Nuclear terrorism: the role of hematology in coping with its health consequences

Purpose of reviewThis 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. Recent findingsThere 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. SummaryThe 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.