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

被引:41
作者
Fliedner, Theodor M. [2 ]
Chao, Nelson J. [1 ]
Bader, Judith L. [3 ,4 ]
Boettger, Axel [5 ]
Case, Cullen, Jr. [6 ]
Chute, John [1 ]
Confer, Dennis L. [6 ]
Ganser, Arnold [7 ]
Gorin, Norbert-Claude [8 ]
Gourmelon, Patrick [9 ]
Graessle, Dieter H. [2 ]
Krawisz, Robert [10 ]
Meineke, Viktor [11 ]
Niederwieser, Dietger [12 ]
Port, Matthias [7 ]
Powles, Ray [13 ]
Sirohi, Bhawna [14 ]
Weinstock, David M. [15 ]
Wiley, Albert [16 ]
Coleman, C. Norman [3 ,4 ]
机构
[1] Duke Univ, Div Cellular Therapy, Dept Med, RadCCORE Radiat Countermeasures Ctr Res Excellenc, Durham, NC 27710 USA
[2] Univ Ulm, Radiat Med Res Grp, D-89069 Ulm, Germany
[3] NCI, NIH, Bethesda, MD 20892 USA
[4] Off Assistant Secretary Preparedness & Response, Dept Hlth & Human Serv, Washington, DC USA
[5] Fed Minist Environm Nat Protect & Nucl Safety, Dept Radiat Protect, Bonn, Germany
[6] NMDP, Minneapolis, MN USA
[7] Hannover Med Sch, Dept Hematol Hemostasis Oncol & Stem Cell Transpl, D-3000 Hannover, Germany
[8] Hosp St Antoine, Dept Hematol & Cell Therapy, Paris, France
[9] IRSN, Fontenay Aux Roses, France
[10] Amer Soc Blood & Marrow Transplantat, Arlington Hts, IL USA
[11] Bundeswehr Inst Radiobiol, Munich, Germany
[12] Univ Leipzig, Dept Hematol & Oncol, Leipzig, Germany
[13] Parkside Oncol Clin, London, England
[14] Addenbrookes Hosp, Dept Med Oncol, Cambridge, England
[15] DFCI, Div Hematol Neoplasia, Boston, MA USA
[16] Radiat Emergency Assistance Ctr Training Site, Oak Ridge, TN USA
关键词
Hemopoietic growth factor; Irradiation; Stem cell transplantation; Stem cell-microenvironment interactions; HEMATOPOIETIC STEM; NUCLEAR EVENTS; HUMAN EMBRYO; NICHE; BLOOD; MANAGEMENT; EXPOSURE; CONSEQUENCES; RESPONSES; SEVERITY;
D O I
10.1002/stem.16
中图分类号
Q813 [细胞工程];
学科分类号
摘要
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. STEM CELLS 2009;27:1205-1211
引用
收藏
页码:1205 / 1211
页数:7
相关论文
共 38 条
[1]  
[Anonymous], 1987, Environ Health Perspect, V74, P3
[2]   Tie2/angiopoietin-1 signaling regulates hematopoietic stem cell quiescence in the bone marrow niche [J].
Arai, F ;
Hirao, A ;
Ohmura, M ;
Sato, H ;
Matsuoka, S ;
Takubo, K ;
Ito, K ;
Koh, GY ;
Suda, T .
CELL, 2004, 118 (02) :149-161
[3]   LEUKOKINETIC STUDIES .4. TOTAL BLOOD, CIRCULATING AND MARGINAL GRANULOCYTE POOLS AND GRANULOCYTE TURNOVER RATE IN NORMAL SUBJECTS [J].
ATHENS, JW ;
WINTROBE, MM ;
ASHENBRUCKER, H ;
CARTWRIGHT, GE ;
MAUER, AM ;
HAAB, OP ;
RAAB, SO .
JOURNAL OF CLINICAL INVESTIGATION, 1961, 40 (06) :989-&
[4]   Chemokine-mediated interaction of hematopoietic progenitors with the bone marrow vascular niche is required for thrombopoiesis [J].
Avecilla, ST ;
Hattori, K ;
Heissig, B ;
Tejada, R ;
Liao, F ;
Shido, K ;
Jin, DK ;
Dias, S ;
Zhang, F ;
Hartman, TE ;
Hackett, NR ;
Crystal, RG ;
Witte, L ;
Hicklin, DJ ;
Bohlen, P ;
Eaton, D ;
Lyden, D ;
de Sauvage, F ;
Rafii, S .
NATURE MEDICINE, 2004, 10 (01) :64-71
[5]   Radiation event medical management (REMM): Website guidance for health care providers [J].
Bader, Judith L. ;
Nemhauser, Jeffrey ;
Chang, Florence ;
Mashayekhi, Bijan ;
Sczcur, Marti ;
Knebel, Ann ;
Hrdina, Chad ;
Coleman, Norman .
PREHOSPITAL EMERGENCY CARE, 2008, 12 (01) :1-11
[6]  
Bennett B., 2006, Health Effects of the Chernobyl Accident and Special Health Care Programmes
[7]  
Brucer M, 1959, ACUTE RAD SYNDROME M
[8]   Osteoblastic cells regulate the haematopoietic stem cell niche [J].
Calvi, LM ;
Adams, GB ;
Weibrecht, KW ;
Weber, JM ;
Olson, DP ;
Knight, MC ;
Martin, RP ;
Schipani, E ;
Divieti, P ;
Bringhurst, FR ;
Milner, LA ;
Kronenberg, HM ;
Scadden, DT .
NATURE, 2003, 425 (6960) :841-846
[9]   Medical Response to a Radiologic/Nuclear Event: Integrated Plan From the Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services [J].
Coleman, C. Norman ;
Hrdina, Chad ;
Bader, Judith L. ;
Norwood, Ann ;
Hayhurst, Robert ;
Forsha, Joseph ;
Yeskey, Kevin ;
Knebel, Ann .
ANNALS OF EMERGENCY MEDICINE, 2009, 53 (02) :213-222
[10]  
CONFER DL, 2003, C MED PLANN CAR RAD