Skip to main content

Total Body Irradiation in Stem Cell Transplant

  • Living reference work entry
  • First Online:
Contemporary Bone Marrow Transplantation

Part of the book series: Organ and Tissue Transplantation ((OTT))

Abstract

Total body irradiation (TBI) is a radiation therapy technique that is designed to deliver radiation to the entire body and has been used to treat a variety of malignant and benign disorders. Total body irradiation sequenced with chemotherapy remains a significant part of hematopoietic stem cell transplantation (HSCT). Better understanding of biological effects of ionizing radiation, improved dosimetry, and enhanced knowledge of radiation therapy-chemotherapy and/or biological interactions has led to refinement in the technique and the use of TBI. This chapter comprehensively addresses TBI in allogeneic stem cell transplantation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • American Association of Physicists in Medicine. Radiation Therapy Committee. Task Group (1986) The physical aspects of total and half body photon irradiation: a report of Task Group 29 Radiation Therapy Committee American Association of Physicists in Medicine. American Institute of Physics, New York

    Google Scholar 

  • Baron F, Storb R (2005) Current roles for allogeneic hematopoietic cell transplantation following nonmyeloablative or reduced-intensity conditioning. Clin Adv Hematol Oncol 3:799–819

    PubMed  Google Scholar 

  • Baron F, Storb R (2006) Allogeneic hematopoietic cell transplantation following nonmyeloablative conditioning as treatment for hematologic malignancies and inherited blood disorders. Mol Ther 13:26–41

    Article  CAS  PubMed  Google Scholar 

  • Baron F, Storb R (2007) Hematopoietic cell transplantation after reduced-intensity conditioning for older adults with acute myeloid leukemia in complete remission. Curr Opin Hematol 14:145–151

    Article  PubMed  Google Scholar 

  • Barrett A, Depledge MH, Powles RL (1983) Interstitial pneumonitis following bone marrow transplantation after low dose rate total body irradiation. Int J Radiat Oncol Biol Phys 9:1029–1033

    Article  CAS  PubMed  Google Scholar 

  • Bearman SI, Anderson GL, Mori M et al (1993) Venoocclusive disease of the liver: development of a model for predicting fatal outcome after marrow transplantation. J Clin Oncol 11:1729–1736

    Article  CAS  PubMed  Google Scholar 

  • Beauchamp-Nicoud A, Feneux D, Bayle C et al (2003) Therapy-related myelodysplasia and/or acute myeloid leukaemia after autologous haematopoietic progenitor cell transplantation in a prospective single centre cohort of 221 patients. Br J Haematol 122:109–117

    Article  PubMed  Google Scholar 

  • Belkacémi Y, Ozsahin M, Pène F et al (1996) Cataractogenesis after total body irradiation. Int J Radiat Oncol Biol Phys 35:53–60

    Article  PubMed  Google Scholar 

  • Bhatia S, Ramsay NK, Steinbuch M et al (1996) Malignant neoplasms following bone marrow transplantation. Blood 87:3633–3639

    Article  CAS  PubMed  Google Scholar 

  • Bhatia S, Robison LL, Francisco L et al (2005) Late mortality in survivors of autologous hematopoietic-cell transplantation: report from the Bone Marrow Transplant Survivor Study. Blood 105:4215–4222

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bhatia S, Francisco L, Carter A et al (2007) Late mortality after allogeneic hematopoietic cell transplantation and functional status of long-term survivors: report from the Bone Marrow Transplant Survivor Study. Blood 110:3784–3792

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Blaise D, Maraninchi D, Archimbaud E et al (1992) Allogeneic bone marrow transplantation for acute myeloid leukemia in first remission: a randomized trial of a busulfan-Cytoxan versus Cytoxan-total body irradiation as preparative regimen: a report from the Group d’Etudes de la Greffe de Moelle Osseuse. Blood 79:2578–2582

    Article  CAS  PubMed  Google Scholar 

  • Borowski B, Benhamou E, Pico JL et al (1994) Prevention of oral mucositis in patients treated with high-dose chemotherapy and bone marrow transplantation: a randomised controlled trial comparing two protocols of dental care. Eur J Cancer B Oral Oncol 30B:93–97

    Article  CAS  PubMed  Google Scholar 

  • Bortin MM, Kay HE, Gale RP, Rimm AA (1982) Factors associated with interstitial pneumonitis after bone-marrow transplantation for acute leukaemia. Lancet 1:437–439

    Article  CAS  PubMed  Google Scholar 

  • Bredeson C, Perry G, Martens C et al (2002) Outpatient total body irradiation as a component of a comprehensive outpatient transplant program. Bone Marrow Transplant 29:667–671

    Article  CAS  PubMed  Google Scholar 

  • Brown JR, Yeckes H, Friedberg JW et al (2005) Increasing incidence of late second malignancies after conditioning with cyclophosphamide and total-body irradiation and autologous bone marrow transplantation for non-Hodgkin’s lymphoma. J Clin Oncol 23:2208–2214

