The tragedy of nuclear hope ignored
The following letter, from Professor Norman Ende, M.D., to Major General P.K. Carlton M.D., (ret.), former Surgeon General of the U.S. Air Force, presents information world leaders, especially the Japanese, should act on immediately as a precautionary measure against mass radiation exposure and a means of treating anyone exposed to radiation levels high enough to cause Hematopoieitic Syndrome (‘radiation sickness’ characterized by the suppression of the bone marrow and loss of immune system functions).
Prof. Ende and General Carlton have tried in vain repeatedly to encourage U.S. agencies to adopt the emergency plan this letter discusses (details presented via links that follow). Likewise, their attempts to reach Japanese leaders during the present crisis have thus far failed to produce the aggressive response needed to safeguard human casualties should a high dose radiation catastrophe occur.
The time to prepare for such a catastrophe is now, before it occurs. Ende’s research reveals unique benefits of using antibiotics and cord blood to treat radiation victims whose level of exposure (between 2 to 10 grays) results in Hematopoietic Syndrome (bone marrow suppression and the loss of immune functions).
The existing medical paradigm for cord blood usage when used to reconstitute bone marrow (for blood-based cancers) holds that a key safety factor concerns “HLA matching.” Cord blood units (or bone marrow stem cells) that are too mismatched with recipients (regarding HLA antigens) can develop a dangerous condition known as “Graft versus Host Disease.” According to Ende, combining two or more (preferably three) HLA mis-matched units of cord blood (prior to administration) virtually eliminates the threat of Graft-vs-Host while speeding the return of immune system functions.
The only requirement regarding ‘matching’ concerns whether cord blood units match the recipient for major blood type.
The critical ‘win-win’ benefits this solution offers a mass casualty situation cannot be overstated. However, subtle details of Ende’s research and proposal must be understood beforehand and steps must be taken to have the needed pieces in place, or many who might be saved could die.
Dear General Carlton,
In case the military receives casualties from a nuclear explosion in Japan, we have just completed an experiment in mice with 10Gy gamma-irradiation. This was followed with antibiotics 4 hours after irradiation and the administration of human umbilical cord blood 24 hours after irradiation that resulted in 100% survival of the irradiated animals. In conclusion of this experiment there were several observations that could be made in treatments of mass casualties:
1) Victims suspected of high dose of irradiation and those known to have received high dose radiation, should receive antibiotics as soon as possible following the exposure (our recent unpublished data)
2) Irradiated patients receiving broad spectrum antibiotics would have at least 24 hours and probably longer before administering cord blood transfusion (our recent unpublished data). This allows a period of time for logistic necessary for the administration of cord blood.
3) Pooled human cord blood (blood type specific) in mice has a higher survival rate than single donor units and there is a direct relationship in mice survival with cell dosage (1, 2, recent unpublished data).
4) We would recommend radiation victims receive 3 units of cord blood (blood type specific).
5) Antibiotic therapy should be continued until intestinal lesions are healed (3).
1. Ende, N., Lu, S., Alcid, M., Chen, R., Mack, R. Pooled umbilical cord blood as a possible universal donor for marrow reconstitution and use in nuclear accidents. Life Sciences Vol 69, No. 13, 1531-1539, 2001.
2. Ende N, Lu S, Mack R, Ponzio NM: The feasibility of using blood bank stored (4ºC) cord blood, unmatched for HLA for marrow. Amer Jr of Clin Path: Vol.111, No.6, June 1999.
3. Azzam EI, Yang Z, Li M, Kim S, Kovalenko OA, Khorshidi M, Ende N. The effect of human cord blood therapy on the intestinal tract of lethally irradiated mice: possible use for mass casualties. Int J Radiat Biol. 2010 Jun; 86(6):467-75.
- Treatment of Mass Casualties Based on Hiroshima & Nagasaki
- Manhattan Nuclear Scenario
- Radiation Critical Care – 2005 report to U.S. Dept. of Defense