Fractionated total body irradiation and bone marrow transplantation in acute lymphoblastic leukemia

Altschuler, C; Resbeut, M.; Blaise, Didier; Maraninchi, D; Stoppa, A. M.; Lagrange, Jean‐Léon; Guillet, J G; Carcassonne, Y

doi:10.1016/0360-3016(90)90220-e

Cited by 15 publications

(13 citation statements)

References 7 publications

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“…Marks et al 42 1521 ALL Demonstrated higher relapse but similar age-adjusted survival in ALL patients treated with RIC vs myeloablative regimens. 8,21,22 As described earlier, these regimens were associated with high risk of death from interstitial pneumonitis. 12,24 Both fractionation and reduction in dose rate were subsequently shown to potentially reduce this risk [24][25][26][27][28] (Table 1).…”

mentioning

confidence: 65%

“…The first uses of TBI were with the intent of eradicating diseased marrow and/or reducing tumor burden. 8,21,22 This is still a common goal of TBI in both the allogeneic and autologous settings. After the myeloablative role of TBI had been established, several groups recognized the potential of TBI as an immunosuppressive.…”

Section: Goals Of Tbimentioning

confidence: 99%

“…25,29,30 Other groups have shown that delivery of TBI in daily or twice-daily fractions appears to improve the therapeutic ratio, allowing higher radiation doses to be delivered safely. 21,29,31,32 These data support use of both reduced dose-rate and fractionated TBI; however, these benefits may be offset by decreased convenience-low-dose rate treatment regimens may require up to 30 min per fraction to deliver, and twice-daily fractions may be inconvenient for both patients and treatment centers. These logistic issues may discourage some practitioners from using TBI as part of BMT regimens, and further work with regard to convenient delivery of TBI in the modern era of expansive supportive care (for example, modern anti-emetics) to further understanding of maximum tolerated dose and dose-rate is warranted.…”

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confidence: 96%

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TBI during BM and SCT: review of the past, discussion of the present and consideration of future directions

Hill‐Kayser

Plastaras

Tochner

et al. 2010

Bone Marrow Transplant

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TBI has been used widely in the setting of BMT over the past 3 decades. Early research demonstrated feasibility and efficacy in the myeloablative setting, in preparation first for allogenic BMT and later for autologous stem cell rescue. As experience with TBI increased, its dual roles of myeloablation and immunosuppression came to be recognized. Toxicity associated with myeloablative TBI remains significant, and this treatment is generally reserved for younger patients with excellent performance status. Reduced intensity conditioning regimens may be useful to provide immunosuppression for patients who are not candidates for myeloablative treatment. Efforts to reduce toxicity through protection of normal tissue using methods of normal tissue blocking and use of TLI, rather than TBI, continue. In the future, modalities such as helical tomotherapy, proton radiotherapy and radioimmunotherapy, may have roles in delivery of radiation to the BM and lymphoid structures with reduced normal tissue toxicity. With further investigation, these efforts may expand the therapeutic ratio associated with TBI, allowing safer delivery to a broader range of patients.

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confidence: 65%

Section: Goals Of Tbimentioning

confidence: 99%

mentioning

confidence: 96%

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TBI during BM and SCT: review of the past, discussion of the present and consideration of future directions

Hill‐Kayser

Plastaras

Tochner

et al. 2010

Bone Marrow Transplant

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“…[67][68][69] After TBI was established as a myeloablative agent in the setting of autologous and allogeneic transplantation, several groups also recognized its potential role as an immunosuppressive agent. 70 TBI can be employed as an immunosuppressant, facilitating engraftment of donor cells and allowing for an immunotherapeutic effect of donor cells against ALL.…”

Section: Role Of Tbimentioning

confidence: 99%

Cellular Therapy of ALL

Moffa¹,

Khan²,

Lister³

2011

Novel Aspects in Acute Lymphoblastic Leukemia

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“…[1,2] Some solid tumors are under the investigation of allogeneic transplantation (Table 1). Successful bone marrow transplantation with a combination of cyclophosphamide and total body irradiation as a conditioning regimen was first reported in the 1970s.…”

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confidence: 99%

Allogenic Stem Cell Transplantation and Total Body Irradiation

Kamer¹

2016

TJ Oncol

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SUMMARYThe clinical importance of bone marrow transplantation has increased considerably in recent decades. More than 450 centers for bone marrow transplantation now exist worldwide, performing more than 5000 transplantations per year. The number of transplant centers and patients has increased dramatically in Turkey in the last several years. When transplant donor and recipient are different individuals, hematopoietic graft is known as allogeneic graft. Total body irradiation (TBI) remains an important component of allogeneic hematopoietic stem cell transplant, with the goal of eradicating residual malignant cells and modulating the immune system of the transplant recipient. TBI is especially advantageous in allogeneic stem cell transplantation, since its biological effects can be exerted uniformly without sparing the "sanctuary" sites, such as nervous system or testicles. In this report, the role of TBI in allogeneic stem cell transplantation is reviewed.

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Fractionated total body irradiation and bone marrow transplantation in acute lymphoblastic leukemia

Cited by 15 publications

References 7 publications

TBI during BM and SCT: review of the past, discussion of the present and consideration of future directions

TBI during BM and SCT: review of the past, discussion of the present and consideration of future directions

Cellular Therapy of ALL

Allogenic Stem Cell Transplantation and Total Body Irradiation

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