    Article  CAS  PubMed  Google Scholar 

  • Buchali A, Feyer P, Groll J et al (2000) Immediate toxicity during fractionated total body irradiation as conditioning for bone marrow transplantation. Radiother Oncol 54:157–162

    Article  CAS  PubMed  Google Scholar 

  • Bunin N, Aplenc R, Kamani N et al (2003) Randomized trial of busulfan vs total body irradiation containing conditioning regimens for children with acute lymphoblastic leukemia: a Pediatric Blood and Marrow Transplant Consortium study. Bone Marrow Transplant 32:543–548

    Article  CAS  PubMed  Google Scholar 

  • Castagna L, Benhamou E, Pedraza E et al (2001) Prevention of mucositis in bone marrow transplantation: a double blind randomised controlled trial of sucralfate. Ann Oncol 12:953–955

    Article  CAS  PubMed  Google Scholar 

  • Chaillet MP, Cosset JM, Socie G et al (1993) Prospective study of the clinical symptoms of therapeutic whole body irradiation. Health Phys 64:370–374

    Article  CAS  PubMed  Google Scholar 

  • Chao NJ (2004) Minors come of age: minor histocompatibility antigens and graft-versus-host disease. Biol Blood Marrow Transplant 10:215–223

    Article  CAS  PubMed  Google Scholar 

  • Chao NJ, Chen BJ (2006) Prophylaxis and treatment of acute graft-versus-host disease. Semin Hematol 43:32–41

    Article  CAS  PubMed  Google Scholar 

  • Chao M, Penagaricano J, Yan Y et al (2012) Voxel-based dose reconstruction for total body irradiation with helical tomotherapy. Int J Radiat Oncol Biol Phys 82:1575–1583

    Article  PubMed  Google Scholar 

  • Chemaitilly W, Hudson MM (2014) Update on endocrine and metabolic therapy-related late effects observed in survivors of childhood neoplasia. Curr Opin Endocrinol Diabetes Obes 21:71–76

    Article  CAS  PubMed  Google Scholar 

  • Chemaitilly W, Sklar CA (2007) Endocrine complications of hematopoietic stem cell transplantation. Endocrinol Metab Clin North Am 36:983–998; ix

    Article  CAS  PubMed  Google Scholar 

  • Chemaitilly W, Boulad F, Heller G et al (2007) Final height in pediatric patients after hyperfractionated total body irradiation and stem cell transplantation. Bone Marrow Transplant 40:29–35

    Article  CAS  PubMed  Google Scholar 

  • Cohen JI (1991) Epstein-Barr virus lymphoproliferative disease associated with acquired immunodeficiency. Medicine 70:137–160

    Article  CAS  PubMed  Google Scholar 

  • Cooke KR, Yanik G (2004) Acute lung injury after allogeneic stem cell transplantation: is the lung a target of acute graft-versus-host disease? Bone Marrow Transplant 34:753–765

    Article  CAS  PubMed  Google Scholar 

  • Corvò R, Frassoni F, Franzone P et al (1989) [Fractionated and hyperfractionated total body irradiation in the conditioning of allogenic bone marrow transplant in acute lymphatic leukemia. Results]. Radiol Med 78:367–372

    Google Scholar 

  • Corvò R, Paoli G, Barra S et al (1999) Total body irradiation correlates with chronic graft versus host disease and affects prognosis of patients with acute lymphoblastic leukemia receiving an HLA identical allogeneic bone marrow transplant. Int J Radiat Oncol Biol Phys 43:497–503

    Article  PubMed  Google Scholar 

  • Cosset JM, Socie G, Dubray B et al (1994) Single dose versus fractionated total body irradiation before bone marrow transplantation: radiobiological and clinical considerations. Int J Radiat Oncol Biol Phys 30:477–492

    Article  CAS  PubMed  Google Scholar 

  • Craciunescu OI, Steffey BA, Kelsey CR et al (2011) Renal shielding and dosimetry for patients with severe systemic sclerosis receiving immunoablation with total body irradiation in the scleroderma: cyclophosphamide or transplantation trial. Int J Radiat Oncol Biol Phys 79:1248–1255

    Article  PubMed  Google Scholar 

  • Curtis RE, Rowlings PA, Deeg HJ et al (1997) Solid cancers after bone marrow transplantation. N Engl J Med 336:897–904

    Article  CAS  PubMed  Google Scholar 

  • Curtis RE, Travis LB, Rowlings PA et al (1999) Risk of lymphoproliferative disorders after bone marrow transplantation: a multi-institutional study. Blood 94: 2208–2216

    CAS  PubMed  Google Scholar 

  • Dahllöf G (2008) Oral and dental late effects after pediatric stem cell transplantation. Biol Blood Marrow Transplant 14:81–83

