The role of total body irradiation (TBI) as a conditioning regime for paediatric acute lymphoblastic leukaemia: A discussion of the evidence |
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| Affiliation: | 1. Department of Radiation Oncology, Baskent University, Adana Medical Faculty, Adana, Turkey;2. Department of Medical Oncology, Baskent University, Adana Medical Faculty, Adana, Turkey;1. Beaumont Neuroscience Center, Royal Oak, MI;2. Department of Translational Science and Molecular Medicine, Michigan State University College of Medicine and Saint Mary''s Health Care, Grand Rapids, MI;1. College of Electronic Science and Engineering, National University of Defense Technology, Changsha 410073, PR China;2. College of Physics and Communication Electronics, Jiangxi Normal University, Nanchang 330022, PR China;1. Departamento de Medicina Interna, Servicio de Cardiología, Hospital Clínico Unversitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria, Murcia, Spain;2. Departamento de Medicina Interna, Universidad de Murcia, Spain;3. Departmento de Medicina Interna, Hospital de la Vega Lorenzo Guirao, Cieza, Murcia, Spain;4. Departamento de Medicina Interna, Sección de Cardiología, Hospital de los Arcos, San Javier, Murcia, Spain;5. Departamento de Bioquímica, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain;1. Hépatologie Pédiatrique and Centre de Référence National de l’Atrésie des Voies Biliaires, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France;3. Radiologie Pédiatrique, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France;4. Santé Publique et Épidémiologie, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France;7. Anesthesie-Réanimation, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France;8. Réanimation Pédiatrique, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France;2. Université Paris-Sud 11, Le Kremlin-Bicêtre, France;5. Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Epidemiology of Reproduction and Children Development Team, Le Kremlin-Bicêtre, France;6. Université Paris Sud 11, UMRS 1018, Le Kremlin-Bicêtre, France;9. Inserm U 757, Université Paris-Sud 11, Orsay, France;1. Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin;2. Radiation Oncology Center, Affiliated Hospital of Medical College, Qingdao University, Qingdao, China |
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| Abstract: | AimThe long term effects of TBI with children can be adverse and has resulted in a debate as to whether chemotherapy only based condition regimes could be used as an alternatives. The aim of this article is to critically evaluate the literature relating to the role of TBI as a conditioning regime in ALL in children, and if there are any alternatives to current practices or future developments.MethodKey databases were searched for terms: conditioning regimes, transplantation, TBI, whole body radiation, systemic irradiation, stem cell transplantation, hematopoietic stem cell, and transplant conditioning.ResultsThirteen research articles from a variety of publications and two guidance documents from several sources were uncovered for critical discussion.Discussion/conclusionThere is little evidence for chemotherapy only regimes in paediatric ALL, but the practice continues. Modulating doses to improve homogeneity and use of IGRT could hold a future solution to reducing long-term toxicity and maintain the efficacy of irradiation. |
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| Keywords: | TBI Stem cell transplant Paediatric ALL |
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