ee EY aeB cee ale sie eaSE

7.

Granulocyte transfusions would be desiratle to prevent intection

in patients with a sranulocyte count falling below 2OU/ul.
these are not practical on any

5.

large

infection in
dBacterial

or

fever

flora,

Since

therapy even

4

In>

is an

arr

a

ne

og

-

than 24 hours

\ —

.4

The onset ot

have b

ane

techni

‘

ORR

sensitivities

and 3

:

»

wee

therapy should

obtained.

If

cultures

are

negative

or fever

ery thropote
Macrophages
produce

eee
e

persists,

=

antibiotic

therapy,

Pon

upon

After initiation of broad-“spectrum?

it should be continued until

washed packed

red

blood cells should be given as

indicated

functional é
colony-stimy

to kee.

&fanuloc

the hemoglobin above 3.5 g.
10.

All bleod products

infusion into

the patient in order

proliferate and

\1,

should be

linpair

the possibility

be within

of a bone marrow

uncertainty about

inhomogeneity of
the

limits of

Suppressed ana
therapy.

the dose,

rescue of

approximately 3800-2000 rad.

bone

below 800 rad

transplants are rejected.

From

the

and

twin

transfusion of
abuve as an
from

.

transplant.

is

bone marrow tror his

indication

for

the earlier discussion

experimental

the

ot

conditions

where

uniform wnele “ody distribution of

icentified.

Although radiation dose

oe

oe.by radtatio
n ,
a0

ne (51-54),

transplantation,

the
was

the

depth-dose curves sea

Jjuses

used above were

delivered

ie

in a

absorpec enerpy.

Aare

power,

wees

Wout

a

pee
Segate

-108-

IG |
ay
™ Me

OBETARTareaoe BE ALSSOLE

eeBay

befo

ene ae
has been sive !
et

A genectthe al

twin.

radiation

mouse

-5

Above roughly 2000 rad theseas

irradiation casualty exPoy

certainty anc

the

hours

immunity 15 not sufticient

that doses anc

yy.

requirement that

In ome

bone marrow

7es

ytes

hours prior ;

in

the

lymphocy tes collectea promptly, ‘the casualty w.

the ideal donor.

snown with any degree

the magnitude of

(50-55).

48

marrow transplantation,

have beef HLA-typed and donors will have been
identical

that might
ag

tadilation dose,

no

lymphocytes

bone marrow transplantation will ouly rarely be indicated

irradiation casualty because

dose

&Tanuloc

irradiated with 2U0U rad before

to kill

ji
vive

Production ¢

the granulocyte count

rises above 500/Ll, fever subsides, and eviagence of infection disappears,ag
.
G9,

gta

accelerates

Ss

or with amphotericin may be considered.

£ra

colony-set,

the most likely agent is an organtsm trom nornal bowel

that are

een

niques

indicattoq ~229

tnough cultures are

ema

ad

include aminoglycoside and carbenicillin with <te::
oS
additional antibiotics being adued as indicated by bacterial culture

m Pj

initial

'

Fever with clinical signs of

sustained more

initiating systemic antibacterial

negative.

Aamittedly,

than 38°C should aruuSe strong suspiciun of

the aranulopenic patient.

infection,

a

scale,

Infection is the zreatest threut to life.

signiticant fever greater

for

ere

=o an

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