    Article  PubMed  Google Scholar 

  • Darrington DL, Vose JM, Anderson JR et al (1994) Incidence and characterization of secondary myelodysplastic syndrome and acute myelogenous leukemia following high-dose chemoradiotherapy and autologous stem-cell transplantation for lymphoid malignancies. J Clin Oncol 12:2527–2534

    Article  CAS  PubMed  Google Scholar 

  • Deeg HJ, Socie G (1998) Malignancies after hematopoietic stem cell transplantation: many questions, some answers. Blood 91:1833–1844

    Article  CAS  PubMed  Google Scholar 

  • Deeg HJ, Sullivan KM, Buckner CD et al (1986) Marrow transplantation for acute nonlymphoblastic leukemia in first remission: toxicity and long-term follow-up of patients conditioned with single dose or fractionated total body irradiation. Bone Marrow Transplant 1:151–157

    CAS  PubMed  Google Scholar 

  • Devergie A, Blaise D, Attal M et al (1995) Allogeneic bone marrow transplantation for chronic myeloid leukemia in first chronic phase: a randomized trial of busulfan-cytoxan versus cytoxan-total body irradiation as preparative regimen: a report from the French Society of Bone Marrow Graft (SFGM). Blood 85:2263–2268

    Article  CAS  PubMed  Google Scholar 

  • Duch MA, Ginjaume M, Chakkor H et al (1998) Thermoluminescence dosimetry applied to in vivo dose measurements for total body irradiation techniques. Radiother Oncol 47:319–324

    Article  CAS  PubMed  Google Scholar 

  • Dusenbery KE, Daniels KA, McClure JS et al (1995) Randomized comparison of cyclophosphamide-total body irradiation versus busulfan-cyclophosphamide conditioning in autologous bone marrow transplantation for acute myeloid leukemia. Int J Radiat Oncol Biol Phys 31:119–128

    Article  CAS  PubMed  Google Scholar 

  • Ellis MJ, Parikh CR, Inrig JK et al (2008) Chronic kidney disease after hematopoietic cell transplantation: a systematic review. Am J Transplant 8:2378–2390

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ferretti GA, Ash RC, Brown AT et al (1987a) Chlorhexidine for prophylaxis against oral infections and associated complications in patients receiving bone marrow transplants. J Am Dent Assoc 114:461–467

    Article  CAS  PubMed  Google Scholar 

  • Ferretti GA, Hansen IA, Whittenburg K et al (1987b) Therapeutic use of chlorhexidine in bone marrow transplant patients: case studies. Oral Surg Oral Med Oral Pathol 63:683–687

    Article  CAS  PubMed  Google Scholar 

  • Ferretti GA, Ash RC, Brown AT et al (1988) Control of oral mucositis and candidiasis in marrow transplantation: a prospective, double-blind trial of chlorhexidine digluconate oral rinse. Bone Marrow Transplant 3:483–493

    CAS  PubMed  Google Scholar 

  • Ferretti GA, Raybould TP, Brown AT et al (1990) Chlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomized double-blind trial. Oral Surg Oral Med Oral Pathol 69:331–338

    Article  CAS  PubMed  Google Scholar 

  • Fisher DR, Hendry JH, Scott D (1988) Long-term repair in vivo of colony-forming ability and chromosomal injury in X-irradiated mouse hepatocytes. Radiat Res 113:40–50

    Article  CAS  PubMed  Google Scholar 

  • FitzGerald TJ, McKenna M, Kase K et al (1986a) Effect of X-irradiation dose rate on the clonagenic survival of human and experimental animal hematopoietic tumor cell lines: evidence for heterogeneity. Int J Radiat Oncol Biol Phys 12:69–73

    Article  CAS  PubMed  Google Scholar 

  • FitzGerald TJ, McKenna M, Rothstein L et al (1986b) Radiosensitivity of human bone marrow granulocyte-macrophage progenitor cells and stromal colony-forming cells: effect of dose rate. Radiat Res 107:205–215

    Article  CAS  PubMed  Google Scholar 

  • Friedman DL, Leisenring W, Schwartz JL, Deeg HJ (2004) Second malignant neoplasms following hematopoietic stem cell transplantation. Int J Hematol 79:229–234

    Article  PubMed  Google Scholar 

  • Garming-Legert K, Remberger M, Ringdén O et al (2011) Long-term salivary function after conditioning with busulfan, fractionated or single-dose TBI. Oral Dis 17:670–676

    Article  CAS  PubMed  Google Scholar 

  • Girinsky T, Benhamou E, Bourhis JH et al (2000) Prospective randomized comparison of single-dose versus hyperfractionated total-body irradiation in patients with hematologic malignancies. J Clin Oncol 18:981–986

    Article  CAS  PubMed  Google Scholar 

  • Gruen A, Ebell W, Wlodarczyk W et al (2013) Total Body Irradiation (TBI) using helical tomotherapy in children and young adults undergoing stem cell transplantation. Radiat Oncol 8:92

