Multi-organ involvement: lessons from the experience of one victim of the Tokai-mura criticality accident

Abstract

Allogeneic placental umbilical cord blood cell transplantation after a short regimen of antithymocyte globulin followed by extensive use of various haematopoietic factors was performed urgently on demand to one of the victims of the JCO Co. Ltd criticality accident of Tokai-mura for the treatment of severe bone marrow failure. After forming a donor/recipient mixed chimera for a short period without causing graft-versus-host disease, the recipient's own haematopoietic cells recovered gradually toward 50 days after transplantation, as expected. However, the functions of the recovered autologous lymphocytes were observed to be severely impaired. After 210 days the patient died of severe opportunistic infections together with late onset non-haematological tissue damage. Our experience indicated that preservation of life without curing the radiation-induced irreversible lymphocyte damage and non-haematological tissue damage would not be possible even if severe transient bone marrow failure was overcome.