scholarly journals Total body irradiation in a case of thalassemia major with source to axis distance based planning: A case report

2020 ◽  
pp. 25-28
Author(s):  
Mayuresh D. Virkar ◽  
Rajkumar Chauhan ◽  
Pranav Chadha ◽  
Kaustav Talapatra ◽  
Reuben Jake Rodrigues ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Total Body Irradiation ◽  
Conditioning Regimen ◽  
Thalassemia Major ◽  
Entire Body ◽  
Hematopoietic Stem ◽  
Total Body

Background: The use of total body radiation (TBI) before hematopoietic stem cell transplantation (HSCT) would increase the engraftment without transplant-related morbidity or mortality among Thalassemia major (TM) cases. Case presentation: A 2-year-old female child, diagnosed with TM was scheduled for haploidentical allogenic transplant-based protocol, and after that, based on protocol she was scheduled to undergo a single session of TBI as a conditioning regimen before haploidentical allogenic hematopoietic stem cell tranplant. A total dose of 4 Gy was administered.. The incidence of graft failure was reduced as TBI was used before allogeneic stem cell transplantation. TBI provided a uniform dose of radiation to the entire body, penetrating areas such as the central nervous system (CNS) and testes. Conclusion: Total Body Irradiation with the SAD technique is the most effective way of treatment. As it is comfortable for the patient to undergo, easily reproducible, and it helps to achieve a uniform dose distribution.

Radiation-induced kidney injury

2019 ◽  
Vol 3 (3) ◽  
pp. 160-167 ◽  
Author(s):  
Jaya Kala
Keyword(s):  
Experimental Data ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Radiation Exposure ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Total Body Irradiation ◽  
Hematopoietic Stem ◽  
Total Body

Renal dysfunction because of radiation exposure was recognized decades ago. The incidence declined when more effective chemotherapeutic agents became available. However, there appears to be a resurgence with the advent of total body irradiation used prior to hematopoietic stem cell transplantation. Several chemotherapeutic drugs used prior to total body irradiation have some ionizing radiation potentiating effects. Chronic kidney disease that occurs after hematopoietic stem cell transplantation is known to occur due to nephrotoxicity from medications, graft-versus-host disease, and the currently under-recognized radiation exposure. The clinical features vary depending on the dose of radiation and the volume of single or bilateral kidneys exposed. The usual symptoms of fatigue, edema, anemia, malignant hypertension, azotemia, and shortness of breath appear in 6–12 months of exposure. Since this is an under-recognized entity, there are no large controlled trials to guide therapy. This review highlights some of the experimental data that have shown some promising results for treatment. There is need for further studies on the current incidence and prevalence and clinical trials to guide treatment, based on the experimental data available.

Allogeneic Hematopoietic Stem-Cell Transplantation for Acute Myeloid Leukemia in Remission: Comparison of Intravenous Busulfan Plus Cyclophosphamide (Cy) Versus Total-Body Irradiation Plus Cy As Conditioning Regimen—A Report From the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation

2013 ◽  
Vol 31 (28) ◽  
pp. 3549-3556 ◽  
Author(s):  
Arnon Nagler ◽  
Vanderson Rocha ◽  
Myriam Labopin ◽  
Ali Unal ◽  
Tarek Ben Othman ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Total Body Irradiation ◽  
Chronic Gvhd ◽  
Conditioning Regimen ◽  
Multivariable Analysis ◽  
Myelogenous Leukemia ◽  
Hematopoietic Stem ◽  
Total Body

Purpose Cyclophosphamide (Cy) combined with total-body irradiation (TBI) or with busulfan (Bu) are currently the most common myeloablative regimens used in allogeneic stem-cell transplantation (alloSCT) in adults with acute myelogenous leukemia (AML). Intravenous (IV) Bu has more predictable bioavailability and a safer toxicity profile than the oral formulation. Comparative studies of outcomes have been performed between oral Bu/Cy and Cy/TBI, but there have been no comparative trials in the era of IV Bu. Patients and Methods We performed a retrospective registry-based study comparing outcomes of patients with AML in first or second remission after alloSCT from sibling donors who underwent IV Bu/Cy (n = 795) or Cy/TBI (n = 864) conditioning. Results Engraftment rate was 98% and 99% after IV Bu/Cy and Cy/TBI, respectively. Grade 2 to 4 acute graft-versus-host disease (GVHD) was significantly lower in the IV Bu/Cy compared with Cy/TBI group (P < .001). Similarly, chronic GVHD was significantly lower in the IV Bu/Cy compared with Cy/TBI group (P = .003). Cumulative incidence of 2-year nonrelapse mortality (NRM; ± standard deviation [SD]) was 12% ± 1% in the IV Bu/Cy group and 15% ± 2% in the Cy/TBI group (P = .14), and 2-year relapse incidence (RI; ± SD) was 26% ± 3% and 21% ± 1%, respectively (P = .012). Leukemia-free survival (LFS) rate (± SD) was 61% ± 2% after IV Bu/Cy and 64% ± 2% after Cy/TBI (P = .27). In multivariable analysis, adjusting for differences between both groups, patients who received IV Bu/Cy had lower acute and chronic GVHD, higher RI, and a trend toward lower NRM. LFS was not statistically different between the two conditioning regimens. Conclusion This retrospective study shows that final outcomes after myeloablative conditioning using IV Bu/Cy were not statistically different from those after Cy/TBI.

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