Cataracts after total body irradiation and bone marrow transplantation in patients with acute leukemia in complete remission: a study of the european group for blood and marrow transplantation

Belkacémi, Yazid; Labopin, Myriam; Vernant, Jean‐Paul; Prentice, H.G.; Thewis, André; Schattenberg, A.V.M.B.; Boogaerts, Marc; Ernst, Peter; Volpe, A. Della; Goldstone, A. H.; Jouet, Jean‐Pierre; Verdonck, Leo F.; Locasciulli, Anna; Rio, Bernard; Özşahin, Mahmut; Gorin, Norbert Claude

doi:10.1016/s0360-3016(98)00077-7

Cited by 98 publications

(82 citation statements)

References 35 publications

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Different risk factors for cataract formation have been described in the literature, these being conditioning regimen, type of transplant, age, acute or chronic graft-versus-host disease (GVHD), steroids and previous prophylactic cranial radiotherapy. 1,4,5,7,9,10,13,17 Both the use of total body irradiation (TBI) in the pre-transplant regimen and the TBI schedule have been proven to be two of the most important risk factors for the development of cataracts. 1,4,6,7,9,10,13 Cataract due to radiation is typically posterior, subcapsular, and different from nuclear cataract located in the central part of the lens, which is usually associated with advanced age.…”

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confidence: 99%

“…1,4,5,7,9,10,13,17 Both the use of total body irradiation (TBI) in the pre-transplant regimen and the TBI schedule have been proven to be two of the most important risk factors for the development of cataracts. 1,4,6,7,9,10,13 Cataract due to radiation is typically posterior, subcapsular, and different from nuclear cataract located in the central part of the lens, which is usually associated with advanced age.…”

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confidence: 99%

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Cataracts in patients receiving stem cell transplantation after conditioning with total body irradiation

Aristei

Alessandro

Santucci

et al. 2002

Bone Marrow Transplant

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Summary:One hundred and ninety-three patients with hematological malignancies and a follow-up у1 year, treated with stem cell transplantation (45 autologous, 99 allogeneic T cell-depleted matched, 49 allogeneic T cell-depleted mismatched) from July 1985 to May 1998, were considered evaluable for the development of cataracts. Total body irradiation (TBI), administered either according to a hyperfractionated scheme (HTBI) or in a single dose (STBI), was employed in the conditioning regimens. HTBI was prescribed in 94% of patients undergoing allogeneic matched transplant, while STBI was used in 71% of patients receiving allogeneic mismatched and in all patients undergoing autologous transplant. The median follow-up was 7.56 years in the HTBI and 3.02 years in the STBI group. Among the different risk factors analyzed by univariate analysis only the TBI scheme and type of transplant reached statistical significance (P Ͻ 0.0001 and P Ͻ 0.001, respectively). By multivariate analysis only the TBI scheme was an independent factor for cataract development (STBI vs HTBI RR 7.2; P Ͻ 0.01). Our results showed that STBI is more cataractogenic than HTBI. The incidence of cataract we observed was among the lowest described in the literature. T cell depletion, because it prevents graft-versus-host disease and reduces the protracted use of post-transplant steroids, explains the results we obtained. Bone Marrow Transplantation (2002) 29, 503-507. DOI: 10.1038/sj/bmt/1703400 Keywords: cataract; total body irradiation; stem cell transplantation Advances in transplant techniques over the past 20 years have improved long-term survival of patients receiving bone marrow transplant (BMT) and, consequently, have

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confidence: 99%

mentioning

confidence: 99%

Cataracts in patients receiving stem cell transplantation after conditioning with total body irradiation

Aristei

Alessandro

Santucci

et al. 2002

Bone Marrow Transplant

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“…In humans, cataract incidence following total body irradiation for hematological malignancies depends on several factors, whose physiopathological mechanisms are not fully understood [2][3][4][5]. Moreover, prophylactic medical treatment is currently unavailable.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of lens opacification depends on irradiation parameters [1][2][3][4]. A cataract rate as high as 100% at 3.5 years has been reported in patients conditioned with a single fraction total body irradiation prior to bone marrow transplantation [5].…”

