Clinical Hematology International

Volume 1, Issue 1, March 2019, Pages 19 - 27

Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation

Authors
Rashmika R. Potdar1, *, Sorab Gupta1, Sebastian Giebel2, Bipin N Savani3, Gabor Varadi1, Arnon Nagler4, Slawomir Blamek5
1Division of Hematology and Oncology, Department of Internal Medicine, Einstein Medical Center, Philadelphia, PA, USA
2Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute-Oncology Center, Gliwice Branch, Gliwice, Poland
3Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center & Veterans Affairs Medical Center, Nashville, TN, USA
4Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
5Department of Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland

Peer review is under the responsibility of IACH

*Corresponding author. Email: drrashmika@gmail.com
Corresponding Author
Rashmika R. Potdar
Received 8 February 2019, Accepted 18 February 2019, Available Online 18 March 2019.
DOI
https://doi.org/10.2991/chi.d.190218.002How to use a DOI?
Keywords
Leukemia; Conditioning regimen; Total body irradiation (TBI); Total marrow irradiation (TMI); Targeted radiation therapy; Radiation toxicities
Abstract

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.

Copyright
© 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal
Clinical Hematology International
Volume-Issue
1 - 1
Pages
19 - 27
Publication Date
2019/03/18
ISSN (Online)
2590-0048
DOI
https://doi.org/10.2991/chi.d.190218.002How to use a DOI?
Copyright
© 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

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  - https://doi.org/10.2991/chi.d.190218.002
ID  - Potdar2019
ER  -