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"In Chernobyl, you had a nuclear fire that at the first stage affected the technicians in the plant," noted Selidovkin. "But there was no cesium 137 introduced into their bodies. Here the irradiation was both incorporated and local." Leide das Neves Ferreira, 6, who had eaten a cesium-tainted sandwich, continued to emit 25 rads a day, even after repeated efforts at decontamination. At that rate, the radioactivity in her body was destroying her bone marrow before it could produce white blood cells.
As a result, the doctors decided to try an untested therapy on Leide and five other patients who were likely to die. With Gale's guidance, they attempted to revitalize the irradiated bone marrow. GM-CSF, or granulocyte- macrophage colony-stimulating factor, is one of at least five hormones that boost the production of white blood cells in the marrow. In cancer patients, CSFs seem to offset the deleterious effects of radiation and chemotherapy on the marrow, thus making larger doses safer to use. Gale wondered if the hormones would work the same magic on people who had been accidentally irradiated.
Using special equipment flown in from the U.S., the doctors injected GM-CSF into each patient's vena cava, the central vein that leads to the heart. Within 48 to 72 hours, the white blood cell count increased in five of the six patients, but Leide died before the treatment could be evaluated. Within a week four of the six patients had died, overwhelmed by pneumonia, blood poisoning and hemorrhaging. But the other two seem to be recovering. "I can't be certain that they would have died if they had not got the treatment," Gale says. "But they did respond."
The drama of the radioactive junkyard is far from over. Doctors will watch ! the survivors closely, particularly for signs of leukemia and skin cancer. The event may have other repercussions as well. Three Mile Island, Chernobyl and Goiania have all shown that nuclear accidents can happen. Doctors are confident that they can meet medical needs in small incidents. However, larger accidents require more technology and resources than any one country can provide. "It would be irresponsible not to take advantage of what we, the Soviets and the Brazilians have learned," says Gale. "We should pool that knowledge." Grim practice may not make perfect. But it could save lives the next time.