title: Treatment Complications and Long-term Outcomes of Total Body Irradiation in Patients with Acute Lymphoblastic Leukemia: A Single Institute Experience.
abstract: The aim of this study was to evaluate treatment-related toxicity and clinical outcomes of total body irradiation (TBI) in patients with acute lymphoblastic leukemia (ALL).
  
  
  
  We performed a retrospective review of all patients with ALL who underwent TBI-based conditioning regimen at our Institution between 2000 and 2012.
  
  
  
  A total of 211 patients were included. The median follow-up was 40 months. The 5-year overall survival and disease-free survival were 64.7% and 62.8%, respectively. The 5-year overall survival rate for the 163 children was 67.6% (95% confidence interval=55-77%). Disease status at time of transplant did not improve disease-free survival. Gastrointestinal acute toxicity was the most common early side-effect (19.9%). Acute graft-versus-host disease was reported in 31 patients (14.7%). Main late toxicities were cataract induction (12.8%) and growth, gonadal and endocrine effects (36%).
  
  
  
  TBI-based conditioning regimen led to a high survival rate with remarkably low radiation-related toxicity, suggesting that TBI provides a feasible therapeutic option in patients with ALL.
authors.affiliation: Department of Radiotherapy, Thrombosis Center, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy fradefelice@hotmail.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: DE Felice
authors.affiliation: Department of Radiotherapy, Thrombosis Center, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Lavinia
authors.initials: L
authors.lastname: Grapulin
authors.affiliation: Department of Radiotherapy, Thrombosis Center, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Musio
authors.affiliation: Department of Radiotherapy, Thrombosis Center, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Jenny
authors.initials: J
authors.lastname: Pomponi
authors.affiliation: Department of Medical Physics, Thrombosis Center, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: DI Felice
authors.affiliation: Department of Cellular Biotechnologies and Hematology, Thrombosis Center, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Anna Paola
authors.initials: AP
authors.lastname: Iori
authors.affiliation: Department of Pediatric Hematology and Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Bertaina
authors.affiliation: Department of Radiotherapy, Thrombosis Center, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy Spencer-Lorillard Foundation, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tombolini
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D041981:Gastrointestinal Tract / Q000473:pathology / Q000528:radiation effects*; D006086:Graft vs Host Disease / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014916:Whole-Body Irradiation / Q000009:adverse effects*
keywords: Total body irradiation; acute lymphoblastic leukemia; child; conditioning regimen; hematologic cancer; radiotherapy