Total marrow and total lymphoid irradiation in bone marrow transplantation for acute leukaemia.
Lancet Oncol
; 21(10): e477-e487, 2020 10.
Article
em En
| MEDLINE
| ID: mdl-33002443
The use of total body irradiation as part of conditioning regimens for acute leukaemia is progressively declining because of concerns of late toxic effects and the introduction of radiation-free regimens. Total marrow irradiation and total marrow and lymphoid irradiation represent more targeted forms of radiotherapy compared with total body irradiation that have the potential to decrease toxicity and escalate the dose to the bone marrow for high-risk patients. We review the technological basis and the clinical development of total marrow irradiation and total marrow and lymphoid irradiation, highlighting both the possible advantages as well as the current roadblocks for widespread implementation among transplantation units. The exact role of total marrow irradiation or total marrow and lymphoid irradiation in new conditioning regimens seems dependent on its technological implementation, aiming to make the whole procedure less time consuming, more streamlined, and easier to integrate into the clinical workflow. We also foresee a role for computer-assisted planning, as a way to improve planning and delivery and to incorporate total marrow irradiation and total marrow and lymphoid irradiation in multi-centric phase 2-3 trials.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Medula Óssea
/
Leucemia Mieloide Aguda
/
Irradiação Linfática
/
Transplante de Medula Óssea
/
Condicionamento Pré-Transplante
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article