Bone Marrow Transplantation and Other Treatment After Radiation Injury: A Review Prepared for the Commission of the European Communities, Directorate-

ISBN-13: 9789024720569 / Angielski / Miękka / 1977 / 83 str.

H. Balner; Hans Balner

Opis

Acute radiation injury in man has been amply reviewed in the past decades (1-8). Information for those reviews was mainly derived from the Hiroshima and Nagasaki experience (3), from radiation accidents as a con- sequence of testing nuclear weapons and the application of nuclear energy (9-13) and from the intentional irradiation of patients, mostly for the treatment of malignancies and/or as conditioning for transplantation (14-20). Further, a large body of data derived from animal experimentation has led to cautious extrapolations to the human situation (14). An elaborate review dealing with early somatic effects of radiation in a man was published by UNSCEAR ) in 1962 (2). It was supplemented in 1969 with a similar document dealing mostly with radiation-induced chromosome aberra- tions, the effects of radiation on the nervous system and, radio-active contamination of the environment by nuclear testing (21). In a more recent UNSCEAR report (1972) the main topics were genetic effects, carcinogenesis and effects of radiation on the immune response (22). The early effects of radiation in man were also expertly and comprehensively reviewed in a report by the United States National Research Council in 1967 (23).

Spis treści

Biological Effects of Radiation.- Physical Factors.- Biological Factors.- Schematic Classification of Radiation Injury.- Localized Effects.- Irradiation of the head region.- Irradiation of the abdominal region.- Irradiation of the skin.- Other localilized effects.- Generalized Effects.- The Major Syndromes of Radiation Injury.- The cerebral syndrome.- The intestinal syndrome.- The bone marrow syndrome.- 10.007/978-94-010-1113-6_4.Therapy of the Bone Marrow Syndrome.- Experimental Data.- Factors influencing the fate of marrow grafts.- The Major Histocompatibility Complex.- Other factors influencing marrow engraftment.- The Graft versus Host (GvH) Reaction.- Cause and pathology of GvH disease GvHD.- Patterns of GvHD.- Symptoms, histology and clinical course of GvHD.- Methods to prevent or mitigate GvH disease.- Donor selection.- Improving the quality of the inoculum.- Treatment of the recipient before or after engraftment.- Supportive treatment and other protective measures.- Clinical Data.- Bone marrow transplantation after accidental radiation.- Bone marrow transplantation for other indications.- Isogeneic and autologous marrow grafts.- Allogeneic bone marrow grafts.- Starategy for the Treatment of Severe Radiation Injury in Man.- General Principles.- Initial Steps at the Various Medical Facilities.- Planning and Logistics of a Possible Bone Marrow Transplant.- The initial period.- The intermediate observation period.- Logistics of a marrow transplant.- “Marrow Banks”.- Individual banks.- Public banks.- Desirability and feasibility.- A few suggestions for the operation of a public marrow bank.- Acknowledgements.- References.