Observational studyBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation2019
Comparison of High Doses of Total Body Irradiation in Myeloablative Conditioning before Hematopoietic Cell Transplantation.
Observational study in Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 33 citations in OpenAlex.
- Trial
- Busulfan Plus Cyclophosphamide Versus Total Body Irradiation Plus Cyclophosphamide for Adults Acute B Lymphoblastic Leukemia: An Open-Label, Multicenter, Phase III Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Total body irradiation-based conditioning in allogeneic transplantation in patients with hematological malignancies: impact in outcomes by stem-cell source.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- A Comparison of Radiation and Alkylator-Based Conditioning Therapy Regimens for Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia: A Clinician's Perspective.Current oncology (Toronto, Ont.) · 2025Review
- Article
- Article
- Multi-isocentric volumetric arc-based total body irradiation: radiation dose impact on oncological outcomes in patients receiving allogeneic hematopoietic cell transplantation.Frontiers in oncology · 2025Article
- Comparable Results Between 8 and 12 Gray TBI in Combination With Fludarabine and Post-Transplant Cyclophosphamide in MRD-Negative but Not in MRD-Positive Acute Lymphoblastic Leukemia Patients Transplanted in First Complete Remission.European journal of haematology · 2025Article
- Total body irradiation: A transition from a Co-60 treatment unit to an IMRT lateral-field extended-SAD technique.Journal of applied clinical medical physics · 2024Article
- Is myelo-ablative pretransplant conditioning really myelo-ablative: Implications for radiation and nuclear accidents?Bone marrow transplantation · 2024Article
- Androgen receptor inhibition suppresses anti-tumor neutrophil response against bone metastatic prostate cancer via regulation of TβRI expression.Cancer letters · 2023Article
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- Article
- Article
- Systematic screening and focused evaluation for veno-occlusive disease/sinusoidal obstructive syndrome (VOD/SOS) following allogeneic stem cell transplant is associated with earlier diagnosis and prompt institution of defibrotide treatment.Frontiers in transplantation · 2022Article
- Neurological complications in Chinese children undergoing hematopoietic stem cell transplantation.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2021Article
- Current Use of Total Body Irradiation in Haploidentical Allogeneic Hematopoietic Stem Cell Transplantation.Journal of Korean medical science · 2021Review
- Total Body Irradiation for Hematopoietic Stem Cell Transplantation: What Can We Agree on?Current oncology (Toronto, Ont.) · 2021Article
- Pulmonary Toxicity After Total Body Irradiation - Critical Review of the Literature and Recommendations for Toxicity Reporting.Frontiers in oncology · 2021Review
- [Advance in hematopoietic and immune reconstitution of allogeneic stem cell transplantation].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2020Article
Corrections and comments
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Authors and funding
34 authors at 20 institutions in 6 countries.
Funding
Abstract
Malignancy relapse is the most common cause of treatment failure among recipients of hematopoietic cell transplantation (HCT). Conditioning dose intensity can reduce disease relapse but is offset by toxicities. Improvements in radiotherapy techniques and supportive care may translate to better outcomes with higher irradiation doses in the modern era. This study compares outcomes of recipients of increasing doses of high-dose total body irradiation (TBI) divided into intermediate high dose (IH; 13-13.75 Gy) and high dose (HD; 14 Gy) with standard dose (SD; 12 Gy) with cyclophosphamide. A total of 2721 patients ages 18 to 60 years with hematologic malignancies receiving HCT from 2001 to 2013 were included. Cumulative incidences of nonrelapse mortality (NRM) at 5 years were 28% (95% confidence interval [CI], 25% to 30%), 32% (95% CI, 29% to 36%), and 34% (95% CI, 28% to 39%) for SD, IH, and HD, respectively (P = .02). Patients receiving IH-TBI had a 25% higher risk of NRM compared with those receiving SD-TBI (12 Gy) (P = .007). Corresponding cumulative incidences of relapse were 36% (95% CI, 34% to 38%), 32% (95% CI, 29% to 36%), and 26% (95% CI, 21% to 31%; P = .001). Hazard ratios for mortality compared with SD were 1.06 (95% CI, .94 to 1.19; P = .36) for IH and .89 (95% CI, .76 to 1.05; P = .17) for HD. The study demonstrates that despite improvements in supportive care, myeloablative conditioning using higher doses of TBI (with cyclophosphamide) leads to worse NRM and offers no survival benefit over SD, despite reducing disease relapse.
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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.