| QIAO Jian-hui,YU Chang-lin,LUO Wei-dong.Clinical report of an extremely severe bone marrow form of acute radiation sickness[J].Chinese Journal of Radiological Medicine and Protection,2007,27(1):6-10 |
| Clinical report of an extremely severe bone marrow form of acute radiation sickness |
| Received:September 18, 2006 |
| DOI： |
| KeyWords:Extremely severe bone marrow form of acute radiation sickness Hematopoietic stem cell transplantation Conditioning regimen |
| FundProject: |
| Author Name | Affiliation | E-mail | | QIAO Jian-hui | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | YU Chang-lin | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | LUO Wei-dong | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 郭梅 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 王丹红 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 孙琪云 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 张石 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 张锡刚 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 李光 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 牛文凯 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 陈建魁 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 李晓兵 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 葛飞娇 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | | | 艾辉胜 | Department of Radiation Medicine & Hematology, Affiliated Hospital, Academy of Military Medical Sciences, Beijing 100071, China | huishengai@163.com |
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| Abstract:: |
| Objective To sum up the experiences from the diagnosis and treatment of patient B subjected to an accidental 60Co exposure on October 21st, 2004, in Jining, Shandong Province, China. Methods Radiation dose of B was assessed by analysis of chromosome aberration and microneucleus assay, simulation test of the accident site, autopsy and electron spin resonance (ESR). The ultimate clinical diagnosis was based on analysis of irradiation dose, clinical manifestations and laboratory results. In therapeutical aspects, total environmental protection, HLA-identical allogeneic peripheral blood stem cell transplantation(PBSCT), anti-infection and protection managements of organs were given. Results Patient B was diagnosed as extremely severe bone marrow form of acute radiation sickness (ARS). HLA-identical allogeneic PBSCT was performed on the patient from his brother on the 7th day after the accident. The hematopoietic recovery began on the 9th day after transplantation. The patient acquired permanent full donor' engraftment without graft versus host disease (GVHD). But the radiation injury was continuing and the patient complicated with polyinfection in lung, and cardiac insufficiency. On the 45th day after the accident, patient B was performed with tracheotomy and maintained ventilation with respirator. On the 75th day after the accident, patient B died of multiple organ failure. Conclusions Early triage diagnosis and total environmental protection should be performed as soon as possible for extremely severe bone marrow form of ARS. It is very important to perform a successful HLA-identical allogeneic PBSCT, in order to extend the life time of the patient. Multiple organ injuries and infections of bacteria and fungi usually occurred on this kind of patients, so intense measures of anti-infection and protection of multiple organs should be taken. The important and difficult point in the treatment of this kind ARS might be for help the immune-reconstruction and tissue repair. |
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