Exposure to acute, high-dose, high dose-rate whole-body ionizing radiations damages the bone marrow resulting in rapid decreases in concentrations of blood cells, especially lymphocytes, granulocytes and platelets with associated risks of infection and bleeding. In several experimental models including non-human primate radiation exposure models giving molecularly cloned haematopoietic growth factor including granulocyte/macrophage colony-stimulating factor (G/M-CSF; sargramostim) and granulocyte colony-stimulating factor (G-CSF; filgrastim and pegylated G-CSF [peg-filgrastim]) accelerates bone marrow recovery and increases survival. Based on these data these molecules are US FDA approved for treating victims of radiation and nuclear incidents, accident and events such as nuclear terrorism and are included in the US National Strategic Stockpile. We discuss the immediate medical response to these events including how to estimate radiation dose and uniformity and which interventions are appropriate in different radiation exposures settings. We also discuss similarities and differences between molecularly cloned haematopoietic growth factors.

暴露于急性、高剂量、高剂量率全身电离辐射会损害骨髓，导致血细胞浓度迅速降低，尤其是淋巴细胞、粒细胞和血小板，并伴有感染和出血风险。在几个实验模型中，包括非人灵长类动物辐射暴露模型，提供分子克隆造血生长因子，包括粒细胞/巨噬细胞集落刺激因子（G/M-CSF；沙格司亭）和粒细胞集落刺激因子（G-CSF；非格司亭和聚乙二醇化 G -CSF [peg-filgrastim]) 加速骨髓恢复并提高存活率。基于这些数据，这些分子被美国 FDA 批准用于治疗辐射和核事故、事故和事件（如核恐怖主义）的受害者，并被列入美国国家战略储备。我们讨论了对这些事件的即时医学反应，包括如何估计辐射剂量和均匀性以及哪些干预措施适用于不同的辐射暴露环境。我们还讨论了分子克隆造血生长因子之间的异同。