Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on?
Total body irradiation (TBI), used as part of the conditioning regimen prior to allogeneic and autologous hematopoietic cell transplantation, is the delivery of a relatively homogeneous dose of radiation to the entire body. TBI has a dual role, being cytotoxic and immunosuppressive. This allows it t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-02-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/28/1/89 |
| _version_ | 1797520711171964928 |
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| author | Mitchell Sabloff Steven Tisseverasinghe Mustafa Ege Babadagli Rajiv Samant |
| author_facet | Mitchell Sabloff Steven Tisseverasinghe Mustafa Ege Babadagli Rajiv Samant |
| author_sort | Mitchell Sabloff |
| collection | DOAJ |
| description | Total body irradiation (TBI), used as part of the conditioning regimen prior to allogeneic and autologous hematopoietic cell transplantation, is the delivery of a relatively homogeneous dose of radiation to the entire body. TBI has a dual role, being cytotoxic and immunosuppressive. This allows it to eliminate disease and create “space” in the marrow while also impairing the immune system from rejecting the foreign donor cells being transplanted. Advantages that TBI may have over chemotherapy alone are that it may achieve greater tumour cytotoxicity and better tissue penetration than chemotherapy as its delivery is independent of vascular supply and physiologic barriers such as renal and hepatic function. Therefore, the so-called “sanctuary” sites such as the central nervous system (CNS), testes, and orbits or other sites with limited blood supply are not off-limits to radiation. Nevertheless, TBI is hampered by challenging logistics of administration, coordination between hematology and radiation oncology departments, increased rates of acute treatment-related morbidity and mortality along with late toxicity to other tissues. Newer technologies and a better understanding of the biology and physics of TBI has allowed the field to develop novel delivery systems which may help to deliver radiation more safely while maintaining its efficacy. However, continued research and collaboration are needed to determine the best approaches for the use of TBI in the future. |
| first_indexed | 2024-03-10T08:00:29Z |
| format | Article |
| id | doaj.art-dbac0b6d2988446392737d3a41205eec |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T08:00:29Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-dbac0b6d2988446392737d3a41205eec2023-11-22T11:31:44ZengMDPI AGCurrent Oncology1198-00521718-77292021-02-0128190391710.3390/curroncol28010089Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on?Mitchell Sabloff0Steven Tisseverasinghe1Mustafa Ege Babadagli2Rajiv Samant3Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, CanadaDivision of Radiation Oncology, Gatineau Hospital, Gatineau, QC J8P 7H2, CanadaDivision of Radiation Oncology, The Ottawa Hospital, Ottawa, ON K1H 8L6, CanadaDivision of Radiation Oncology, The Ottawa Hospital, Ottawa, ON K1H 8L6, CanadaTotal body irradiation (TBI), used as part of the conditioning regimen prior to allogeneic and autologous hematopoietic cell transplantation, is the delivery of a relatively homogeneous dose of radiation to the entire body. TBI has a dual role, being cytotoxic and immunosuppressive. This allows it to eliminate disease and create “space” in the marrow while also impairing the immune system from rejecting the foreign donor cells being transplanted. Advantages that TBI may have over chemotherapy alone are that it may achieve greater tumour cytotoxicity and better tissue penetration than chemotherapy as its delivery is independent of vascular supply and physiologic barriers such as renal and hepatic function. Therefore, the so-called “sanctuary” sites such as the central nervous system (CNS), testes, and orbits or other sites with limited blood supply are not off-limits to radiation. Nevertheless, TBI is hampered by challenging logistics of administration, coordination between hematology and radiation oncology departments, increased rates of acute treatment-related morbidity and mortality along with late toxicity to other tissues. Newer technologies and a better understanding of the biology and physics of TBI has allowed the field to develop novel delivery systems which may help to deliver radiation more safely while maintaining its efficacy. However, continued research and collaboration are needed to determine the best approaches for the use of TBI in the future.https://www.mdpi.com/1718-7729/28/1/89total body irradiation (TBI)hematopoieticstem cell transplantation |
| spellingShingle | Mitchell Sabloff Steven Tisseverasinghe Mustafa Ege Babadagli Rajiv Samant Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on? Current Oncology total body irradiation (TBI) hematopoietic stem cell transplantation |
| title | Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on? |
| title_full | Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on? |
| title_fullStr | Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on? |
| title_full_unstemmed | Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on? |
| title_short | Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on? |
| title_sort | total body irradiation for hematopoietic stem cell transplantation what can we agree on |
| topic | total body irradiation (TBI) hematopoietic stem cell transplantation |
| url | https://www.mdpi.com/1718-7729/28/1/89 |
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