Evidence map›Paper›PMID 28396164›Full record

ArticleBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation2017

Dose Escalation of Total Marrow Irradiation in High-Risk Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation.

Susanta Hui, Claudio Brunstein, Yutaka Takahashi, Todd DeFor, Shernan G Holtan, Veronika Bachanova, Christopher Wilke, Darren Zuro, Celalettin Ustun, Daniel Weisdorf and 2 more

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07532824 (Proton Total Marrow Irradiation-Based Conditioning for Allogeneic Hematopoietic Stem Cell Transplantation in High-Risk Acute Myeloid Leukemia and Myelodysplastic Syndrome), which is not on this map. Cited by 27 papers.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07532824 phase1 / phase2recruitingnot on this mapstarted 2025, after this paper: background citation

Proton Total Marrow Irradiation-Based Conditioning for Allogeneic Hematopoietic Stem Cell Transplantation in High-Risk Acute Myeloid Leukemia and Myelodysplastic Syndrome

TypeinterventionalSponsorInstitute of Hematology and Blood Transfusion, Czech RepublicRan2025 to 2029Enrolled16ConditionsAcute Myeloid Leukemia (AML), Myelodysplastic Syndrome (MDS)/AML, Proton Therapy, MDS and AML Prior to Allogeneic SCTArmsProton Total Marrow Irradiation
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 51 citations in OpenAlex.

  1. Trial
  2. Article
  3. New age HCT conditioning regimens: what works and why?Hematology. American Society of Hematology. Education Program · 2025
    Review
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Article
  17. Practice Patterns of Pediatric Total Body Irradiation Techniques: A Children's Oncology Group Survey.International journal of radiation oncology, biology, physics · 2021
    Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Susanta HuiDepartment of Therapeutic Radiology, University of Minnesota, Minneapolis, Minnesota.
Claudio BrunsteinDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Yutaka TakahashiDepartment of Therapeutic Radiology, University of Minnesota, Minneapolis, Minnesota.
Todd DeForBlood and Marrow Transplant Program, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
Shernan G HoltanDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Veronika BachanovaDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Christopher WilkeDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Darren ZuroDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Celalettin UstunDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Daniel WeisdorfDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Kathryn DusenberyDepartment of Therapeutic Radiology, University of Minnesota, Minneapolis, Minnesota.
Michael R VernerisDepartment of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Electronic address: michael.verneris@ucdenver.edu.
University of Minnesota · US

Funding

Women's CancerP30CA077598 · NCI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI Jeffrey S. Miller · 1998 to 2026
$100.4M
University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR000114 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R · 2012 to 2015
$35.0M
University of Minnesota Clinical and Translational Science Institute (UMN CTSI)KL2TR000113 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R · 2012 to 2015
$5.4M
Conformal Total Body and Marrow Irradiation for LeukemiaR01CA154491 · NCI · UNIVERSITY OF MINNESOTA · PI HUI, SUSANTA K, WONG, JEFFREY Y · 2011 to 2024
$5.0M
Lymphoid Tissue Inducer/NK22 Cells and Post-transplant Immune RecoveryR01AI100879 · NIAID · UNIVERSITY OF MINNESOTA · PI VERNERIS, MICHAEL R. · 2013 to 2017
$1.9M
NCATS NIH HHS KL2 TR000113NCATS NIH HHS UL1 TR000114NCI NIH HHS P30 CA077598NCI NIH HHS R01 CA154491NIAID NIH HHS R01 AI100879
6 · The paper itself

Abstract

Patients with refractory leukemia or minimal residual disease (MRD) at transplantation are at increased risk of relapse. Augmentation of irradiation, especially to sites of disease (ie, bone marrow) is one potential strategy for overcoming this risk. We studied the feasibility of radiation dose escalation in high-risk patients using total marrow irradiation (TMI) in a phase I dose-escalation trial. Four pediatric and 8 adult patients received conditioning with cyclophosphamide and fludarabine in conjunction with image-guided radiation to the bone marrow at 15 Gy and 18 Gy (in 3-Gy fractions), while maintaining the total body irradiation (TBI) dose to the vital organs (lungs, hearts, eyes, liver, and kidneys) at <13.2 Gy. The biologically effective dose of TMI delivered to the bone marrow was increased by 62% at 15 Gy and by 96% at 18 Gy compared with standard TBI. Although excessive dose-limiting toxicity, defined by graft failure or excessive specific organ toxicity, was not encountered, 3 of 6 patients experienced treatment-related mortality at 18 Gy. Thus, we halted enrollment at this dose level and treated an additional 4 patients at 15 Gy. The 1- year overall survival was 42% (95% confidence interval [CI], 15%-67%) and disease-free survival was 22% (95% CI, 4%-49%). The rate of relapse was 36% (95% CI, 10%-62%), and nonrelapse mortality was 42% (95% CI, 14%-70%). This study shows that TMI dose escalation to 15 Gy is feasible with acceptable toxicity in pediatric and adult patients with high-risk leukemia undergoing umbilical cord blood and sibling donor transplantation.

Indexed as

AdultChildChild, PreschoolFemaleHematopoietic Stem Cell TransplantationHumansMaleMaximum Tolerated DoseMiddle AgedNeoplasm, ResidualTransplantation ConditioningTransplantation, HomologousWhole-Body IrradiationYoung AdultBMTCord bloodTotal marrow irradiation

Identifiers

PMID28396164
PMCPMC5531195
OpenAlexW2604874530

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.