Marrow Donors Save Radiation Victims

Press, Volume CVI, Issue 31084, 13 June 1966, Page 9

Marrow Donors Save Radiation Victims

(N Z.P.A.-Reuter) PARIS. France is developing the Curie Foundation in Paris as the leading European centre for the treatment of “Atomic Diseases.” The foundation has already saved the lives of five Jugoslav and one Belgian nuclear scientists and workers who had received near-fatal doses of irradiation. It has also treated a number of minor cases involving French and European workers.

As Europe moves fast into the nuclear field with atomic research centres and nuclear power plants being built in many parts of the Continent, there is increasing potential danger of radiation accidents. Few cities in Europe can provide adequate medical treatment.

The Curie Foundation, named after Pierre Curie, the French discoverer of radium, is assembling all the multiple requirements needed to deal with the victims of nuclear energy accidents. Dr. Jean Courtial, head of the foundation, says that the scientific and clinical importance of bone marrow grafting is very great. He gave full credit to the team of French doctors and research workers who undertook the first successful grafting in 1958. The attempt, he said, was made possible by the gesture of volunteer marrow donors who underwent a surgical operation in order to save the lives of some unknown persons. But the dangers from accidents are all the more fearful in that medicine does not yet know fully how to ward them off.

Complex tests are made to measure the degree of irradiation. The bombing of Hiroshima, the few nuclear reactor accidents in various parts of the world, and experiments on animals, have shown that the medical prognosis depends closely upon the degree of irradiation. Thus, 20 per cent of the cases in which irradiation amounts to 300 roentgens (unit of exposure to X-rays) ar- fatal. When the number of roentgens rises to 400 and 600, the mortality figures are 50 per cent and 100 per cent respectively. The first clinical signs of acute irradiation are fever, loss of weight, generalised depilation, digestive disorders, disturbance in the blood cells and hemorrhage. Death, which is so far regarded as the inevitable con-

sequence of certain heavy irradiations, is frequently the result of the damage done to the digestive mucosae, which, ceasing to perform their normal role as barriers, allow infectious germs to enter the organism.

The Curie Foundation medical team is led by Dr. Henri Jammet, head of the radioisotope department, who was in over-all charge of the Jugoslav nuclear scientists. It includes Professor Georges Mathe, a leukaemia specialist and promoter of the method of bone marrow grafting which saved them, and Dr. Jean Duplan of the Pasteur Institute, who actually did the grafting.

The foundation also boasts some of the world’s most modern equipment including a spectro-photometer which can trace and measure the minutest dose <rf irradiation, so essential for the medical prognosis.

A Belgian nuclear technician, Mr F. Jansen, is making good progress at the Curie Foundation after undergoing treatment for radiation burns and sickness suffered on New Year’s eve. Mr Jansen, aged 30, who worked at the Belgian nuclear research centre at Mol, near Antwerp, picked up the wrong rod. He received a heavy dose of irradiation in the left foot and leg, and was flown to Paris by helicopter. The other parts of his body were considerably less affected. The doctors in Paris decided against bone marrow grafting which involves dangers of general infection known as “secondary disease.” Instead, they treated him with gamma and beta rays. There were anxious moments. Mr Jansen at one time developed complications. But the parts of his body which escaped injury, his face, chest and back, were able to 'regenerate white cells and within a few weeks restored the necessary quantity of white cells per cubic millimetre. There is still concern over his leg, but his life has been saved. He lives in a sterilised tent and is allowed to read the newspapers. But these, like his food and everything else, are sterilised before reaching him. In the case of the Jugoslav scientists, the intensity of the irradiation was such that they had lost the ability to synthesise the anti-bodies which are as necessary to the fight against infection as to the destruction of a foreign inclusion, or graft.

This fact, added to the aggravation of their condition, determined the action of the doctors who were treating them. Three weeks had elapsed when an appeal was launched to “marrow donors” who had registered a year

previously as volunteers with the French national blood transfusion centre, at the request of an employee of the French electricity company whose child was dying of leukaemia.

A thick liquid containing 10,000 to 15,000 million medullary cells were injected into the venous system of two of the Jugoslav scientists. One of them, the most seriously affected, had only 15 white blood cells in his entire organism at the time of the injection. The normal count is 4000 per cubic millimetre. Three days after this first grafting, the blood, of the Jugoslavs became practically normal. This showed that the injected marrow cells had lodged in the irradiated bones and had replaced the destroyed substance. As one of the Curie doctors put it two, Jugoslav scientists were “manufacturing” French blood.

One of them, Vranic, died five days later as the result of a serious haemorrhage. He had received more than three times the fatal dose of radiation, and was much admired by all the French doctors and nurses who treated him, both for his courage and for the tragic lucidity with which he endured for almost a month the death struggle of which he was fully conscious. The condition of his colleague, Masic, improved so much, on the other hand, that it was decided to perform the same operation on the other victims.

They were all saved. As a mark of gratitude, the Jugoslav Nuclear Energy CommLsion invited the Frenchmen who contributed marrow for their scientists to spend a month’s holiday in Jugoslavia. The Mol accident brings the total to eight. The others were: four at Los Alamos (U.S.A.) in 1945, 1946, and 1958 (16 victims); one at Argonne (France) in 1952 (four victims); one at Oak Ridge (U.S.A.) in 1958 (eight victims); and the one at Vinca (Jugoslavia) in 1958. Dr. Courtial said there was so great a disproportion between the number of victims of a bombed city such as Hiroshima and the local hospital and medical facilities that a cruel therapeutic choice must be foreseen for the future.

This choice is based chiefly on the nation of the “victim’s chance of survival” and the Franco-Jugoslav experience provided important information in this field. The Curie Foundation Is also keeping in close touch with all nuclear medical centres in the world, particularly with the Memorial Hospital in New York, the Anderson Hospital in Houston, Texas and the Royal Marsden Hospital in London.