Innovative approaches in the diagnosis and treatment of acute radiation syndrome. Advanced diagnostic techniques and therapeutic strategies for managing hematopoietic acute radiation syndrome following high-dose exposure

Medical Review (Med. pregled), 2025, 61(2), 18-25.

G. Racheva

Research Laboratory of Radiation protection and Radiobiology, Military Medical Academy – Sofia

Abstract. The aim of the review is to summarize the scientific knowledge, innovative diagnostic methods and medical therapeutic approaches of Acute Radiation Syndrome (ARS), and in particular of Hematopoietic Acute Radiation Syndrome (H-ARS). It is necessary to emphasize that the evaluation of the potential risk for the development of ARS includes a complex consideration of the type of irradiation, determination of the radiation dose (threshold dose for the development of ARS is ≥ 1 Gy) and what parts of the body are affected (whole body or partially irradiation). On the basis of the obtained assessment, radiobiology specialist physicians create an optimized individual treatment scheme. The paper describes in detail the newest directions in the diagnosis of ARS (biodosimetry) and the therapy of H-ARS, summarized on the basis of studies, literature data and laboratory/clinical experience. The current work focuses on the biodosimetry methods applicable in Bulgaria and on the scientific studies of potential effective therapeutic agents for the treatment of H-ARS, which gradually enter in the contemporary clinical practice.

Key words: biomarkers, therapeutic agents for the treatment of Acute radiation syndrome and Hematopoietic acute radiation syndrome, antibiotics, colony-stimulating factors, cytokines, metabolites of the renin-angiotensin-aldosterone system

Address for correspondence: Galina Petrova Racheva, MD, PhD, Research Laboratory of Radiation Protection and Radiobiology, Military Medical Academy, 3 “Sv. Georgi Sofiyski” Str., 1606 Sofia, Bulgaria, e-mail: