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274 Radium
or four to five weeks or until the blood findings were similar to those
observed prior to irradiation."
"Si'Mmarv. A study has been made of ihe blood of 42 cases, chiefly
of cancer before and after 56 roentgen-ray irradiation treatments. Particular
attention was given to the observations on 22 of the patients given
36 intensive short wave length treatments. The other irradiations were
milder. Cases of disease of the hemopoietic tissue are not included and
the statements below require modification when applied to such conditions."
"The most important effect of customary therapeutic doses of
irradiation on the blood elements is to decrease the number of while cells,
especially lymphocytes, so that leukopenia and lymphopenia may occur.
Preceding the decrease in the white count a transient increase develops.
due to increment of polymorphonuclear neutrophiles. Very small doses
of irradiation may permit a lymphocytosis.
"When a customary iherapeutic dose of short wave length roentgenrays
is given, it causes the white count to reach its lowest point about
six days later; at that time leukopenia (a count below 5000 per cu.mm.)
is more often present than not. A decrease below normal of the absolute
numbers of bone-marrow white cells, which is indicative of marrow
depression, is not unusual. Leukopenia lasts on the average about
nine days, but may persist for over four weeks, liven if the white count
remains above 5000 per cu-mm., the white count often does not return
to its pretreatment level for a momh. If treatment is given again before
the number of cells have remained for some time at their original level.
leukopenia of a greater degree and duration is produced than after the first
treatment.
"The fall in the lymphocytes is greatest in the firsttwenty-four hours.
but they continue to drop for about three days. These cells rise with the
white count, but do so proportionately more slowly. Subsequent treatments
may keep the lymphocytes fewer in proportion to the white count
than fo'lovving the firstirradiation."
"The new short-wave-length roentgen-ray therapy, suitably given.
produces no changes in the blood that are of a different character from
from those occuring afier milder yet intensive irradiation. However, it
does produce more rapid, marked and persistent changes than milder
treatment, and if the treatment consists of merely moderate long-wave
exposures it may not even cause a decrease of white cells."
"An eosinophilia. of often 7 and as high as 23 per cent, is usual two
to three weeks after short-wave-length irradiation. It appears to develop
particularly following repeated exposures."
"After irradiation the blood contains many degenerated white cells.
especially in the firstthree days. There is scant mention in the literature
of this feature of the blood in man. larger doses produce greater
numbers of these cells than smaller doses. After short-wave-length
therapeutic irradiations the degenerated cells often amount 10 25 per
100 formed white cells."
"Some increase of immature white cells may be observed, especially
at about the time the white count begins to rise, after large doses of irradiation."
"A slight increase of the platelets soon after irradiation is common.
They are depressed less readily than the white cells, but following the
transient rise they are often found slightly decreased and rarely markedly.
Combined with leukopenia they may be an indication of greater marrow