    Article  PubMed  PubMed Central  Google Scholar 

  • Hartman AR, Williams SF, Dillon JJ (1998) Survival, disease-free survival and adverse effects of conditioning for allogeneic bone marrow transplantation with busulfan/cyclophosphamide vs total body irradiation: a meta-analysis. Bone Marrow Transplant 22:439–443

    Article  CAS  PubMed  Google Scholar 

  • Heinzelmann F, Ottinger H, Müller C-H et al (2006) Total-body irradiation–role and indications: results from the German Registry for Stem Cell Transplantation (DRST). Strahlenther Onkol 182:222–230

    Article  PubMed  Google Scholar 

  • Hendry JH (1985) The cellular basis of long-term marrow injury after irradiation. Radiother Oncol 3:331–338

    Article  CAS  PubMed  Google Scholar 

  • Hensley ML, Hagerty KL, Kewalramani T et al (2009) American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants. J Clin Oncol 27:127–145

    Article  CAS  PubMed  Google Scholar 

  • Hölttä P, Alaluusua S, Saarinen-Pihkala UM et al (2005) Agenesis and microdontia of permanent teeth as late adverse effects after stem cell transplantation in young children. Cancer 103:181–190

    Article  PubMed  Google Scholar 

  • Hwang WYK, Koh L-P, Ng HJ et al (2004) A randomized trial of amifostine as a cytoprotectant for patients receiving myeloablative therapy for allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 34:51–56

    Article  CAS  PubMed  Google Scholar 

  • James SE, Arlett CF, Green MH, Bridges BA (1983) Radiosensitivity of human T-lymphocytes proliferating in long term culture. Int J Radiat Biol Relat Stud Phys Chem Med 44:417–422

    Article  CAS  PubMed  Google Scholar 

  • Jen YM, Hendry JH (1991) Acute response of mouse kidney clonogens to fractionated irradiation in situ and then assayed in primary culture. Br J Radiol 64:142–148

    Article  CAS  PubMed  Google Scholar 

  • Jornet N, Ribas M, Eudaldo T (1996) Calibration of semiconductor detectors for dose assessment in total body irradiation. Radiother Oncol 38:247–251

    Article  CAS  PubMed  Google Scholar 

  • Keane TJ, van Dyk J, Rider WD (1982) Interstitial pneumonitis after bone-marrow transplantation. Lancet 1:967

    Article  CAS  PubMed  Google Scholar 

  • Kelsey CR, Chino J, Craciunescu O et al (2009) Severe pulmonary toxicity after myeloablative conditioning using total body irradiation: an assessment of possible predictive factors. Int J Radiat Oncol Biol Phys 75:S478

    Article  Google Scholar 

  • Kelsey CR, Horwitz ME, Chino JP et al (2011) Severe pulmonary toxicity after myeloablative conditioning using total body irradiation: an assessment of risk factors. Int J Radiat Oncol Biol Phys 81:812–818

    Article  PubMed  Google Scholar 

  • Khan FM, Williamson JF, Sewchand W, Kim TH (1980) Basic data for dosage calculation and compensation. Int J Radiat Oncol Biol Phys 6:745–751

    Article  CAS  PubMed  Google Scholar 

  • Kim TH, Khan FM, Galvin JM (1980) Total body irradiation conference: a report of the work party: comparison of total body irradiation techniques for bone marrow transplantation. Int J Radiat Oncol Biol Phys 6:779–784

    Article  CAS  PubMed  Google Scholar 

  • Kolb HJ, Socié G, Duell T et al (1999) Malignant neoplasms in long-term survivors of bone marrow transplantation. Late effects working party of the European Cooperative Group for blood and marrow transplantation and the European Late Effect Project Group. Ann Intern Med 131:738–744

    Article  CAS  PubMed  Google Scholar 

  • Krishnan A, Bhatia S, Slovak ML et al (2000) Predictors of therapy-related leukemia and myelodysplasia following autologous transplantation for lymphoma: an assessment of risk factors. Blood 95:1588–1593

    Article  CAS  PubMed  Google Scholar 

  • Landgren O, Gilbert ES, Rizzo JD et al (2009) Risk factors for lymphoproliferative disorders after allogeneic hematopoietic cell transplantation. Blood 113: 4992–5001

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lawton CA, Barber-Derus S, Murray KJ et al (1989) Technical modifications in hyperfractionated total body irradiation for T-lymphocyte deplete bone marrow transplant. Int J Radiat Oncol Biol Phys 17:319–322

    Article  CAS  PubMed  Google Scholar 

  • Lawton CA, Cohen EP, Murray KJ et al (1997) Long-term results of selective renal shielding in patients undergoing total body irradiation in preparation for bone marrow transplantation. Bone Marrow Transplant 20: 1069–1074

