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First global consensus for evidence-based management of the hematopoietic syndrome resulting from exposure to ionizing radiation.

Publication ,  Journal Article
Dainiak, N; Gent, RN; Carr, Z; Schneider, R; Bader, J; Buglova, E; Chao, N; Coleman, CN; Ganser, A; Gorin, C; Hauer-Jensen, M; Huff, LA ...
Published in: Disaster Med Public Health Prep
October 2011

OBJECTIVE: Hematopoietic syndrome (HS) is a clinical diagnosis assigned to people who present with ≥ 1 new-onset cytopenias in the setting of acute radiation exposure. The World Health Organization convened a panel of experts to evaluate the evidence and develop recommendations for medical countermeasures for the management of HS in a hypothetical scenario involving the hospitalization of 100 to 200 individuals exposed to radiation. The objective of this consultancy was to develop recommendations for treatment of the HS based upon the quality of evidence. METHODS: English-language articles were identified in MEDLINE and PubMed. Reference lists of retrieved articles were distributed to panel members before the meeting and updated during the meeting. Published case series and case reports of individuals with HS, published randomized controlled trials of relevant interventions used to treat nonirradiated individuals, reports of studies in irradiated animals, and prior recommendations of subject matter experts were selected. Studies were extracted using the Grading of Recommendations Assessment Development and Evaluation (GRADE) system. In cases in which data were limited or incomplete, a narrative review of the observations was made. No randomized controlled trials of medical countermeasures have been completed for individuals with radiation-associated HS. The use of GRADE analysis of countermeasures for injury to hematopoietic tissue was restricted by the lack of comparator groups in humans. Reliance on data generated in nonirradiated humans and experimental animals was necessary. RESULTS: Based upon GRADE analysis and narrative review, a strong recommendation was made for the administration of granulocyte colony-stimulating factor or granulocyte macrophage colony-stimulating factor and a weak recommendation was made for the use of erythropoiesis-stimulating agents or hematopoietic stem cell transplantation. CONCLUSIONS: Assessment of therapeutic interventions for HS in humans exposed to nontherapeutic radiation is difficult because of the limits of the evidence.

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Published In

Disaster Med Public Health Prep

DOI

EISSN

1938-744X

Publication Date

October 2011

Volume

5

Issue

3

Start / End Page

202 / 212

Location

United States

Related Subject Headings

  • Strategic, Defence & Security Studies
  • Stem Cell Transplantation
  • Radiation, Ionizing
  • Humans
  • Granulocyte Colony-Stimulating Factor
  • Evidence-Based Medicine
  • Cytokines
  • Consensus
  • Acute Radiation Syndrome
  • 4206 Public health
 

Citation

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ICMJE
MLA
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Dainiak, N., Gent, R. N., Carr, Z., Schneider, R., Bader, J., Buglova, E., … Meineke, V. (2011). First global consensus for evidence-based management of the hematopoietic syndrome resulting from exposure to ionizing radiation. Disaster Med Public Health Prep, 5(3), 202–212. https://doi.org/10.1001/dmp.2011.68
Dainiak, Nicholas, Robert Nicolas Gent, Zhanat Carr, Rita Schneider, Judith Bader, Elena Buglova, Nelson Chao, et al. “First global consensus for evidence-based management of the hematopoietic syndrome resulting from exposure to ionizing radiation.Disaster Med Public Health Prep 5, no. 3 (October 2011): 202–12. https://doi.org/10.1001/dmp.2011.68.
Dainiak N, Gent RN, Carr Z, Schneider R, Bader J, Buglova E, et al. First global consensus for evidence-based management of the hematopoietic syndrome resulting from exposure to ionizing radiation. Disaster Med Public Health Prep. 2011 Oct;5(3):202–12.
Dainiak, Nicholas, et al. “First global consensus for evidence-based management of the hematopoietic syndrome resulting from exposure to ionizing radiation.Disaster Med Public Health Prep, vol. 5, no. 3, Oct. 2011, pp. 202–12. Pubmed, doi:10.1001/dmp.2011.68.
Dainiak N, Gent RN, Carr Z, Schneider R, Bader J, Buglova E, Chao N, Coleman CN, Ganser A, Gorin C, Hauer-Jensen M, Huff LA, Lillis-Hearne P, Maekawa K, Nemhauser J, Powles R, Schünemann H, Shapiro A, Stenke L, Valverde N, Weinstock D, White D, Albanese J, Meineke V. First global consensus for evidence-based management of the hematopoietic syndrome resulting from exposure to ionizing radiation. Disaster Med Public Health Prep. 2011 Oct;5(3):202–212.
Journal cover image

Published In

Disaster Med Public Health Prep

DOI

EISSN

1938-744X

Publication Date

October 2011

Volume

5

Issue

3

Start / End Page

202 / 212

Location

United States

Related Subject Headings

  • Strategic, Defence & Security Studies
  • Stem Cell Transplantation
  • Radiation, Ionizing
  • Humans
  • Granulocyte Colony-Stimulating Factor
  • Evidence-Based Medicine
  • Cytokines
  • Consensus
  • Acute Radiation Syndrome
  • 4206 Public health