THERAPEUTIC APPROACHES TO HEMATOPOIETIC S YNDROME FOLLOWING ACCIDENTAL WHOLE-BODY IRRADIATION

Since the first radiation accidents which resulted in severe health ef fects in the workforce or the population, great progress has been made in the fields of diagnosis, prognosis and treatment of accidentally o verexposed victims. Since then, progress has also been made in the med ical management of diseases such as aplasia. Because of the relative s carcity of radiation accidents, there is a need for complementary rese arches, in order to take advantage of new techniques and medical appro aches. After whole body overexposure, the key issue is the therapeutic decision, ie, the choice between bone marrow transplantation and othe r strategies. The indications of bone marrow transplantation cover onl y a short range of doses, provided the exposure is distributed uniform ly within the body. The last accidental overexposures which happened i n the world have demonstrated the possible efficiency of haematopoieti c growth factors, most of them being still under clinical trials. Acti ons based on these various approaches are summarized, as well as the l essons which have been learned.