Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation
Acute myeloid leukemia and acute lymphoblastic leukemia are the most common indications for allogeneic hematopoietic stem cell transplantation. Total body irradiation (TBI) is an important part of conditioning regimens. TBI-based regimens offer advantages in sanctuary sites but are associated with s...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAABRON PRESS
2019-03-01
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| Series: | Clinical Hematology International |
| Subjects: | |
| Online Access: | https://www.atlantis-press.com/article/125905874/view |
| _version_ | 1797230268366454784 |
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| author | Rashmika R. Potdar Sorab Gupta Sebastian Giebel Bipin N Savani Gabor Varadi Arnon Nagler Slawomir Blamek |
| author_facet | Rashmika R. Potdar Sorab Gupta Sebastian Giebel Bipin N Savani Gabor Varadi Arnon Nagler Slawomir Blamek |
| author_sort | Rashmika R. Potdar |
| collection | DOAJ |
| description | Acute myeloid leukemia and acute lymphoblastic leukemia are the most common indications for allogeneic hematopoietic stem cell transplantation. Total body irradiation (TBI) is an important part of conditioning regimens. TBI-based regimens offer advantages in sanctuary sites but are associated with significant risks of early and late side effects, including pulmonary toxicity, growth retardation, and second malignancy. TBI is also associated with technical problems, such as dose heterogeneity. With evolving techniques in radiation oncology, it is possible to focus the dose to the entire skeleton while sparing the rest of the body. This technique is called total marrow irradiation (TMI). TMI is able to deliver the same or higher doses to bone marrow while reducing toxicity. With the success of TMI, we are moving toward ultra-personalized conditioning. We review the clinical role of the irradiation-based regimens currently in clinical use, emphasizing on their strengths and limitations. Novel technologies with targeted irradiation accompanied by the modern imaging techniques and increased knowledge of the disease process can help us achieve our goal of maximum response with minimum toxicity. |
| first_indexed | 2024-04-24T15:25:47Z |
| format | Article |
| id | doaj.art-9429fc16114e400d8e653e3f80cbb60d |
| institution | Directory Open Access Journal |
| issn | 2590-0048 |
| language | English |
| last_indexed | 2024-04-24T15:25:47Z |
| publishDate | 2019-03-01 |
| publisher | SAABRON PRESS |
| record_format | Article |
| series | Clinical Hematology International |
| spelling | doaj.art-9429fc16114e400d8e653e3f80cbb60d2024-04-02T06:23:25ZengSAABRON PRESSClinical Hematology International2590-00482019-03-011110.2991/chi.d.190218.002Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell TransplantationRashmika R. PotdarSorab GuptaSebastian GiebelBipin N SavaniGabor VaradiArnon NaglerSlawomir BlamekAcute myeloid leukemia and acute lymphoblastic leukemia are the most common indications for allogeneic hematopoietic stem cell transplantation. Total body irradiation (TBI) is an important part of conditioning regimens. TBI-based regimens offer advantages in sanctuary sites but are associated with significant risks of early and late side effects, including pulmonary toxicity, growth retardation, and second malignancy. TBI is also associated with technical problems, such as dose heterogeneity. With evolving techniques in radiation oncology, it is possible to focus the dose to the entire skeleton while sparing the rest of the body. This technique is called total marrow irradiation (TMI). TMI is able to deliver the same or higher doses to bone marrow while reducing toxicity. With the success of TMI, we are moving toward ultra-personalized conditioning. We review the clinical role of the irradiation-based regimens currently in clinical use, emphasizing on their strengths and limitations. Novel technologies with targeted irradiation accompanied by the modern imaging techniques and increased knowledge of the disease process can help us achieve our goal of maximum response with minimum toxicity.https://www.atlantis-press.com/article/125905874/viewLeukemiaConditioning regimenTotal body irradiation (TBI)Total marrow irradiation (TMI)Targeted radiation therapyRadiation toxicities |
| spellingShingle | Rashmika R. Potdar Sorab Gupta Sebastian Giebel Bipin N Savani Gabor Varadi Arnon Nagler Slawomir Blamek Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation Clinical Hematology International Leukemia Conditioning regimen Total body irradiation (TBI) Total marrow irradiation (TMI) Targeted radiation therapy Radiation toxicities |
| title | Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation |
| title_full | Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation |
| title_fullStr | Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation |
| title_full_unstemmed | Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation |
| title_short | Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation |
| title_sort | current status and perspectives of irradiation based conditioning regimens for patients with acute leukemia undergoing hematopoietic stem cell transplantation |
| topic | Leukemia Conditioning regimen Total body irradiation (TBI) Total marrow irradiation (TMI) Targeted radiation therapy Radiation toxicities |
| url | https://www.atlantis-press.com/article/125905874/view |
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