CLINICAL AND HEMATOLOGICAL ASPECTS OF CS-137 - THE GOIANIA RADIATION ACCIDENT

Fifty persons involved in the Cs-137 accident in Goiania showed symptoms of whole-body and local acute irradiation and also external or internal contamination mainly due to ingestion or absorption of Cs-137. Fourteen of the 50 developed severe bone marrow depression characterized by neutropenia and thrombocytopenia. Eight of these 14 received GM-CSF intravenously. None were submitted to bone marrow transplantation. Four of the 14 died due to hemorrhage and infection. For those with significant internal contamination evaluated by in-vitro and in-vivo assays, Prussian Blue was administered with doses ranging from 1.5 to 10 g d-1. Besides Prussian Blue, other measures were taken to increase decorporation of Cs-137, including administration of diuretics, water overload, and ergometric exercises. From 50 to 100 persons are being followed in a medical protocol.