Transplantation for accidental acute high-dose total body neutron- and γ-radiation exposure

Abstract

Summary:Accidental exposure to acute high-dose total body neutron radiation is rare. We report a 35-year-old man exposed to a total body dose of 5.4 Gy neutron-and 8.5-13 Gy ␥-radiation in a radiation criticality accident. He received a blood stem cell transplant from his HLAidentical sister. There was bone marrow recovery with complete donor chimerism. Random chromatid breaks were observed in donor cells suggesting a bystander effect of neutron exposure. The subject died 82 days after the accident (75 days post transplant) from multiorgan failure. Bone Marrow Transplantation (2002) 29, 935-939.

Severe acute radiation syndrome: treatment of a lethally 60Co-source irradiated accident victim in China with HLA-mismatched peripheral blood stem cell transplantation and mesenchymal stem cells

“…This was in contrast to previous reports from the Chernobyl nuclear accident, the Tokaimura accident in Japan, and the Shanghai accident in China [3, 5, 6, 19]. It should be noted that conditioning with fludarabine and GVHD prophylactic with CSA, MMF and CD25 antibody might have played an important role in ensuring donor engraftment and prevention of GVHD [12, 20, 21].…”

Neutrons do not produce a bystander effect in zebrafish irradiated in vivo

“…However, the authors appear to have used alpha particles in addition to neutrons. Another study by Chiba et al (2002) reports a bystander eff ect in transplanted bone marrow following accidental whole body neutron and gamma exposure. Our fi ndings that both in vivo and in vitro neutrons do not appear to produce bystander eff ects do not contradict the above studies but our suggestion that the gamma eff ect is negated by neutrons is not supported by the other studies.…”

Radiation-induced genomic instability and bystander effects: inter-related nontargeted effects of exposure to ionizing radiation

“…Evidence that these effects are not restricted to experimental models is provided by a recent report of a 35-year-old man accidentally exposed to acute high-dose total body neutron radiation who received a stem cell transplant from his HLA-identical sister. In monitoring this patient, chromosomal instability in donor female cells was demonstrated consistent with a bystander effect of the neutron exposure (Chiba et al, 2002).…”