Total body irradiation before allogeneic bone marrow transplantation: is more dose better?

Abstract

PURPOSE:

This study was performed to retrospectively assess the potential influence of total-body irradiation (TBI) dose on overall survival in patients undergoing allogeneic bone-marrow transplants (BMT) for hematologic malignancies.

METHODS AND MATERIALS:

Between October 1984 and December 1996, 116 patients were conditioned with high-dose chemotherapy and fractionated TBI before allogeneic BMT. The median age was 34 years (range 3-60). The TBI dose was given in 6 fractions, twice-a-day, over 3 days before BMT. The total dose was 10 Gy in 24 patients, 12 Gy in 66 patients, and 13.5 Gy in 26 patients.

RESULTS:

TBI dose was inversely correlated with overall survival. Five-year survival was 62% for patients conditioned with 10 Gy, 55% for patients conditioned with 12 Gy, and 46% for patients conditioned with 13.5 Gy. Age at BMT was also independently correlated with survival, with the best outcome for patients < 40 years old.

CONCLUSION:

A TBI dose (fractionated) > 10 Gy may not necessarily be associated with a better outcome in patients undergoing allogeneic bone-marrow transplant for hematologic malignancies.

• Authors: S Bieri, C Helg, B Chapuis, R Miralbell
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 49 Issue 4 Pg. 1071-7 (Mar 15 2001) ISSN: 0360-3016 [Print] United States
• PMID: 11240249 (Publication Type: Journal Article)

Chemical References

• Radiation-Sensitizing Agents
• Cytarabine
• Etoposide
• Cyclophosphamide
• Thiotepa
• Busulfan
• Daunorubicin

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bone Marrow Transplantation (methods, mortality)
• Busulfan (therapeutic use)
• Child
• Child, Preschool
• Cyclophosphamide (therapeutic use)
• Cytarabine (therapeutic use)
• Daunorubicin (therapeutic use)
• Etoposide (therapeutic use)
• Female
• Humans
• Leukemia, Myeloid, Acute (mortality, therapy)
• Male
• Middle Aged
• Myelodysplastic Syndromes (mortality, therapy)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (mortality, therapy)
• Radiation-Sensitizing Agents (therapeutic use)
• Radiotherapy Dosage
• Retrospective Studies
• Thiotepa (therapeutic use)
• Transplantation Conditioning (methods, mortality)
• Transplantation, Homologous
• Whole-Body Irradiation (methods, mortality)