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High risk of acute pulmonary toxicity with both myeloablative and non-myeloablative total body irradiation-based conditioning for allogeneic stem cell transplantation

Bone Marrow Transplantation volume 59, pages 150–152 (2024)Cite this article

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Allogeneic hematopoietic stem transplantation (HSCT) is an established treatment for high-risk or relapsed hematologic malignancies. Total body irradiation (TBI) is an integral component of many conditioning regimens. Among the adverse events associated with TBI, one of the most clinically significant is pulmonary toxicity [1, 2]. Pulmonary toxicity seems to occur more frequently with TBI-based conditioning regimens compared with regimens in which only chemotherapy is utilized [3,4,5].

The conditioning regimen prior to allogeneic HSCT can either be myeloablative (~12–14 Gy TBI) or non-myeloablative (~2 Gy TBI). In addition to higher TBI doses, myeloablative regimens include higher doses of chemotherapy which may also increase the risk of pulmonary complications. Patterns and predictors of pulmonary toxicity with non-myeloablative regimens have not been studied as extensively as in myeloablative regimens [5, 6] which prompted the present analysis.

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Research data are stored in an institutional repository and will be shared upon reasonable request to the corresponding author.

References

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Funding

The study was funded by Radiation Oncology Department, Duke University.

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Authors and Affiliations

  1. Department of Radiation Oncology, Duke University Medical Center, Durham, NC, 27710, USA

    Pranalee Patel, Edina Wang & Chris R. Kelsey

  2. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, 27710, USA

    Mairead Dillon, Donna Niedzwiecki & Kerri-Anne Crowell

  3. Department of Medicine, Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, 27710, USA

    Mitchell E. Horwitz

Authors
  1. Pranalee Patel
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  2. Mairead Dillon
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  3. Donna Niedzwiecki
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  4. Kerri-Anne Crowell
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  5. Mitchell E. Horwitz
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  6. Edina Wang
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  7. Chris R. Kelsey
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Contributions

PP, CK, and MH were responsible for designing the study and obtaining the data from the medical record. MD, DN, and KAC analyzed the data and completed all of the statistical analyses. All authors contributed to writing, reviewing, and approving the final manuscript.

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Correspondence to Chris R. Kelsey.

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Patel, P., Dillon, M., Niedzwiecki, D. et al. High risk of acute pulmonary toxicity with both myeloablative and non-myeloablative total body irradiation-based conditioning for allogeneic stem cell transplantation. Bone Marrow Transplant 59, 150–152 (2024). https://doi.org/10.1038/s41409-023-02140-y

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  • DOI: https://doi.org/10.1038/s41409-023-02140-y

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