Section: Introductionmentioning

confidence: 99%

Lens epithelial cell protection by aminothiol WR-1065 and anetholedithiolethione from ionizing radiation

Belkacémi¹,

Rat²,

Piel³

et al. 2001

Int. J. Cancer

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SUMMARY Lens epithelium disorganization, glutathione (GSH) depletion, and epithelial cell death have been incriminated in the cytopathogenic mechanisms that lead to cataract formation following UVB and x-ray exposures. The objective of this study was to determine the in vitro capacity of the aminothiol WR-1065, the active metabolite of amifostine, and anetholedithiolethione (ADT or Sulfarlem ) to protect bovine lens epithelial cells against x-ray irradiation. WR-1065 and ADT were used at a concentration of 20 M. A single dose of 10 Gy was delivered at a rate of 2 Gy/min. Fluorimetric assays were then performed using a neutral red probe to evaluate cell viability, a Hoechst 33342 probe (HO) to evaluate nuclear condensation and apoptosis, and a monobromobimane probe to estimate the intracellular GSH pool. Twenty-four hours after x-ray exposure, cells pretreated with WR-1065 showed increased GSH levels, improved cell viability, and decreased HO fluorescence in addition to a lesser proportion of cells with apoptotic nuclear modifications. Between 72 and 120 hr postirradiation, ADT-pretreated cells also showed increased intracellular GSH levels and cell viability and decreased HO fluorescence and apoptotic cell morphology. This in vitro study demonstrates that WR-1065 and ADT protects lens epithelial cells from x-ray injury; thus, ADT and amifostine are appropriate candidates for clinical trials in humans. They are currently used in preventing radiation-induced xerostomia and should be further tested in the prevention of late radiation-induced ocular complications such as sicca syndrome and cataract.

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“…Formation begins to appear usually within 3-5 years, and the incidence following fractionated TBI appears to be between 40 and 70%. 2,10,21,22 Dry eye syndrome occurs in 40-75% of allo-HSCT recipients, and may be the heralding symptom of ocular GvHD. 23 Secondary complications include conjunctival keratitis, corneal keratinization, ulceration and perforation of the cornea.…”

Section: Ophthalmologicalmentioning

confidence: 99%

What do we need to know about allogeneic hematopoietic stem cell transplant survivors?

Clark

Savani

Mohty

et al. 2016

Bone Marrow Transplant

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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for over 70 benign and malignant hematologic and immunological processes. Over the past several decades, significant technological and post-transplant supportive advances have been made, resulting in a decrease in early transplant mortality and continued growth in the population of allo-HSCT survivors. With the expansion in the number of long-term survivors, as well as of those considering a transplant, the focus of transplant medicine has been shifted significantly to include a more prominent role for the care of the 'long-term' survivor. These patients have survived the acute critical phase of transplantation and have potentially achieved remission from their primary disease, yet allo-HSCT patients do not return to pre-transplant health status. For survivors 42 years removed, the time of transplant all-cause mortality is four-to nine-fold higher than age-matched peers within the general population. These patients represent a distinct, high-risk population that must be monitored for long-term transplant complications, including chronic GvHD (cGvHD), multi-organ dysfunctions and secondary malignancies. This article will review in a non-exhaustive manner, the approach to long-term care of an allo-HSCT recipient.

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Cataracts after total body irradiation and bone marrow transplantation in patients with acute leukemia in complete remission: a study of the european group for blood and marrow transplantation

Cited by 98 publications

References 35 publications

Cataracts in patients receiving stem cell transplantation after conditioning with total body irradiation

Cataracts in patients receiving stem cell transplantation after conditioning with total body irradiation

Lens epithelial cell protection by aminothiol WR-1065 and anetholedithiolethione from ionizing radiation

What do we need to know about allogeneic hematopoietic stem cell transplant survivors?

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