stem cell function. Bone Marrow Transplant 1988; 3:77–82.

    Google Scholar 

  3. Champlin RE, Gale RP, Kastenberg W. Radiation accidents and nuclear energy; medical consequences and therapy. Ann Intern Med 1988; 109:730–744.

    PubMed  CAS  Google Scholar 

  4. Wald N. Diagnosis and therapy of radiation injuries. Bull NY Acad Med 1983; 59: 1129–1138.

    CAS  Google Scholar 

  5. von Bekkum DW, DeVries MJ. Radiation Chimeras Academic Press, New York, 1967.

    Google Scholar 

  6. Monroy RL, Vreisendorp HM, MacVittie TJ. Improved survival of dogs exposed to fission neutron irradiation and transplanted with DLA-identical bone marrow. Bone Marrow Transplant 1987; 2:375–384.

    PubMed  CAS  Google Scholar 

  7. Thomas ED, Storb R, Gift RA, et al. Bone marrow transplantation. N Engl J Med 1975; 292:895–902.

    Article  PubMed  CAS  Google Scholar 

  8. Champlin RE, Gale RP. Bone marrow transplantation for acute leukemia: Advances and comparison with alternative therapies. Semin Hematol 1986, in press.

    Google Scholar 

  9. Thomas ED, LeBond R, Graham T, et al. Marrow infusions in dogs given sublethal or lethal irradiation. Radiat Res 1970; 41:113–124.

    Article  PubMed  CAS  Google Scholar 

  10. Storb R, Weiden PL, Schroeder ML, et al. Marrow grafts between canine littermates, homozygous or heterozygous, for lymphocyte defined histocompatibility antigens. Transplantation 1976; 21:299.

    Article  PubMed  CAS  Google Scholar 

  11. Anasetti C, Amos D, Beatty PG, et al. Effect of HLA compatibility on engraftment of bone marrow transplants in patients with leukemia or lymphoma. N Engl J Med 1989; 320: 197–204.

    Article  PubMed  CAS  Google Scholar 

  12. Champlin RE, Gale RP. Early complications of bone marrow transplantation. Sem Hematol 1984;21:101–108.

    CAS  Google Scholar 

  13. Glucksberg H, Storb R, Fefer A, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors. Transplantation 1974; 18:295–304.

    Article  Google Scholar 

  14. Grebe SC, Streillin JW. Graft versus host reactions: A review. Adv Immunol 1976; 23:119–221.

    Article  Google Scholar 

  15. Lum L. The kinetics of immune reconstitution after human marrow transplantation. Blood 1987; 69:369–380.

    PubMed  CAS  Google Scholar 

  16. Winston DJ, Ho WG, Champlin RE, Gale RP. Infectious complications of marrow transplantation. Exp Hematol 1984; 12:205–215.

    PubMed  CAS  Google Scholar 

  17. Meyers JP. Prevention and treatment of cytomegalovirus infections after marrow transplantation. Bone Marrow Transplant 1988; 3:95–104.

    PubMed  CAS  Google Scholar 

  18. Champlin R. Role of bone marrow transplantation for nuclear accidents: Implications of the Chernobyl disaster. Semin Hematol 1987; 24(Suppl 2):1–4.

    CAS  Google Scholar 

  19. Beatty PG, Clift RA, Michelson EM, et al. Marrow transplantation from related donors other than HLA-identical siblings. N Engl J Med 1985; 313:765–771.

    Article  PubMed  CAS  Google Scholar 

  20. Trentin JJ. Grafted marrow rejection mortality contrasted to homologous disease in irradiated mice receiving homologous marrow. J Natl Cancer Inst 1959; 22:219–228.

    PubMed  CAS  Google Scholar 

  21. Ferrera J, Lipton J, Hellman S, Burakoff S, Mauck P. Engraftment following T-cell depleted marrow transplantation. Transplantation 1987; 44:495–503.

    Article  Google Scholar 

  22. Lapidot T, Singer TS, Reisner Y. Transient engraftment of T-cell depleted allogeneic bone marrow in mice improves survival rate following lethal radiation. Bone Marrow Transplant 1988;3:157–164.

    PubMed  CAS  Google Scholar 

  23. USSR State Committee on the Utilization of Atomic Energy. The accident at the Chernobyl nuclear power plant and its consequences. Presented at the IAEA Experts Meeting—August 25–29, 1986.

    Google Scholar 

  24. Baranov A, Gale RP, Guskova A, et al. Bone marrow transplantation after the Chernobyl nuclear accident. N Eng Med 1989; 321:205–212.

    Article  CAS  Google Scholar 

  25. Bond VP, Cronkite EP. Workshop on short-term health effects of reactor accidents: Chernobyl BNL 52030. US Dept of Energy, 1986.

    Google Scholar 

  26. Wald N. Hematological parameters after acute radiation injury. In: Manual of Radiation Hematology. IAEA, Vienna, 1986: 253–264.

