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Factors associated with pulmonary toxicity after myeloablative conditioning using fractionated total body irradiation
Radiation Oncology Journal ; : 257-267, 2017.
Article in English | WPRIM | ID: wpr-144717
ABSTRACT

PURPOSE:

Pulmonary toxicities, including infectious pneumonia (IP) and idiopathic pneumonia syndrome (IPS), are serious side effects of total body irradiation (TBI) used for myeloablative conditioning. This study aimed to evaluate clinical factors associated with IP and IPS following TBI. MATERIALS AND

METHODS:

Fifty-eight patients with hematologic malignancies who underwent TBI before allogeneic hematopoietic stem cell transplantation between 2005 and 2014 were reviewed. Most patients (91%) received 12 Gy in 1.5 Gy fractions twice a day. Pulmonary toxicities were diagnosed based on either radiographic evidence or reduced pulmonary function, and were subdivided into IP and IPS based on the presence or absence of concurrent infection.

RESULTS:

Pulmonary toxicities developed in 36 patients (62%); 16 (28%) had IP and 20 (34%) had IPS. IP was significantly associated with increased treatment-related mortality (p = 0.028) and decreased survival (p = 0.039). Multivariate analysis revealed that the risk of developing IPS was significantly higher in patients who received stem cells from a matched unrelated donor than from a matched sibling donor (p = 0.021; hazard ratio [HR] = 12.67; 95% confidence interval [CI], 1.46–110.30). Combining other conditioning agents with cyclophosphamide produced a higher tendency to develop IP (p = 0.064; HR = 6.19; 95% CI, 0.90–42.56).

CONCLUSION:

IP and IPS involve different risk factors and distinct pathogeneses that should be considered when planning treatments before and after TBI.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Pneumonia / Stem Cells / Tissue Donors / Multivariate Analysis / Risk Factors / Mortality / Whole-Body Irradiation / Hematopoietic Stem Cell Transplantation / Hematologic Neoplasms / Cyclophosphamide Type of study: Etiology study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Radiation Oncology Journal Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pneumonia / Stem Cells / Tissue Donors / Multivariate Analysis / Risk Factors / Mortality / Whole-Body Irradiation / Hematopoietic Stem Cell Transplantation / Hematologic Neoplasms / Cyclophosphamide Type of study: Etiology study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Radiation Oncology Journal Year: 2017 Type: Article