Late Toxicity in Children Undergoing Hematopoietic Stem Cell Transplantation with TBI-containing Conditioning Regimens for Hematological Malignancies

Total Body Irradiation (TBI) in Pediatric Patients

“…In pediatric patients, especially high rates of late sequelae following TBI have been observed in studies with long median follow-up times of over 3 years [23,29]. Consistent with our data, hypothyroidism was observed in 12% of pediatric patients after a median FU of 3 years.…”

“…In the 1980s, dose rates were reduced resulting in a further decrease in late effects, especially cataractogenesis, renal toxicity, and interstitial pneumonitis [1,7,16] . Nevertheless, severe long-term sequelae, especially the induction of secondary malignancy, hormonal dysregulation, reproductive insufficiency, as well as growth retardation and the development of osteochondromas in pediatric patients remained an issue [15,21,23,29].…”

Retrospective, Monocentric Analysis of Late Effects after Total Body Irradiation (TBI) in Adults

“…Heinzelmann et al [4] recently reported results from the German Registry for Stem Cell Transplantation (DSRT) with a comprehensive overview about role and indications for TBI. Beside its efficacy in the different treatment schedules, patients surviving TBI are known to be at risk to develop a broad variety of late side effects [1,3,5,10,12,14]. Although patient survival is still the major concern in patients undergoing TBI [4], the knowledge of late effects of this treatment approach is important for patient information and comparison of different treatment strategies.…”

Advanced-Stage III/IV Follicular Lymphoma

“…As compared to autologous HSCT, the allogeneic stem cell source provides a pluripotent progenitor pool free of contaminated tumor cells and includes T cells capable of promoting the graft-versus-lymphoma (GVL) effect as part of an alloreactive mechanism [44,84]. In this context, total-body irradiation (TBI) plays a key role in the conditioning regimen prior to allogeneic HSCT [23,31,60,63,71] in order to eradicate malignant clonogenic cells and to achieve a sufficient immunosuppression [12]. The first series of successful allogeneic transplantations in patients with relapsed/chemorefractory FL was performed by van Besien et al mainly using a TBI-based conventional myeloablative conditioning protocol [82].…”