Treatment consensus guidance based on a threshold whole-body or significant partial body radiation exposure.
| . | Proposed Range for Cytokines (Gy) . | Proposed Range for Antibiotics and Other Supportive Care (Gy) . | Proposed Range for Referral for SCT Consideration . |
|---|---|---|---|
| * Prophylactic antibiotics to include a fluroquinolone, acyclovir, and fluconazole when ANC < 500 and continued until neutrophil recovery. Follow Infectious Diseases Society of America (IDSA) guidelines for febrile neutropenia if fever develops while on prophylaxis.13 | |||
| § Would consider initiating at 2 Gy in non-adolescent children and the elderly. Recommend initiation of granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) in those patients who develop an ANC < 500 and not already receiving a colony stimulating factor. | |||
| ¥ If resources are available. | |||
| Small Volume of Casualties (Radiation Accident or RDD) = 100 Casualties | |||
| Healthy Individual, no other injuries | 3–10§ | 2–10* | 7–10 |
| 4–10 if previous autograft stored or syngeneic donor available | |||
| Multiple injuries or burns | 2–6§ | 2–6* | N/A |
| Mass Casualty Scenario (IND) > 100 Casualties | |||
| Healthy Individual, no other injuries | 3–7§ | 2–7¥ | 7–10 (if resources allow) |
| 4–10 if previous autograft stored or syngeneic donor available | |||
| Multiple injuries or burns | 2–6¥ | 2–6¥ | N/A |
| . | Proposed Range for Cytokines (Gy) . | Proposed Range for Antibiotics and Other Supportive Care (Gy) . | Proposed Range for Referral for SCT Consideration . |
|---|---|---|---|
| * Prophylactic antibiotics to include a fluroquinolone, acyclovir, and fluconazole when ANC < 500 and continued until neutrophil recovery. Follow Infectious Diseases Society of America (IDSA) guidelines for febrile neutropenia if fever develops while on prophylaxis.13 | |||
| § Would consider initiating at 2 Gy in non-adolescent children and the elderly. Recommend initiation of granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) in those patients who develop an ANC < 500 and not already receiving a colony stimulating factor. | |||
| ¥ If resources are available. | |||
| Small Volume of Casualties (Radiation Accident or RDD) = 100 Casualties | |||
| Healthy Individual, no other injuries | 3–10§ | 2–10* | 7–10 |
| 4–10 if previous autograft stored or syngeneic donor available | |||
| Multiple injuries or burns | 2–6§ | 2–6* | N/A |
| Mass Casualty Scenario (IND) > 100 Casualties | |||
| Healthy Individual, no other injuries | 3–7§ | 2–7¥ | 7–10 (if resources allow) |
| 4–10 if previous autograft stored or syngeneic donor available | |||
| Multiple injuries or burns | 2–6¥ | 2–6¥ | N/A |