Development of Medical Technology for Contingency Response to Marrow Toxic Substance
Abstract
The bone marrow is the site where hematopoietic (blood-forming) stem cells reside and divide into the circulating blood cells, white cells that provide immunity and protection against infection, red cells that carry oxygen from the lungs throughout the body, and platelets that help to stop bleeding. An industrial accident, a military incident, a deliberate act, or a terrorist act in which a number of individuals are exposed to marrow toxic agents will result in injuries from mild to lethal.[1] But the extent of individualinjuries and the likelihood of recovery in many cases will not be apparent until days or weeks after the event. For example, acute radiation syndrome (ARS) is associated with hematopoietic toxicity at radiation levels greater than 1 Gray (100 rads). Causalities with major marrow injuries who will need aggressive medical support and ultimately could receive hematopoietic cell transplantation (HCT). NMDP operates the Radiation Injury Treatment Network (RITN). RITN wasformed collaboratively by the NMDP, American Society of Transplant and Cellular Therapy (ASTCT) and the Department of the Navy in 2006. RITN comprises a national network of medical centerswith expertise in the management of bone marrow failure and works with partners from other medical specialties to assist with managing ARS and its health-related consequences. Its mission is to maximize health-related outcomes among military and civilian casualties with ARS following a mass casualty disaster involving radiological, nuclear, or chemical agents with bone marrow toxicity.The NMDP World Headquarters (WHQ) orchestrates the selection and testing necessary to rapidly identify the best available donor or cord blood unit by utilizing its state-of-the-art communication infrastructure, sample repository, laboratory network, and human leukocyte antigen (HLA) expertise. NMDP promotes on-going immunobiologic, bioinformatics and clinical research activities to advance the science and technology ofHCT and directly translates research results to improve outcomes and quality of life for all patients, most notably for ethnically diverse patients as exemplified by the U.S. Warfighter population. The overall goal is to develop, test and maturethe ability of the NMDP WHQ and NMDP contracted network sites to address contingency events wherein civilian or military personnel are exposed to marrow toxic agents, primarily ionizing radiation or chemical weapons containing nitrogen mustard. As a result of prior efforts in this regard a solid foundation has been established. We hypothesize that the proposed specific aims will enhance and expand our capabilities to respond to a marrow toxic contingency event while advancing the science of cellular therapy and transplantto improve outcomes and access for all patients in need of a curative cellular therapy. We will test our central hypothesis and attain our objectives via the following specific aims:Aim 1: Develop and Maintain the Radiation Injury Treatment Network (RITN) to prepare for the care of patients resulting from a hematopoietic toxic eventAim 2: Development of Science and Technology for Rapid Identification of Matched DonorsThe significance of this proposal is for NMDP to continue critical investigation into optimizing unrelated donor HCT for all civilian and military persons in need through additional support by and continued partnership with the Office ofNaval Research since 1986.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Feb 24, 2025
- Source ID
- N000142512146
Entities
People
- Jeffery Auletta
Organizations
- National Marrow Donor Program
- Office of Naval Research
- United States Navy