Cytokine therapy of acute radiation syndrome.

Radiological accidents/incidents are common with nearly 400 reported since 1944 exposing about 3000 people to substantial doses of ionizing radiations with 127 deaths. Damage to hematopoietic stem and progenitor cells with resulting bone marrow failure is a common consequence of exposure to whole body acute high-dose and -dose-rate ionizing radiations and is termed hematopoietic-acute radiation syndrome, or H-ARS. Therapy of H-ARS includes transfusions, anti-bacterial and -viral drugs, molecularly-cloned hematopoietic growth factors and hematopoietic cell transplants. We considered the role of recombinant human granulocyte-colony-stimulating factor (rhu G-CSF; filgrastim) and recombinant human granulocyte-macrophage colony-stimulating factor (rhu GM-CSF; sargramostim) in the setting of H-ARS. The favorable benefit-to-risk ratio of these drugs over hematopoietic cell transplants suggests giving them soon after exposure to acute high-dose and-dose-rate whole body ionizing radiations.