    Article  CAS  PubMed  Google Scholar 

  • Lund MB, Kongerud J, Brinch L et al (1995) Decreased lung function in one year survivors of allogeneic bone marrow transplantation conditioned with high-dose busulfan and cyclophosphamide. Eur Respir J 8: 1269–1274

    Article  CAS  PubMed  Google Scholar 

  • MacDonald KPA, Hill GR, Blazar BR (2017) Chronic graft-versus-host disease: biological insights from preclinical and clinical studies. Blood 129:13–21

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mah K, Keane TJ, Van Dyk J et al (1994) Quantitative effect of combined chemotherapy and fractionated radiotherapy on the incidence of radiation-induced lung damage: a prospective clinical study. Int J Radiat Oncol Biol Phys 28:563–574

    Article  CAS  PubMed  Google Scholar 

  • Mancosu P, Navarria P, Castagna L et al (2015) Plan robustness in field junction region from arcs with different patient orientation in total marrow irradiation with VMAT. Phys Med 31:677–682

    Article  PubMed  Google Scholar 

  • Matsuoka S, Okamoto S, Watanabe R et al (2003) Granisetron plus dexamethasone versus granisetron alone in the prevention of vomiting induced by conditioning for stem cell transplantation: a prospective randomized study. Int J Hematol 77:86–90

    Article  CAS  PubMed  Google Scholar 

  • Mertens AC, Ramsay NK, Kouris S, Neglia JP (1998) Patterns of gonadal dysfunction following bone marrow transplantation. Bone Marrow Transplant 22:345–350

    Article  CAS  PubMed  Google Scholar 

  • Metayer C, Curtis RE, Vose J et al (2003) Myelodysplastic syndrome and acute myeloid leukemia after autotransplantation for lymphoma: a multicenter case-control study. Blood 101:2015–2023

    Article  CAS  PubMed  Google Scholar 

  • Michel G, Gluckman E, Esperou-Bourdeau H et al (1994) Allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: impact of conditioning regimen without total-body irradiation–a report from the Société Française de Greffe de Moelle. J Clin Oncol 12: 1217–1222

    Article  CAS  PubMed  Google Scholar 

  • Milligan DW, Ruiz De Elvira MC, Kolb HJ et al (1999) Secondary leukaemia and myelodysplasia after autografting for lymphoma: results from the EBMT. EBMT Lymphoma and Late Effects Working Parties. European Group for Blood and Marrow Transplantation. Br J Haematol 106:1020–1026

    Article  CAS  PubMed  Google Scholar 

  • Morgan TL, Falk PM, Kogut N et al (1996) A comparison of single-dose and fractionated total-body irradiation on the development of pneumonitis following bone marrow transplantation. Int J Radiat Oncol Biol Phys 36:61–66

    Article  CAS  PubMed  Google Scholar 

  • Moulder JE, Fish BL, Cohen EP, Bonsib SM (1996) Angiotensin II receptor antagonists in the prevention of radiation nephropathy. Radiat Res 146:106–110

    Article  CAS  PubMed  Google Scholar 

  • Moulder JE, Fish BL, Cohen EP (2007) Treatment of radiation nephropathy with ACE inhibitors and AII type-1 and type-2 receptor antagonists. Curr Pharm Des 13:1317–1325

    Article  CAS  PubMed  Google Scholar 

  • Moulder JE, Cohen EP, Fish BL (2014) Mitigation of experimental radiation nephropathy by renin-equivalent doses of angiotensin converting enzyme inhibitors. Int J Radiat Biol 90:762–768

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Nguyen DT, Shayani S, Palmer J et al (2015) Palifermin for prevention of oral mucositis in allogeneic hematopoietic stem cell transplantation: a single-institution retrospective evaluation. Support Care Cancer 23: 3141–3147

    Article  PubMed  Google Scholar 

  • Okamoto S, Takahashi S, Tanosaki R et al (1996) Granisetron in the prevention of vomiting induced by conditioning for stem cell transplantation: a prospective randomized study. Bone Marrow Transplant 17:679–683

    CAS  PubMed  Google Scholar 

  • Ozsahin M, Pène F, Touboul E et al (1992) Total-body irradiation before bone marrow transplantation. Results of two randomized instantaneous dose rates in 157 patients. Cancer 69:2853–2865

    Article  CAS  PubMed  Google Scholar 

  • Paix A, Antoni D, Waissi W et al (2018) Total body irradiation in allogeneic bone marrow transplantation conditioning regimens: a review. Crit Rev Oncol Hematol 123:138–148

    Article  PubMed  Google Scholar 

  • Papas AS, Clark RE, Martuscelli G et al (2003) A prospective, randomized trial for the prevention of mucositis in patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant 31:705–712

    Article  CAS  PubMed  Google Scholar 

  • Park S, Brice P, Noguerra ME et al (2000) Myelodysplasias and leukemias after autologous stem cell transplantation for lymphoid malignancies. Bone Marrow Transplant 26:321–326

