Estimating Risk of Hematopoietic Acute Radiation Syndrome in Children

Adams, Tim G.; Sumner, Louise; Casagrande, Rocco

doi:10.1097/hp.0000000000000720

Cited by 9 publications

(3 citation statements)

References 22 publications

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“…Further, radiation exposure is a matter of concern in children. Regarding acute radiation syndrome, it is reported that hematopoietic disorders are more likely to occur in children than in adults (14). Krille et al (15) investigated the late effects of exposure to ionizing radiation from CT in a pediatric case, suggesting that this was a risk factor for a secondary cancer.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Utility of Ultrasonography for Duodenal Ulcers in Pediatric Cases in Japan

et al. 2020

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Objective: To evaluate the diagnostic utility of wall hypertrophy of the duodenal bulb with a hyperechoic lumen, designated as the "HH sign," using ultrasound sonography (US) in pediatric duodenal ulcer (DU) patients. Study design:We performed a US for five pediatric subjects diagnosed with DU by upper gastroscopy to determine the presence of the potentially diagnostic HH sign. The sonographic images were analyzed before and after DU treatment. Computed tomography was performed in three cases and fecal occult blood test (FOBT) in all five cases.Results: Upper gastroscopy confirmed DU in all patients. While the HH sign was observed using US in four cases, with the DU located in the anterior bulb, the FOBT was positive in only one case. In these four cases, the HH sign diminished in response to treatment, as visualized by US. This was observed for both the initial as well as recurrent episodes. A mass-like region was observed in only one case, with the ulcer located in the proximity of the inferior duodenal wall. Conclusion:The HH sign is useful for the follow-up of DU, and US may be a suitable modality for the follow-up. We believe that this diagnostic marker can aid in following up a greater number of DU cases.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Utility of Ultrasonography for Duodenal Ulcers in Pediatric Cases in Japan

et al. 2020

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“…Computational modeling estimates that children can be twice as sensitive to acute effects of radiation, with younger children at greatest risk (54). Fortunately, Neupogen, Neulasta, Leukine, and Nplate have all been approved for adult and pediatric populations, and the Biomedical Advanced Research and Development Authority (BARDA), within the HHS, has procured all four MCMs for potential use in a mass casualty scenario.…”

Section: Pediatric Populationsmentioning

confidence: 99%

Considerations of Medical Preparedness to Assess and Treat Various Populations During a Radiation Public Health Emergency

et al. 2023

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During a radiological or nuclear public health emergency, given the heterogeneity of civilian populations, it is incumbent on medical response planners to understand and prepare for a potentially high degree of inter-individual variability in the biological effects of radiation exposure. A part of advanced planning should include a comprehensive approach, in which the range of possible human responses in relation to the type of radiation expected from an incident has been thoughtfully considered. Although there are several reports addressing the radiation response for special populations (as compared to the standard 18–45-year-old male), the current review surveys published literature to assess the level of consideration given to differences in acute radiation responses in certain sub-groups. The authors attempt to bring clarity to the complex nature of human biology in the context of radiation to facilitate a path forward for radiation medical countermeasure (MCM) development that may be appropriate and effective in special populations. Consequently, the focus is on the medical (as opposed to logistical) aspects of preparedness and response. Populations identified for consideration include obstetric, pediatric, geriatric, males, females, individuals of different race/ethnicity, and people with comorbidities. Relevant animal models, biomarkers of radiation injury, and MCMs are highlighted, in addition to underscoring gaps in knowledge and the need for consistent and early inclusion of these populations in research. The inclusion of special populations in preclinical and clinical studies is essential to address shortcomings and is an important consideration for radiation public health emergency response planning. Pursuing this goal will benefit the population at large by considering those at greatest risk of health consequences after a radiological or nuclear mass casualty incident.

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“…Recently, Leukinet (granulocyte-macrophage colony-stimulating factor; GM-CSF) was approved by the FDA as a radiomitigator to increase survival and to facilitate the recovery of white blood cells in adults and pediatric patients acutely exposed to a sub-lethal dose of radiation (12). Hematopoietic organs are highly susceptible to the cytotoxic effects of radiation, resulting in immune suppression including neutropenia, thrombocytopenia, and/or anemia (13)(14)(15). Patients with neutropenia often experience reduced defense against infection and inflammation, consequently followed by mortality due to sepsis (16).…”

Section: Introductionmentioning

confidence: 99%

Mitigating Effects of 1-Palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) on Hematopoietic Acute Radiation Syndrome after Total-Body Ionizing Irradiation in Mice

Kim¹,

Jeong

Shin

et al. 2019

Radiation Research

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Acute radiation syndrome (ARS) occurs as a result of partial-or whole-body, high-dose exposure to radiation in a very short period of time. Survival is dependent on the severity of the hematopoietic sub-syndrome of ARS. In this study, we investigated the mitigating effects of a lipid molecule, 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG), on the kinetics of hematopoietic cells, including absolute neutrophil count (ANC), red blood cells (RBCs) and platelet counts, in mice after gamma-ray total-body irradiation (TBI). Male and female BALB/c mice (11 weeks old) received a LD 70/30 dose of TBI. PLAG significantly and dosedependently attenuated radiation-induced mortality (P ¼ 0.0041 for PLAG 50 mg/kg; P , 0.0001 for PLAG 250 mg/kg) and body weight loss (P , 0.0001 for PLAG 50 and 250 mg/ kg) in mice. Single-fraction TBI sharply reduced ANC within 3 days postirradiation and maintained the neutropenic state (ANC , 500 cells/ll) by approximately 26.8 6 0.8 days. However, administration of PLAG attenuated radiationinduced severe neutropenia (ANC , 100 cells/ll) by effectively delaying the mean day of its onset and decreasing its duration. PLAG also significantly mitigated radiationinduced thrombocytopenia (P , 0.0001 for PLAG 250 mg/kg) and anemia (P ¼ 0.0023 for PLAG 250 mg/kg) by increasing mean platelet and RBC counts, as well as hemoglobin levels, in peripheral blood. Moreover, delayed administration of PLAG, even at 48 and 72 h after gamma-ray irradiation, significantly attenuated radiation-induced mortality in a time-dependent manner. When compared to olive oil and palmitic linoleic hydroxyl (PLH), only PLAG effectively attenuated radiation-induced mortality, indicating that it has a distinctive mechanism of action. Based on these preclinical observations, we concluded that PLAG has high potential as a radiation countermeasure for the improvement of survivability and the treatment of hematopoietic injury in gamma-rayinduced ARS.

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Estimating Risk of Hematopoietic Acute Radiation Syndrome in Children

Cited by 9 publications

References 22 publications

Diagnostic Utility of Ultrasonography for Duodenal Ulcers in Pediatric Cases in Japan

Diagnostic Utility of Ultrasonography for Duodenal Ulcers in Pediatric Cases in Japan

Considerations of Medical Preparedness to Assess and Treat Various Populations During a Radiation Public Health Emergency

Mitigating Effects of 1-Palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) on Hematopoietic Acute Radiation Syndrome after Total-Body Ionizing Irradiation in Mice

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