2025 Volume 62 Issue 2 Pages 161-166
Total body irradiation (TBI) and total lymphoid/thoraco-abdominal irradiation (TLI/TAI) are standard treatments performed before hematopoietic cell transplantation. At our institution, TBI at 200 MU/min was initiated in January 2019, and the outcomes of pediatric patients treated with TBI or TLI/TAI were retrospectively analyzed. Twenty-nine patients aged ≤ 19 years who underwent TBI or TLI/TAI as a pretreatment for allogeneic hematopoietic cell transplantation at our institution between January 2019 and April 2024 were included. The patients’ median age during irradiation was 109 months. Thirteen patients underwent myeloablative conditioning with TBI of 12 Gy/6 fr, and 16 patients underwent reduced-intensity conditioning with TBI in 12 cases (2–6 Gy/1–3 fr) and TLI/TAI in four cases (3 Gy/1 fr). The median follow-up period was 24.0 months. Three patients died (two died from worsening respiratory status), two patients recovered autologous hematopoiesis, and one patient experienced relapse of the primary disease. We observed 14 cases of grade 2–4 acute graft-versus-host disease (GVHD) and three cases of chronic GVHD. Additionally, one case each of nephrotic syndrome, hyperuricemia, and treatment-related secondary malignant disease were found to be late effects of CTCAE ver.5 grade ≥ 3. Although the follow-up period was short and backgrounds and treatments varied, the results were considered acceptable. Strategies to reduce the impact on the organs at risk while maintaining tumor control and viability, are warranted.