    Article  CAS  PubMed  Google Scholar 

  • Patriarca F, Poletti V, Costabel U et al (2009) Clinical presentation, outcome and risk factors of late-onset non-infectious pulmonary complications after allogeneic stem cell transplantation. Curr Stem Cell Res Ther 4:161–167

    Article  CAS  PubMed  Google Scholar 

  • Peñagarícano JA, Chao M, Van Rhee F et al (2011) Clinical feasibility of TBI with helical tomotherapy. Bone Marrow Transplant 46:929–935

    Article  PubMed  Google Scholar 

  • Penney DP, Siemann DW, Rubin P, Maltby K (1994) Morphological correlates of fractionated radiation of the mouse lung: early and late effects. Int J Radiat Oncol Biol Phys 29:789–804

    Article  CAS  PubMed  Google Scholar 

  • Prentice HG, Cunningham S, Gandhi L et al (1995) Granisetron in the prevention of irradiation-induced emesis. Bone Marrow Transplant 15:445–448

    CAS  PubMed  Google Scholar 

  • Ramm U, Licher J, Moog J et al (2008) In vivo dosimetry with semiconducting diodes for dose verification in total-body irradiation. Strahlenther Onkol 184: 376–380

    Article  PubMed  Google Scholar 

  • Ribas M, Jornet N, Eudaldo T et al (1998) Midplane dose determination during total body irradiation using in vivo dosimetry. Radiother Oncol 49:91–98

    Article  CAS  PubMed  Google Scholar 

  • Ringdén O, Ruutu T, Remberger M et al (1994) A randomized trial comparing busulfan with total body irradiation as conditioning in allogeneic marrow transplant recipients with leukemia: a report from the Nordic Bone Marrow Transplantation Group. Blood 83: 2723–2730

    Article  PubMed  Google Scholar 

  • Rizzo JD, Curtis RE, Socié G et al (2009) Solid cancers after allogeneic hematopoietic cell transplantation. Blood 113:1175–1183

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rozman C, Carreras E, Qian C et al (1996) Risk factors for hepatic veno-occlusive disease following HLA-identical sibling bone marrow transplants for leukemia. Bone Marrow Transplant 17:75–80

    CAS  PubMed  Google Scholar 

  • Sampath S, Schultheiss TE, Wong J (2005) Dose response and factors related to interstitial pneumonitis after bone marrow transplant. Int J Radiat Oncol Biol Phys 63:876–884

    Article  PubMed  Google Scholar 

  • Sanders JE, Buckner CD, Leonard JM et al (1983) Late effects on gonadal function of cyclophosphamide, total-body irradiation, and marrow transplantation. Transplantation 36:252–255

    Article  CAS  PubMed  Google Scholar 

  • Sanders JE, Buckner CD, Amos D et al (1988) Ovarian function following marrow transplantation for aplastic anemia or leukemia. J Clin Oncol 6:813–818

    Article  CAS  PubMed  Google Scholar 

  • Sarradin V, Simon L, Huynh A et al (2018) Total body irradiation using helical tomotherapy®: treatment technique, dosimetric results and initial clinical experience. Cancer Radiother 22:17–24

    Article  CAS  PubMed  Google Scholar 

  • Savani BN, Montero A, Wu C et al (2005) Prediction and prevention of transplant-related mortality from pulmonary causes after total body irradiation and allogeneic stem cell transplantation. Biol Blood Marrow Transplant 11:223–230

    Article  PubMed  Google Scholar 

  • Schultheiss TE, Wong J, Liu A et al (2007) Image-guided total marrow and total lymphatic irradiation using helical tomotherapy. Int J Radiat Oncol Biol Phys 67:1259–1267

    Article  PubMed  Google Scholar 

  • Sebban C, Mounier N, Brousse N et al (2006) Standard chemotherapy with interferon compared with CHOP followed by high-dose therapy with autologous stem cell transplantation in untreated patients with advanced follicular lymphoma: the GELF-94 randomized study from the Groupe d’Etude des Lymphomes de l’Adulte (GELA). Blood 108:2540–2544

    Article  CAS  PubMed  Google Scholar 

  • Senzolo M, Germani G, Cholongitas E et al (2007) Veno occlusive disease: update on clinical management. World J Gastroenterol 13:3918–3924

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shank B, O’Reilly RJ, Cunningham I et al (1990) Total body irradiation for bone marrow transplantation: the Memorial Sloan-Kettering Cancer Center experience. Radiother Oncol Suppl 1:68–81

    Article  Google Scholar 

  • Shulman HM, McDonald GB, Matthews D et al (1980) An analysis of hepatic venocclusive disease and centrilobular hepatic degeneration following bone marrow transplantation. Gastroenterology 79:1178–1191

