Hematopoietic Recovery using Multi-Cytokine Therapy in 8 Patients Presenting Radiation-Induced Myelosuppression after Radiological Accidents.

Treatment of accidental radiation-induced myelosuppression is primarily based on supportive care and requires specific treatment based on hematopoietic growth factors injection or hematopoietic cell transplantation for the most severe cases. The cytokines used consisted of pegylated erythropoietin (darbepoetin alfa) 500 IU once per week, pegylated G-CSF (pegfilgrastim) 6 mg × 2 once, stem cell factor 20 µg.kg-1 for five days, and romiplostim (TPO analog) 10 µg.

Default operational intervention levels (OILs) for severe nuclear power plant or spent fuel pool emergencies.

Experience and studies show that for an emergency at a nuclear power plant involving severe core damage or damage to the fuel in spent fuel pools, the following actions may need to be taken in order to prevent severe deterministic health effects and reduce stochastic health effects: (1) precautionary protective actions and other response actions for those near the facility (i.e., within the zones identified by the International Atomic Energy Agency) taken immediately upon detection of facility conditions indicating possible severe damage to the fuel in the core or in the spent fuel pool; and (2) protective actions and other response actions taken based on environmental monitoring and sampling results following a release.

First global consensus for evidence-based management of the hematopoietic syndrome resulting from exposure to ionizing radiation.

Objective: Hematopoietic syndrome (HS) is a clinical diagnosis assigned to people who present with ≥ 1 new-onset cytopenias in the setting of acute radiation exposure. The World Health Organization convened a panel of experts to evaluate the evidence and develop recommendations for medical countermeasures for the management of HS in a hypothetical scenario involving the hospitalization of 100 to 200 individuals exposed to radiation. The objective of this consultancy was to develop recommendations for treatment of the HS based upon the quality of evidence.

Literature review and global consensus on management of acute radiation syndrome affecting nonhematopoietic organ systems.

Objectives: The World Health Organization convened a panel of experts to rank the evidence for medical countermeasures for management of acute radiation syndrome (ARS) in a hypothetical scenario involving the hospitalization of 100 to 200 victims. The goal of this panel was to achieve consensus on optimal management of ARS affecting nonhematopoietic organ systems based upon evidence in the published literature.

Methods: English-language articles were identified in MEDLINE and PubMed.

Severe deterministic effects of external exposure and intake of radioactive material: basis for emergency response criteria.

Lessons learned from responses to past events have shown that more guidance is needed for the response to radiation emergencies (in this context, a 'radiation emergency' means the same as a 'nuclear or radiological emergency') which could lead to severe deterministic effects. The International Atomic Energy Agency (IAEA) requirements for preparedness and response for a radiation emergency, inter alia, require that arrangements shall be made to prevent, to a practicable extent, severe deterministic effects and to provide the appropriate specialised treatment for these effects. These requirements apply to all exposure pathways, both internal and external, and all reasonable scenarios, to include those resulting from malicious acts (e.