Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany.
Institute of Molecular Medicine and Experimental Immunology, University Hospital Bonn, Bonn, Germany.
Cancer Med. 2023 Mar;12(6):7170-7174. doi: 10.1002/cam4.5452. Epub 2022 Nov 20.
Total body irradiation (TBI) remains an important component in many conditioning regimens before allogeneic hematopoietic stem cell transplantation (allo-HSCT). Because of its frequent toxicity, patient selection is crucial, making it of interest to identify factors improving engraftment. In this retrospective single center analysis, the characteristics of 48 adult such patients were studied. Mean overall survival (OS) was 22.2 months after allo-HSCT. Interestingly, people with an interval ≥3 days between TBI completion and allo-HSCT showed improved OS, when compared to a shorter interval (p = 0.10). Peripheral blood kinetics after successful engraftment also differed, with a longer interval resulting in a higher platelet count and lower leukocyte and neutrophil (p < 0.05) count. These data suggest that the exact timing of TBI before allo-HSCT might directly impact a patient's survival and could help single out those at higher risk of graft failure who might benefit from an altered conditioning regimen.
全身照射（TBI）仍然是异基因造血干细胞移植（allo-HSCT）前许多预处理方案的重要组成部分。由于其频繁的毒性，患者选择至关重要，因此寻找可改善植入的因素很有意义。在这项回顾性单中心分析中，研究了 48 例成人患者的特征。allo-HSCT 后，患者的平均总生存期（OS）为 22.2 个月。有趣的是，与较短间隔相比，TBI 完成与 allo-HSCT 之间间隔≥3 天的患者 OS 得到改善（p=0.10）。成功植入后的外周血动力学也有所不同，较长间隔导致血小板计数较高，白细胞和中性粒细胞计数较低（p<0.05）。这些数据表明，allo-HSCT 前 TBI 的精确时间可能直接影响患者的生存，并有助于甄别那些更有可能发生移植物失败的高危患者，他们可能受益于改变预处理方案。