    Article  CAS  PubMed  Google Scholar 

  • Singhal S, Powles R, Treleaven J et al (1997) Pilocarpine hydrochloride for symptomatic relief of xerostomia due to chronic graft-versus-host disease or total-body irradiation after bone-marrow transplantation for hematologic malignancies. Leuk Lymphoma 24:539–543

    Article  CAS  PubMed  Google Scholar 

  • Smith RA, Cokkinides V, Brawley OW (2009) Cancer screening in the United States, 2009: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin 59:27–41

    Article  PubMed  Google Scholar 

  • Smith RA, Cokkinides V, Brooks D et al (2010) Cancer screening in the United States, 2010: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin 60:99–119

    Article  PubMed  Google Scholar 

  • Socié G, Kolb HJ (1995) Malignant diseases after bone marrow transplantation: the case for tumor banking and continued reporting to registries. EBMT Late-Effects Working Party. Bone Marrow Transplant 16:493–495

    PubMed  Google Scholar 

  • Socié G, Curtis RE, Deeg HJ et al (2000) New malignant diseases after allogeneic marrow transplantation for childhood acute leukemia. J Clin Oncol 18:348–357

    Article  PubMed  Google Scholar 

  • Socié G, Clift RA, Blaise D et al (2001) Busulfan plus cyclophosphamide compared with total-body irradiation plus cyclophosphamide before marrow transplantation for myeloid leukemia: long-term follow-up of 4 randomized studies. Blood 98:3569–3574

    Article  PubMed  Google Scholar 

  • Soubani AO, Miller KB, Hassoun PM (1996) Pulmonary complications of bone marrow transplantation. Chest 109:1066–1077

    Article  CAS  PubMed  Google Scholar 

  • Spitzer TR, Bryson JC, Cirenza E et al (1994) Randomized double-blind, placebo-controlled evaluation of oral ondansetron in the prevention of nausea and vomiting associated with fractionated total-body irradiation. J Clin Oncol 12:2432–2438

    Article  CAS  PubMed  Google Scholar 

  • Springer A, Hammer J, Winkler E et al (2016) Total body irradiation with volumetric modulated arc therapy: Dosimetric data and first clinical experience. Radiat Oncol 11:46

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Stein A, Palmer J, Tsai N-C et al (2017) Phase I trial of total marrow and lymphoid irradiation transplantation conditioning in patients with relapsed/refractory acute leukemia. Biol Blood Marrow Transplant 23:618–624

    Article  PubMed  PubMed Central  Google Scholar 

  • Stiff P, Mumby P, Miler L et al (2006) Autologous hematopoietic stem cell transplants that utilize total body irradiation can safely be carried out entirely on an outpatient basis. Bone Marrow Transplant 38:757–764

    Article  CAS  PubMed  Google Scholar 

  • Sullivan KM, Parkman R (1983) The pathophysiology and treatment of graft-versus-host disease. Clin Haematol 12:775–789

    Article  CAS  PubMed  Google Scholar 

  • Sureda A, Arranz R, Iriondo A et al (2001) Autologous stem-cell transplantation for Hodgkin’s disease: results and prognostic factors in 494 patients from the Grupo Español de Linfomas/Transplante Autólogo de Médula Osea Spanish Cooperative Group. J Clin Oncol 19:1395–1404

    Article  CAS  PubMed  Google Scholar 

  • Symons K, Morrison C, Parry J et al (2018) Volumetric modulated arc therapy for total body irradiation: a feasibility study using Pinnacle3 treatment planning system and Elekta Agilityâ„¢ linac. J Appl Clin Med Phys 19:103–110

    Article  PubMed  PubMed Central  Google Scholar 

  • Tarbell NJ, Guinan EC, Chin L et al (1990) Renal insufficiency after total body irradiation for pediatric bone marrow transplantation. Radiother Oncol 18(Suppl 1):139–142

    Article  PubMed  Google Scholar 

  • Taylor PR, Jackson GH, Lennard AL et al (1997) Low incidence of myelodysplastic syndrome following transplantation using autologous non-cryopreserved bone marrow. Leukemia 11:1650–1653

    Article  CAS  PubMed  Google Scholar 

  • Thames HD, Bentzen SM, Turesson I et al (1989) Fractionation parameters for human tissues and tumors. Int J Radiat Biol 56:701–710

    Article  CAS  PubMed  Google Scholar 

  • Thames HD, Bentzen SM, Turesson I et al (1990) Time-dose factors in radiotherapy: a review of the human data. Radiother Oncol 19:219–235

    Article  CAS  PubMed  Google Scholar 

  • Thomas ED, Sanders JE, Flournoy N et al (1979) Marrow transplantation for patients with acute lymphoblastic leukemia in remission. Blood 54:468–476

    Article  CAS  PubMed  Google Scholar 

  • Thomas ED, Clift RA, Hersman J et al (1982) Marrow transplantation for acute nonlymphoblastic leukemic in first remission using fractionated or single-dose irradiation. Int J Radiat Oncol Biol Phys 8:817–821

