Low dose radiation before allogeneic reduced intensity transplant – pro

Low dose radiation is being added to conditioning regimens before reduced intensity allogeneic transplants.It is not currently known whether the effects are on the whole positive or negative, or not effective at all. A number of restrospective reviews have come to different conclusions.

In a report by Du and colleagues, where 80% of patients received radiation-free conditioning, age >50 years was an independent adverse factor for survival on multivariable analysis.Low dose radiation may protect against graft cersus host disease; it can also produce pneumonitis, myelitis and other complications. Arguing for tis sue iw anecdotal experience as well as studies of incresing doses in numan and animal models as well as retropective reviews. The goal of low doe radiation is to control immune response following a reduced intensity allogneic transplant. The ultimmate effect is now known with certainty. This procedure is being investigated.

Y . Belkacemi , M . Labopin , C . Hennequin , S . Hoffstetter , M . Vygoda , M . Lundel , M . Mungai , N . Basara Low Dose Total Body Irradiation Prior to Allograft for Heamtologic Malignancies: a Retrospective Review from the Acute Leukemia Working Party of the European Blood and Marrow Transplantation .
International Journal of Radiation OncologyBiologyPhysics , Volume 63 , Pages S420 – S420

S S Farag et al, Radiation-free regimens result in similar outcomes of allogeneic hematopoietic progenitor cell transplantation in patients aged 50 years compared to younger adults with low-risk disease Bone Marrow Transplantation (2003) 31, 87–93.

Du W, Dansey R, Abella EM et al. Successful allogeneic bone marrow transplantation in selected patients over 50 years of age-a single institution’s experience. Bone Marrow Transplant 1998; 21: 1043–1047.
Champlin R, Khouri I, Anderlini P et al. Nonmyeloablative preparative regimens for allogeneic hematopoietic transplantation. Bone Marrow Transplant 2001; 27: S13–S22.

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