    Google Scholar 

  27. Biological Dosimetry: Chromosomal Aberration Analysis for Dose Assessment. Technical Report 260, IAEA, Vienna, 1986.

    Google Scholar 

  28. Brooks JW, Evans EI, Han WT, Reid JD. The influence of external body radiation on mortality from thermal burns. Ann Surg 1952; 136:533–545.

    PubMed  CAS  Google Scholar 

  29. Mathe G, Jammet H, Pendic B, et al. Transfusions et greffes de moellecular homologue chez des humains irradies a haute dose accidentellement. R Etud Clin Biol 1959; 4:226–238.

    CAS  Google Scholar 

  30. Gilberti MV. The 1967 radiation accident near Pittsburg, Pennsylvania follow up report. In: Medical Basis for Accident Preparedness, Hubner KF, Fry SA, eds. Elsevier, Dordrecht, 1980:131–140.

    Google Scholar 

  31. Butturini A, Gale RP. T-cell depletion. Bone Marrow Transplantation 1988; 3:185–192.

    PubMed  CAS  Google Scholar 

  32. Butturini A, Seeger R, Gale RP. Recipient immune competent T-lymphocytes can survive intensive conditioning for bone marrow transplantation. Blood 1986; 68:954–956.

    PubMed  CAS  Google Scholar 

  33. Reisner Y, Ben-Bassat B, Douer D, et al. Demonstration of clonable alloreactive host T cells in a primate model for bone marrow transplantation. Proc Natl Acad Sci USA 1986; 83:4012–4015.

    Article  PubMed  CAS  Google Scholar 

  34. Metcalf D. The granulocyte-macrophage colony stimulating factors. Science 1985; 229: 16–22.

    Article  PubMed  CAS  Google Scholar 

  35. Souza LM, Boone TC, Gabrilove J, et al., Recombinant human granulocyte-colony stimulating factor: Effects on normal and leukemic myeloid cells. Science 1986; 232:61–65.

    Article  PubMed  CAS  Google Scholar 

  36. Champlin RE, Nimer S, Oreland P, Oette D, Golde DW. Treatment of refractory aplastic anemia with recombinant human granulocyte-macrophage colony stimulating factor. Blood 1989; 73:694–699.

    PubMed  CAS  Google Scholar 

  37. Gabrilove JL, Jakubowski A, Scher H, et al. Effect of granulocyte colony-stimulating factor on neutropenia and associated morbidity due to chemotherapy for transitional cell carcinoma of the urothelium. N Engl J Med 1988; 318:1414–1422.

    Article  PubMed  CAS  Google Scholar 

  38. Brandt SJ, Peters WP, Antwater SK, et al. Effect of recombinant human granulocyte, macrophage-colony stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation. N Engl J Med 1988; 318: 869–876.

    Article  PubMed  CAS  Google Scholar 

  39. Yang YC, Ciarietta AB, Temple PA, et al. Human IL-3 (multi-CSF): Identification by expression cloning of a novel hematopoietic growth factor related to murine IL-3. Cell 1986; 47:3–10.

    Article  PubMed  CAS  Google Scholar 

  40. Mochizuki Y, Eisenman JR, Conlon PJ, et al. Interleukin 1 regulates hematopietic activity, a role previously ascribed to hemopoetin 1. Proc Natl Acad Sci USA 1987; 84:5271–5287.

    Article  Google Scholar 

  41. Leary AG, Ikebushi K, Hirai Y, et al. Synergism between interleukin-6 and interleukin-3 in supporting proliferation of human hematopoietic stem cells: Comparison with interleukin-1 alpha. Blood 1988; 71:1759–1763.

    PubMed  CAS  Google Scholar 

  42. Monsoy RL, Skelly RR, Davis TA, et al. Effect of interleukin-1 on the recovery of primates after radiation and autologous bone marrow transplantation. Blood 1989; 70(Suppl 1): 1–1103.

    Google Scholar 

  43. Schuening FG, Storb R, Goehle S, et al. Effect of recombinant human granulocyte colony-stimulating factor on hematopoiesis of normal dogs and on hematopoietic recovery after otherwise lethal total body irradiation. Blood 1989; 74:1308–1313.

    PubMed  CAS  Google Scholar 

  44. Butturini A, Desouza PC, Gale RP, et al. Use of recombinant granulocyte-macrophage colony-stimulating factor in the Brazil radiation accident. Lancet 1988; 2:471–475.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Richard Champlin
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. MD Anderson Cancer Center, Houston, Texas, USA

    Richard Champlin M.D.

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Kluwer Academic Publishers

About this chapter

Cite this chapter

Champlin, R. (1990). Role of bone marrow transplantation as treatment for victims of nuclear accidents. In: Champlin, R. (eds) Bone Marrow Transplantation. Cancer Treatment and Research, vol 50. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1493-6_17

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-1493-6_17

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8803-9

  • Online ISBN: 978-1-4613-1493-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation