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Radiation Injury Treatment Network

As part of the C.W. Bill Young Cell Transplantation Program (Program), contractors must have an emergency response process. Additionally, the Program has created a specialized group, the Radiation Injury Treatment Network® (RITN). The RITN was developed to respond to a potential disaster resulting in mass casualties with marrow toxic injuries from ionizing radiation exposure or other hazardous material (such as sulfur mustard). The marrow creates new blood-forming cells each and every day. If the marrow is injured and cannot do this, a person may need a bone marrow or umbilical cord blood transplant. Many of the casualties with radiation injury will be salvageable but require outpatient and/or inpatient care.

Recognizing this, the US National Marrow Donor Program® (NMDP), US Navy and American Society for Blood and Marrow TransplantationTM (ASBMT) collaboratively developed RITN, which comprises of medical centers with expertise in the management of bone marrow failure, stem cell donor centers and umbilical cord blood banks across the US.

The RITN goals include:

  • Developing treatment guidelines for managing hematologic toxicity among victims of radiation exposure
  • Educating health care professionals about pertinent aspects of radiation exposure management
  • Providing capacity data for the coordination of the medical response to radiation events
  • Providing comprehensive evaluation and treatment for victims of radiation exposure or other marrow toxic injuries at participating centers

After a marrow toxic incident resulting in mass casualties, RITN centers may be asked to:

  • Accept casualties from a distant incident
  • Provide supportive care for casualties with marrow toxic injuries
  • Provide treatment expertise to practitioners caring for casualties at other locations
  • Collect data on casualties treated at their treatment facility
  • Facilitate marrow transplantation for the small percentage  of casualties who require hematopoietic cell transplantation

RITN Training

The RITN has identified and provided training information to its network of transplant centers, donor centers, and cord blood banks. All other Program centers and banks are informed about the RITN and may be asked to help during an emergency that exceeds the response capabilities of the RITN.

Each facility incorporates the RITN Acute Radiation Syndrome treatment guidelines. Each RITN center participates in an annual situational tabletop exercise (a scenario-based discussion of the response process) to assess and improve plans, procedures, and staff response.

RITN Center Locations

Centers are dispersed throughout the United States; some are pediatric treatment centers.

How RITN was Developed

The RITN was developed through the cooperative efforts of the National Marrow Donor Program (NMDP) and the American Society for Blood and Marrow Transplantation (ASBMT). The NMDP and ASBMT collaborated with:

  • Department of Defense, Office of Naval Research
  • Health Resources and Services Administration
  • Center for International Blood and Marrow Transplant Research® (CIBMTR)
  • Comprehensive Cancer Centers designated by the National Cancer Institute
  • National Library of Medicine-Radiation Emergency Medical Management
  • U.S. Department of Energy National Nuclear Security Administration,  Radiation Emergency Assistance Center/Training Site
  • Office of Preparedness and Emergency Operations, Office of Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services
  • AABB (formerly the American Association of Blood Banks) Interorganizational Task Force on Domestic Disasters and Acts of Terrorism
  • Radiation Emergency Medical Management website organized by the National Library of Medicine
  • National Association of County and City Health Officials (NACCHO)
  • Association of State and Territorial Health Officials (ASTHO)
  • National Alliance for Radiation Readiness (NARR) managed by ASTHO and funded by the CDC
  • World Health Organization/Radiation Emergency Medical Preparedness and Assistance Network (REMPAN)
  • The European Group for Blood & Marrow Transplantation Nuclear Accident Sub-Committee
  • New England Center for Emergency Preparedness (NECEP)
  • Physicians at the forefront of bone marrow and cord blood transplantation