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Le syndrome hématopoïétique induitpar une irradiation accidentelle : évaluation et traitements possibles

Published online by Cambridge University Press:  03 June 2006

J.-M. Bertho
J.-M. Bertho*
Affiliation:
IRSN, DRPH/SRBE, Laboratoire de thérapie cellulaire et de radioprotection accidentelle, 92262 Fontenay-aux-roses Cedex, France
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Abstract

Le syndrome hématopoïétique induit par une irradiation accidentelle reste difficile à traiter, essentiellement du fait de l’hétérogénéité de l’irradiation. La conséquence est qu’il y a toujours un territoire médullaire partiellement protégé de l’irradiation. Le choix d’une stratégie thérapeutique va dépendre essentiellement de l’évaluation des dommages radio-induits à la moelle osseuse, telle qu’elle peut être faite à partir de différents bio-indicateurs de dose ou de dommages comme le suivi de la concentration sanguine de Flt3 ligand. Les options thérapeutiques restent limitées à la greffe de cellules souches hématopoïétiques ou aux traitements de soutien. Récemment, de nouvelles approches de thérapie cellulaire autologue ont été proposées, et ont apporté un éclairage nouveau sur le syndrome de défaillance multi-viscérale radio-induit. D’autres résultats récents du laboratoire montrent que parmi les choix possibles, la stimulation de l’hématopoïèse résiduelle par l’injection de cytokines telles que le G-CSF reste l’une des options thérapeutiques les plus intéressantes. Ces donnés nouvelles soulignent l’importance de la notion d’hématopoïèse résiduelle, mais aussi le fait que les mécanismes de régulation de l’hématopoïèse résiduelle après irradiation restent mal connus.

Keywords

acute exposureradiation damagebone marrowbiological indicatortreatment
Type
Other
Information
Radioprotection , Volume 41 , Issue 2 , April 2006 , pp. 215 - 227
Copyright
© EDP Sciences, 2006

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