Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation
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- 10.2991/chi.d.190218.002How to use a DOI?
- Leukemia; Conditioning regimen; Total body irradiation (TBI); Total marrow irradiation (TMI); Targeted radiation therapy; Radiation toxicities
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.
- © 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
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TY - JOUR AU - Rashmika R. Potdar AU - Sorab Gupta AU - Sebastian Giebel AU - Bipin N Savani AU - Gabor Varadi AU - Arnon Nagler AU - Slawomir Blamek PY - 2019 DA - 2019/03/18 TI - Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation JO - Clinical Hematology International SP - 19 EP - 27 VL - 1 IS - 1 SN - 2590-0048 UR - https://doi.org/10.2991/chi.d.190218.002 DO - 10.2991/chi.d.190218.002 ID - Potdar2019 ER -