2025 Volume 62 Issue 1 Pages 32-39
Total body irradiation (TBI) is important in identifying residual tumor cells and reducing the risk of graft failure during allogeneic hematopoietic cell transplantation in pediatric patients with various hematological malignancies and non-malignant diseases (NMDs). Contrastingly, based on the effects of TBI-related adverse effects on long-term quality of life, non-irradiation conditioning or reduced-intensity conditioning (RIC) has been developed, especially in pediatric patients.
High-dose TBI-based myeloablative conditioning (MAC) remains the major conditioning regimen for pediatric hematological malignancies to elucidate residual tumor cells. Conversely, low-dose irradiation-based RIC has been the mainstay conditioning regimen for various NMDs to reduce the risk of TBI-related adverse effects without increasing the frequency of graft failure. TBI-related adverse effects are serious problems, particularly for infants and patients with diseases showing high radiosensitivity. Therefore, there are high expectations for the development of novel radiation technology considering these pediatric features.
