{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:30:26Z","timestamp":1793439026443,"version":"4.5.0"},"reference-count":77,"publisher":"Radiation Research Society","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiation Research"],"published-print":{"date-parts":[[2021,9,23]]},"abstract":"<jats:p>Treatment of accidental radiation-induced myelosuppression is primarily based on supportive care and requires specific treatment based on hematopoietic growth factors injection or hematopoietic cell transplantation for the most severe cases. The cytokines used consisted of pegylated erythropoietin (darbepoetin alfa) 500 IU once per week, pegylated G-CSF (pegfilgrastim) 6 mg \u00d7 2 once, stem cell factor 20 \u00b5g.kg\u20131 for five days, and romiplostim (TPO analog) 10 \u00b5g.kg \u20131 once per week, with different combinations depending on the accidents. As the stem cell factor did not have regulatory approval for clinical use in France, the French regulatory authorities (ANSM, formerly, AFSSAPS) approved their compassionate use as an investigational drug \u201con a case-by-case basis\u201d. According to the evolution and clinical characteristics, each patient's treatment was adopted on an individual basis. Daily blood count allows initiating G-CSF and SCF delivery when granulocyte &lt;1,000\/mm3, TPO delivery when platelets &lt;50,000\/mm3, and EPO when Hb&lt;80 g\/L. The length of each treatment was based on blood cell recovery criteria. The concept of \u201cstimulation strategy\u201d is linked to each patient's residual hematopoiesis, which varies among them, depending on the radiation exposure's characteristics and heterogeneity. This paper reports the medical management of 8 overexposed patients to ionizing radiation. The recovery of bone marrow function after myelosuppression was accelerated using growth factors, optimized by multiple-line combinations. Particularly in the event of prolonged exposure to ionizing radiation in dose ranges inducing severe myelosuppression (in the order of 5 to 8 Gy), with no indication of hematopoietic stem cell transplantation.<\/jats:p>","DOI":"10.1667\/rade-21-00169.1","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T23:20:20Z","timestamp":1632439220000},"page":"668-679","source":"Crossref","is-referenced-by-count":15,"title":["Hematopoietic Recovery using Multi-Cytokine Therapy in 8 Patients Presenting Radiation-Induced Myelosuppression after Radiological Accidents"],"prefix":"10.1667","volume":"196","author":[{"given":"Marc","family":"Benderitter","sequence":"first","affiliation":[{"name":"Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Herrera-Reyes","sequence":"additional","affiliation":[{"name":"Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvan","family":"Gigov","sequence":"additional","affiliation":[{"name":"Military Hospital, Department of Hematology and Chemotherapy for Solid Tumors, Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Souleau","sequence":"additional","affiliation":[{"name":"Percy Armed Forces Hospital, Department of Hematology, 92140 Clamart, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Huet","sequence":"additional","affiliation":[{"name":"Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Trompier","sequence":"additional","affiliation":[{"name":"Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Fagot","sequence":"additional","affiliation":[{"name":"Percy Armed Forces Hospital, Department of Hematology, 92140 Clamart, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Gr\u00e9goire","sequence":"additional","affiliation":[{"name":"Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Val\u00e8re","family":"Malfuson","sequence":"additional","affiliation":[{"name":"Percy Armed Forces Hospital, Department of Hematology, 92140 Clamart, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Konopacki-Potet","sequence":"additional","affiliation":[{"name":"Percy Armed Forces Hospital, Department of Hematology, 92140 Clamart, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Buglova","sequence":"additional","affiliation":[{"name":"International Atomic Energy Agency, Wagramerstrasse 5, A-1400 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Jacques","family":"Lataillade","sequence":"additional","affiliation":[{"name":"Ecole du Val de Gr\u00e2ce, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radia","family":"Tamarat","sequence":"additional","affiliation":[{"name":"Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Gourmelon","sequence":"additional","affiliation":[{"name":"Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"de Revel","sequence":"additional","affiliation":[{"name":"Percy Armed Forces Hospital, Department of Hematology, 92140 Clamart, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1243","reference":[{"key":"34","unstructured":"TM Fliedner, I Friesecke, K Beyrer,  \"Medical management of radiation accidents: Manual on the acute radiation syndrome.\"  (2001)"},{"key":"1","doi-asserted-by":"crossref","unstructured":"LJ Cole, HM Haire, EL Alpen,  \"Radiation Research.\"  32, \"Partial shielding of dogs: effectiveness of small external epicondylar lead cuffs against lethal x-radiation.\" 54 (1967)","DOI":"10.2307\/3572306"},{"key":"2","doi-asserted-by":"crossref","unstructured":"J Down, A Boudewijn, R van Os, et al.  \"Blood.\"  86, \"Variations in radiation sensitivity and repair among different hematopoietic stem cell subsets following fractionated irradiation.\" 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\"Blood.\"  78, \"Recombinant human stem cell factor, a c-kit ligand, stimulates hematopoiesis in primates.\" (1991)","DOI":"10.1182\/blood.V78.8.1975.bloodjournal7881975"},{"key":"74","doi-asserted-by":"crossref","unstructured":"F Herodin, P Bourin, J-F Mayol, et al.  \"Blood.\"  101, \"Short-term injection of anti-apoptotic cytokine combinations soon after lethal \u03b3-irradiation promotes survival.\" (2003)","DOI":"10.1182\/blood-2002-06-1634"},{"key":"75","doi-asserted-by":"crossref","unstructured":"A Baranov, RP Gale, A Guskova, et al.  \"New England Journal of Medicine.\"  321, \"Bone marrow transplantation after the chernobyl nuclear accident.\" (1989)","DOI":"10.1056\/NEJM198907273210401"},{"key":"76","doi-asserted-by":"crossref","unstructured":"TM Fliedner, NJ Chao, JL Bader, et al.  \"Stem Cells (Dayton, Ohio).\"  27, \"Stem cells, multiorgan failure in radiation emergency medical preparedness: a U.S.\/European Consultation Workshop.\" 1205 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