The Medical Research Center
Brookhaven National Laboratory
AQ LQ22
Upton, L. L, New York
Early and Late Cytologic Effects of Whole
Body Irradiation on Human Marrow
By T. M. Fuiepner, Goutp A. ANDREWs, EuGENE P. CRONKITE
AND Victor P. Bonp
HE HEMATOLOGIC manifestations of whole body irradiation in man
have been studied extensively.!}? These studies have been based on ex-
posures in nuclear warfare,'* on accidents in laboratories or fallout field,?°
and on large volume radiation therapy. They have been reviewed in detail recently.!8 Serial examinations of blood cell levels (neutrophilic granulo-
cytes, lymphocytes, platelets and reticulocytes) have been found to be an
indispensable aid in the clinical assessment of the exposed individual. In most
of the surviving persons, blood cell counts returned to approximately preirradiation levels within a few months, although someslight but statistically
significant changes are seen to persist for years when adequate control data
are available. Furthermore, despite apparent recovery, chromosomal ab-
normalities persist in hemopoietic cells, as demonstrated by blood cell cultures
or bone marrow examination,"*suggesting a persisting latent injury.
In most of these studies, bone marrow examinations have not been per-
formed or have not been reported in detail. Their value in the evaluation of
the exposed person has not been clearly established and it has even been
suggested that they are dangerous because of the possibility of introducing
infection.
Little is known about bone marrow changes in man after whole body ir-
radiation as a function of time and dose. However, extensive studies in ex-
perimental animals have shown characteristic cytologic and histologic consequences during the first hours and days after exposure.'™*! Since the marrow
is one of the most radiosensitive organs of the body, serial examinations after
radiation exposure should provide valuable additional information both for
clinical management and for a better understanding of the pathogenesis of
marrow failure secondary to ionizing radiation. Samples can be obtained with
ease and repeatedly, and the danger of infections is small. (They apparently
have not been reported?*).
It is the purpose of this paper to describe some of the cytologic manifesta-
tions of radiation injury in marrow smears of eight men “early” (during the
first 2-3 weeks) and “late” (3.5 years) after accidental exposure to mixed
neutron-gammairradiation. From these results, some guidelines can be derived
for a diagnostically more meaningful evaluation of marrow smears under such
circumstances. Details about the accident, the general hematologic findings
From the Medical Research Center, Brookhaven Nationa? Laboratory, Upton, N. Y.,
and Medical Division, Oak Ridge Institute of Nuclear Studies, Oak Ridge, Tenn.
Research supported by the U. S. Atomic Energy Commission and presented in part at
the IX Congress of the International Society of Hematology, Mexico, September 1962.
Submitted July 25, 1963; accepted for publication Sept. 17, 1963.
47)
REPOSITORY
BN2.
RECORDS
COLLECTION ZARSHALL
BOX No. MEDIAL DEPT,
FOLDER ~2276 - 698
Bioop, Vou. 23, No. 4 (Apri), 1964
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