title: Various Regimens of Total Body Irradiation for Hematopoietic Stem Cell Transplant.
abstract: We aimed to evaluate the safety of total body irradiation before bone marrow transplant.
  
  
  
  We analyzed 110 patients (65 male, 45 female) who underwent total body irradiation for hematopoietic stem cell transplant between May 1998 and March 2013. Median age at total body irradiation was 17 years (range, 1-62 y). Median observation time was 777 days (range, 31-5494 d). Initial diagnoses were acute lymphoblastic leukemia (24 patients), acute myeloid leukemia (26 patients), chronic myeloid leukemia (7 patients), myelodysplastic syndrome (8 patients), malignant lymphoma (13 patients), mucopolysaccharidosis (12 patients), neuroblastoma (10 patients), and other diseases (10 patients). The total fractionated dose used for total body irradiation was 12 Gy in 69 patients and 6.0-10.8 Gy in 29 patients. Single-dose total body irradiation was administered to 12 patients. Most patients (63 of 110) received chemotherapy consisting of cyclophosphamide alone.
  
  
  
  Ocular complications were observed in 29.5% of the patients. Hypothyroidism, interstitial pneumonia, obliterative bronchiolitis, and veno-occlusive disease developed in 8.2%, 1.8%, 0.9%, and 2.7% of patients. Growth abnormality was observed in 10 (20%) of the 50 pediatric patients. The use of a lower dose (< 12 Gy vs 12 Gy) of fractionated total body irradiation did not decrease the incidence of adverse events; however, nonmyeloablative conditioning with low-dose singlefraction total body irradiation reduced the incidence of adverse events. Three patients who underwent total body irradiation as reirradiation therapy achieved long-term survival without adverse events.
  
  
  
  Fractionated total body irradiation given at a lower dose (<12 Gy vs 12 Gy) did not decrease the incidence of adverse events.
authors.affiliation: Department of Radiology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Ishibashi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Maebayashi
authors.forename: Takuya
authors.initials: T
authors.lastname: Aizawa
authors.forename: Masakuni
authors.initials: M
authors.lastname: Sakaguchi
authors.forename: Osamu
authors.initials: O
authors.lastname: Abe
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Sakanishi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Endoh
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Saito
authors.forename: Jiro
authors.initials: J
authors.lastname: Kawamori
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000627:therapeutic use*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007951:Leukemia, Myeloid / Q000628:therapy*; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009083:Mucopolysaccharidoses / Q000628:therapy*; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D009447:Neuroblastoma / Q000628:therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D019172:Transplantation Conditioning; D014916:Whole-Body Irradiation; D055815:Young Adult
chemical_list: D003520:Cyclophosphamide