367. Stem Cells. 1997;15 Suppl 2:263-8.
Therapy of radiation injury.
MacVittie TJ(1).
Author information:
(1)University of Maryland Cancer Center, Baltimore, USA.
It is apparent from preclinical and clinical research to date that continued
evaluation of new and alternative treatment strategies is required to eliminate
the obligate periods of neutropenia and thrombocytopenia after acute high-dose
irradiation. Future treatment strategies may involve new combinations of
cytokines to affect hematopoietic stem cell proliferation and "engineered"
cellular grafts to provide short-term in vivo expansion of neutrophils and
platelets in an effort to bridge the cytopenic gap until endogenous or
transplanted stem cells regenerate the hematopoietic and immune systems.
Cytokine-mobilized peripheral blood and cord blood will provide alternative
sources of allogeneic stem and progenitor cells in support of primary
engraftment, delayed engraftment or secondary failure of the initial graft, as
well as starting populations for various ex vivo expansion protocols. Further
insights into the relative quality of stem cell populations and the factors that
regulate their survival and self renewal, and the identification and roles of
adhesion molecules in stem cell mobilization, engraftment, and interaction with
the adult marrow microenvironment will provide the basis for future treatment
strategies for the radiation-induced hematopoietic syndrome. As our ability to
treat the hematopoietic syndrome improves, damage to other organ systems such as
the skin, lung, and/or gastrointestinal tissue will emerge as dose-limiting. At
the same time, the characterization of receptors for inflammatory cytokines,
cytokine receptor antagonists, and anti-endotoxin antibodies has allowed
significant insights into the mechanisms and pathogenesis of sepsis. However,
translation of this knowledge into a treatment modality for septic patients is
precluded by the lack of any clear-cut beneficial effect from the many clinical
trials. The research and clinical results presented in this volume and recent
conferences reflect the body of knowledge that will lead to further developments
in assessment, prophylaxis, and treatment of radiation injuries in the areas of
infectious disease and the hematopoietic, gastrointestinal, and cutaneous
syndromes.
PMID: 9368312 [PubMed - indexed for MEDLINE]