Reduced incidence of interstitial pneumonitis after allogeneic hematopoietic stem cell transplantation using a modified technique of total body irradiation View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-12

AUTHORS

Yun Chiang, Cheng-Hong Tsai, Sung-Hsin Kuo, Chieh-Yu Liu, Ming Yao, Chi-Cheng Li, Shang-Yi Huang, Bor-Sheng Ko, Chien-Ting Lin, Hsin-An Hou, Wen-Chien Chou, Jia-Hau Liu, Chien-Chin Lin, Shang-Ju Wu, Szu-Chun Hsu, Yao-Chang Chen, Kai-Hsin Lin, Dong-Tsamn Lin, Hsien-Tang Chou, Meng-Yu Lu, Yung-Li Yang, Hsiu-Hao Chang, Ming-Chih Liu, Xiu-Wen Liao, Jian-Kuen Wu, Sheng-Chieh Chou, Chieh-Lung Cheng, Chien-Yuan Chen, Woei Tsay, Hwei-Fang Tien, Jih-Luh Tang, Yu-Hsuan Chen

ABSTRACT

Allogeneic hematopoietic stem cell transplantation is a curative-intent treatment for patients with high-risk hematologic diseases. However, interstitial pneumonitis (IP) and other toxicities remain major concerns after total body irradiation (TBI). We have proposed using linear accelerators with rice-bag compensators for intensity modulation (IM-TBI), as an alternative to the traditional cobalt-60 teletherapy with lung-shielding technique (Co-TBI). Patients who received a TBI-based myeloablative conditioning regimen between 1995 and 2014 were recruited consecutively. Before March 2007, TBI was delivered using Co-TBI (n = 181); afterward, TBI was administered using IM-TBI (n = 126). Forty-four patients developed IP; of these cases, 19 were idiopathic. The IP-related mortality rate was 50% in the total IP cohort and 63% in the idiopathic subgroup. The 1-year cumulative incidences of IP and idiopathic IP were 16.5% and 7.4%, respectively; both rates were significantly higher in the Co-TBI group than in the IM-TBI group. Multivariate analysis revealed that Co-TBI was an independent prognostic factor for both total and idiopathic IP. In the acute myeloid leukemia subgroup, patients with different TBI techniques had similar outcomes for both overall and relapse-free survival. In conclusion, IM-TBI is an easy and effective TBI technique that could substantially reduce the complication rate of IP without compromising treatment efficacy. More... »

PAGES

36730

References to SciGraph publications

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/srep36730

    DOI

    http://dx.doi.org/10.1038/srep36730

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1025289867

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27830767


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