Early dose assessment following severe radiation accidents.

Early treatment of victims of high level acute whole-body x-ray or gamma exposure has been shown to improve their likelihood of survival. However, in such cases, both the magnitude of the exposure and the dosimetry profile(s) of the victim(s) are often not known in detail for days to weeks. A simple dose-prediction algorithm based on lymphocyte kinetics as documented in prior radiation accidents is presented here. This algorithm provides an estimate of dose within the first 8 h following an acute whole-body exposure. Early lymphocyte depletion kinetics after a severe radiation accident follow a single exponential, L(t) = L(o)e(-k(D¿t), where k(D) is a rate constant, dependent primarily on the average dose, D. Within the first 8 h post-accident, K(D) may be calculated utilizing serial lymphocyte counts. Data from the REAC/TS Radiation Accident Registry were used to develop a dose-prediction algorithm from 43 gamma exposure cases where both lymphocyte kinetics and dose reconstruction were felt to be reasonably reliable. The inverse relationship D(K) may be modeled by a simple two parameter curve of the form D = a/(1 + b/K) in the range 0 < or = D < or = 15 Gy, with fitting parameters (mean +/- SD): a = 13.6 +/- 1.7 Gy, and b = 1.0 +/- 0.20 d(-1). Dose estimated in this manner is intended to serve only as a first approximation to guide initial medical management.

[1]  A. Farese,et al.  Combined administration of recombinant human megakaryocyte growth and development factor and granulocyte colony-stimulating factor enhances multilineage hematopoietic reconstitution in nonhuman primates after radiation-induced marrow aplasia. , 1996, The Journal of clinical investigation.

[2]  K. Schwab High-Dose Cancer Therapy. Pharmacology Hematopoietins Stem Cells , 1992 .

[3]  B. Dubray,et al.  Prospective study of the clinical symptoms of therapeutic whole body irradiation. , 1993, Health physics.

[4]  J. Nénot,et al.  Haematopoietic growth factors in the treatment of therapeutic and accidental irradiation-induced bone marrow aplasia. , 1995, International journal of radiation biology.

[5]  Ira V. Hiscock,et al.  Medical Effects of the Atomic Bomb in Japan , 1956, The Medical journal of Australia.

[6]  R. Gale,et al.  Hematopoietic recovery after 10-Gy acute total body radiation. , 1994, Blood.

[7]  T. MacVittie,et al.  Therapeutic use of recombinant human G-CSF (rhG-CSF) in a canine model of sublethal and lethal whole-body irradiation. , 1990, International journal of radiation biology.

[8]  C. Baum,et al.  Combination therapy for radiation-induced bone marrow aplasia in nonhuman primates using synthokine SC-55494 and recombinant human granulocyte colony-stimulating factor. , 1996, Blood.

[9]  C. Baum,et al.  Acceleration of hematopoietic reconstitution with a synthetic cytokine (SC-55494) after radiation-induced bone marrow aplasia. , 1996, Blood.

[10]  William H. Press,et al.  Numerical Recipes in FORTRAN - The Art of Scientific Computing, 2nd Edition , 1987 .

[11]  S. J. Baum,et al.  Symptomatology of acute radiation effects in humans after exposure to doses of 0.5-30 Gy. , 1989, Health physics.

[12]  Henry I. Kohn,et al.  Sources, Effects and Risks of Ionizing Radiation , 1989 .

[13]  Ruth B. Hofstra,et al.  Clinical studies of radiation effects in man: a preliminary report of a retrospective search for dose-relationships in the prodromal syndrome. , 1967, Radiation research. Supplement.

[14]  H. Meiners [Principles of radiation protection]. , 1987, Zahnarztliche Mitteilungen.

[15]  C. Lushbaugh,et al.  THE IMPORTANCE OF DOSIMETRY TO THE MEDICAL MANAGEMENT OF PERSONS ACCIDENTALLY EXPOSED TO HIGH LEVELS OF RADIATION , 1965 .