    Article  CAS  PubMed  Google Scholar 

  • Thomas O, Mahé M, Campion L et al (2001) Long-term complications of total body irradiation in adults. Int J Radiat Oncol Biol Phys 49:125–131

    Article  PubMed  Google Scholar 

  • Thomson AE, Vaughan-Smith S, Peel WE (1982) A mathematical model resolving normal human blood lymphocyte population x-ray survival curves into six components: radiosensitivity, death rate and size of two responding subpopulations. Int J Radiat Biol Relat Stud Phys Chem Med 41:15–32

    Article  CAS  PubMed  Google Scholar 

  • Tichelli A, Passweg J, Wójcik D et al (2008) Late cardiovascular events after allogeneic hematopoietic stem cell transplantation: a retrospective multicenter study of the Late Effects Working Party of the European Group for Blood and Marrow Transplantation. Haematologica 93:1203–1210

    Article  PubMed  Google Scholar 

  • Travis EL (1980) The sequence of histological changes in mouse lungs after single doses of x-rays. Int J Radiat Oncol Biol Phys 6:345–347

    Article  CAS  PubMed  Google Scholar 

  • Uckun FM, Song CW (1989) Radiobiological features of human pluripotent bone marrow progenitor cells (CFU-GEMM). Int J Radiat Oncol Biol Phys 17: 1021–1025

    Article  CAS  PubMed  Google Scholar 

  • Uckun FM, Chandan-Langlie M, Jaszcz W et al (1993) Radiation damage repair capacity of primary clonogenic blasts in acute lymphoblastic leukemia. Cancer Res 53:1431–1436

    CAS  PubMed  Google Scholar 

  • van Kempen-Harteveld ML, Struikmans H, Kal HB et al (2000) Cataract-free interval and severity of cataract after total body irradiation and bone marrow transplantation: influence of treatment parameters. Int J Radiat Oncol Biol Phys 48:807–815

    Article  PubMed  Google Scholar 

  • van Kempen-Harteveld ML, Struikmans H, Kal HB et al (2002) Cataract after total body irradiation and bone marrow transplantation: degree of visual impairment. Int J Radiat Oncol Biol Phys 52:1375–1380

    Article  PubMed  Google Scholar 

  • Vardiman JW, Harris NL, Brunning RD (2002) The World Health Organization (WHO) classification of the myeloid neoplasms. Blood 100:2292–2302

    Article  CAS  PubMed  Google Scholar 

  • Wadleigh M, Ho V, Momtaz P, Richardson P (2003) Hepatic veno-occlusive disease: pathogenesis, diagnosis and treatment. Curr Opin Hematol 10:451–462

    Article  PubMed  Google Scholar 

  • Weiner RS, Dicke KA (1987) Risk factors for interstitial pneumonitis following allogeneic bone marrow transplantation for severe aplastic anemia: a preliminary report. Transplant Proc 19:2639–2642

    CAS  PubMed  Google Scholar 

  • Weshler Z, Breuer R, Or R et al (1990) Interstitial pneumonitis after total body irradiation: effect of partial lung shielding. Br J Haematol 74:61–64

    Article  CAS  PubMed  Google Scholar 

  • Wingard JR, Sostrin MB, Vriesendorp HM et al (1988) Interstitial pneumonitis following autologous bone marrow transplantation. Transplantation 46:61–65

    Article  CAS  PubMed  Google Scholar 

  • Wong JYC, Rosenthal J, Liu A et al (2009) Image-guided total-marrow irradiation using helical tomotherapy in patients with multiple myeloma and acute leukemia undergoing hematopoietic cell transplantation. Int J Radiat Oncol Biol Phys 73:273–279

    Article  PubMed  Google Scholar 

  • Wong JYC, Filippi AR, Dabaja BS et al (2018) Total body irradiation: guidelines from the International Lymphoma Radiation Oncology Group (ILROG). Int J Radiat Oncol Biol Phys 101:521–529

    Article  PubMed  Google Scholar 

  • Woo SB, Sonis ST, Monopoli MM, Sonis AL (1993) A longitudinal study of oral ulcerative mucositis in bone marrow transplant recipients. Cancer 72:1612–1617

    Article  CAS  PubMed  Google Scholar 

  • Yuen KY, Woo PC, Tai JW et al (2001) Effects of clarithromycin on oral mucositis in bone marrow transplant recipients. Haematologica 86:554–555

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rimpa Achari .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Achari, R., Das, A., Mahata, A. (2020). Total Body Irradiation in Stem Cell Transplant. In: Chandy, M., Radhakrishnan, V., Sukumaran, R. (eds) Contemporary Bone Marrow Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-64938-2_23-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-64938-2_23-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64938-2

  • Online ISBN: 978-3-319-64938-2

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics