Stem Cells, Multiorgan Failure in Radiation Emergency Medical Preparedness: A U.S./European Consultation Workshop

Author:

Fliedner Theodor M.1,Chao Nelson J.2,Bader Judith L.34,Boettger Axel5,Case Cullen6,Chute John2,Confer Dennis L.6,Ganser Arnold7,Gorin Norbert-Claude8,Gourmelon Patrick9,Graessle Dieter H.1,Krawisz Robert10,Meineke Viktor11,Niederwieser Dietger12,Port Matthias7,Powles Ray13,Sirohi Bhawna14,Weinstock David M.15,Wiley Albert16,Coleman C. Norman34

Affiliation:

1. Radiation Medicine Research Group, Ulm University, Germany

2. Division of Cellular Therapy, Department of Medicine, Duke University, RadCCORE Radiation Countermeasures Center of Research Excellence, Durham, North Carolina, USA

3. National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA

4. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, Washington, D.C., USA

5. Department of Radiation Protection, Federal Ministry of Environment, Nature Protection and Nuclear Safety, Bonn, Germany

6. National Marrow Donor Program (NMDP), Minneapolis, Minnesota, USA

7. Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany

8. Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Paris, France

9. Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France

10. American Society for Blood and Marrow Transplantation, Arlington Heights, Illinois, USA

11. Bundeswehr Institute of Radiobiology, Munich, Germany

12. Department of Hematology and Oncology, University of Leipzig, Germany

13. Parkside Oncology Clinic, London, United Kingdom

14. Department of Medical Oncology, Addenbrookes Hospital, Cambridge, United Kingdom

15. Division of Hematologic Neoplasia, Dana-Faber Cancer Institute (DFCI), Boston, Massachusetts, USA

16. Radiation Emergency Assistance Center/Training Site (REACT/TS), Oak Ridge, Tennessee, USA

Abstract

Abstract The concern of the public regarding terrorist actions involving nuclear emergencies resulted in the reopening of the discussion regarding the best ways to cope with the inevitable health impairments. Medical experts from the US and from Europe considered it of importance to harmonize at an international level the diagnostic and therapeutic approaches regarding the radiation-induced health impairments. The present contribution is the result of the first U.S./European Consultation Workshop addressing approaches to radiation emergency preparedness and assistance, which was held recently at Ulm University, Ulm, Germany. Discussions dealt with the assessment of the extent of damage after total body exposure and, in particular, the quantity and quality of the damage to the hematopoietic stem cell pool. Secondly, the pathogenesis of the multiorgan failure was considered because of the organ-to-organ interactions. Thirdly, approaches were considered to harmonize the “triage-methods” used on an international level using the “Response Category” approach as developed for the European Communities. These discussions lead to the conclusion that there is a strong need for continuing education of physicians, nurses, and support personnel to address the issues posed by the management of patients suffering from radiation syndromes. Finally, the discussions expressed the need for more international cooperation in research and development of more refined methods to treat patients with any type of radiation syndromes. Disclosure of potential conflicts of interest is found at the end of this article.

Publisher

Oxford University Press (OUP)

Subject

Cell Biology,Developmental Biology,Molecular Medicine

Reference40 articles.

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2. Hematologic consequences of exposure to ionizing radiation;Dainiak;Exp Hematol,2002

3. The haematologist and radiation casualties;Dainiak;Hematology (Am Soc Hematol Educ Program),2003

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