Potential for a pluripotent adult stem cell treatment for acute radiation sickness

Table 1 Approximate threshold doses of conventionally fractionated therapeutic radiation for clinically detrimental nonstochastic effects in various tissues

Organ	Injury at 5 yr	Threshold dose (sv)1	Irradiation field (area)
Fetus	Death	2	Whole
Bone marrow	Hypoplasia	2	Whole
Ovary	Permanent sterility	2-3	Whole
Lens	Cataract	5	Whole
Testes	Permanent sterility	5-15	Whole
Cartilage, child	Arrested growth	10	Whole
Breast, child	Hypoplasia	10	5 cm2
Bone, child	Arrested growth	20	10 cm2
Bone marrow	Hypoplasia, fibrosis	20	Localized
Muscle, child	Hypoplasia	20-30	Whole
Kidney	Nephrosclerosis	23	Whole
Lymph nodes	Atrophy	33-45	-
Liver	Liver failure, ascites	35	Whole
Lung	Pneumonitis, fibrosis	40	Lobe
Heart	Pericarditis, pancarditis	40	Whole
Stomach, small intestine, colon	Ulcer, perforation	45	100 cm2
Thyroid	Hypothyroidism	45	Whole
Pituitary	Hypopituitarism	45	Whole
Lymphatics	Sclerosis	50	-
Central nervous system (brain)	Necrosis	50	Whole
Spinal cord	Necrosis, transection	50	5 cm2
Salivary glands	Xerostomia	50	50 cm2
Cornea	Keratitis	50	Whole
Capillaries	Telangiectasis, fibrosis	50-60	-
Breast, adult	Atrophy, necrosis	> 50	Whole
Rectum	Ulcer, stricture	55	100 cm2
Skin	Ulcer, severe fibrosis	55	100 cm2
Eye	Panophthalmitis, hemorrhage	55	Whole
Oral mucosa	Ulcer, severe fibrosis	60	50 cm2
Esophagus	Ulcer, stricture	60	75 cm2
Cartilage, adult	Necrosis	60	Whole
Urinary bladder	Ulcer, contracture	60	Whole
Bone, adult	Necrosis, fracture	60	10 cm2
Ear (inner)	Deafness	> 60	Whole
Adrenal	Hypoadrenalism	> 60	Whole
Vagina	Ulcer, fistula	90	5 cm
Muscle, adult	Atrophy	> 100	Whole
Uterus	Necrosis, perforation	> 100	Whole

¹Dose causing effect in 1% to 5% of exposed persons. Modified from[49,50].

Table 2 Symptoms, therapy and prognosis of whole body ionizing radiation injury

	0-1 Sv	1-2 Sv	2-6 Sv	6-10 Sv	10-20 Sv	> 50 Sv
Therapeutic needs	None	Observation	Specific treatment	Possible treatment	Palliative	Palliative
Vomiting	None	5%-50%	> 3 Gy, 100%	100%	100%	100%
Time to nausea, vomiting	-	3 h	2 h	1 h	30 min	< 30 min
Main locus of injury	None	Lymphocytes	Bone marrow	Bone marrow	Small bowel	Brain
Symptoms and signs	-	Moderate leukopenia, epilation	Leukopenia, hemorrhage, epilation	Leukopenia, hemorrhage, epilation	Diarrhea, fever, electrolyte imbalance	Ataxia, coma, convulsions
Critical period	-	-	4-6 wk	4-6 wk	5-14 d	1-4 h
Therapy	Re-assurance	Observation	Transfusion of granulocytes, platelets	Transfusion, antibiotics, bone marrow transplantation	Fluids and salts, possible bone marrow transplantation	Palliative
Prognosis	Excellent	Excellent	Guarded	Guarded	Poor	Hopeless
Lethality	None	None	0%–80%	80%-100%	100%	100%
Time of death	-	-	2 mo	1-2 mo	2 wk	1-2 d
Cause of death	-	-	Infection, hemorrhage	Hemorrhage, infection, pneumonitis	Enteritis, infection	Cerebral edema

Modified from[51].