Experts suggest Fukushima clean-up workers store blood cells for future use

By Dr. Ananya Mandal, MDApr 15 2011

As Japan still reels with the after effects of the March 11 earthquake, tsunami and subsequent radiation exposure, plant workers are working to control the radiation leakage from the Fukushima Daiichi complex. Experts note that the work there will take years, posing a risk of accidental exposure.

This radiation they say can destroy the blood-making cells of the bone marrow, a potentially fatal outcome that can be treated with transplants of blood stem cells. Such transplants are standard therapy now for blood diseases like leukaemia. Getting those cells from a donor takes time, and potential incompatibility between the donated cells and the recipient can lead to severe complications, the experts explain. At present they suggest that the plant's workers have their own blood stem cells banked now. That involves getting injections for several days to get stem cells from the marrow to enter the bloodstream. Then blood would be drawn from one arm, processed to extract the stem cells, and returned into the other arm. That takes several hours.

Once the stem cells were stored, any workers who later got accidentally exposed to a large radiation dose could get infusions of their own cells. This comes after discussions of experts from institutions including Toranomon Hospital and the Japanese Foundation for Cancer Research in Tokyo. The idea is published in a letter online Thursday by the journal Lancet.

“Such an approach would be the industry’s best defense” in the event of a major accident, Tanimoto and colleagues said. “The most important mission is to save the nuclear workers’ lives and to protect local communities.”

The reaction to this idea has been mixed. Some medical groups have supported it, while other experts have said it would pose an undue physical and psychological burden on nuclear workers, they wrote. In any case, some transplant teams are ready to collect and store the cells, they said. According to a U.S. stem cell transplant expert said the idea might have some limited use. Dr. Nelson Chao of Duke University said the proposal would be reasonable for workers who enter high-radiation zones to clean up the nuclear complex. He added that it would be of limited usefulness to workers who end up getting radiation doses within a rather narrow range. If they get less than that, they'll recover anyway. If they get more, they'd also sustain lethal and untreatable damage to the gut and other organs including the lung. Stem cell transplants could not help with that, he explained.

About 107 transplant teams are standing by to handle the cells, the scientists wrote, citing a March 29 statement from the Japanese Society for Haematopoietic Cell Transplantation. More than 50 hospitals in Europe have agreed to assist if needed, Tanimoto and colleagues wrote.

“The danger of a future accidental radiation exposure is not passed,” the Japanese researchers warned in The Lancet.