TY - JOUR
T1 - Marrow damage and hematopoietic recovery following allogeneic bone marrow transplantation for acute leukemias
T2 - Effect of radiation dose and conditioning regimen
AU - Wilke, Christopher
AU - Holtan, Shernan G.
AU - Sharkey, Leslie
AU - Defor, Todd
AU - Arora, Mukta
AU - Premakanthan, Priya
AU - Yohe, Sophia
AU - Vagge, Stefano
AU - Zhou, Daohong
AU - Holter Chakrabarty, Jennifer L.
AU - Mahe, Marc
AU - Corvo, Renzo
AU - Dusenbery, Kathryn
AU - Storme, Guy
AU - Weisdorf, Daniel J.
AU - Verneris, Michael R.
AU - Hui, Susanta
N1 - Funding Information:
This work was supported by the National Institute of Health grants (1R01CA154491).
Funding Information:
This work was supported by the National Institute of Health grants ( 1R01CA154491 ).
Publisher Copyright:
© 2015 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 118 (2016) 6571.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background and purpose Total body irradiation (TBI) is a common component of hematopoietic cell transplantation (HCT) conditioning regimens. Preclinical studies suggest prolonged bone marrow (BM) injury after TBI could contribute to impaired engraftment and poor hematopoietic function. Materials and methods We studied the longitudinal changes in the marrow environment in patients receiving allogeneic HCT with myeloablative (MA, n = 42) and reduced intensity (RIC, n = 56) doses of TBI from 2003-2013, including BM cellularity, histologic features of injury and repair, hematologic and immunologic recovery. Results Following MA conditioning, a 30% decrease in the marrow cellularity persisted at 1 year post-transplant (p = 0.03). RIC HCT marrow cellularity transiently decreased but returned to baseline by 6 months even though the RIC group received mostly umbilical cord blood (UCB) grafts (82%, vs. 17% in the MA cohort, p < 0.01). There was no evidence of persistent marrow vascular damage or inflammation. Recipients of more intensive conditioning did not show more persistent cytopenias with the exception of a tendency for minimal thrombocytopenia. Immune recovery was similar between MA and RIC. Conclusions These findings suggest that TBI associated with MA conditioning leads to prolonged reductions in marrow cellularity, but does not show additional histological evidence of long-term injury, which is further supported by similar peripheral counts and immunologic recovery.
AB - Background and purpose Total body irradiation (TBI) is a common component of hematopoietic cell transplantation (HCT) conditioning regimens. Preclinical studies suggest prolonged bone marrow (BM) injury after TBI could contribute to impaired engraftment and poor hematopoietic function. Materials and methods We studied the longitudinal changes in the marrow environment in patients receiving allogeneic HCT with myeloablative (MA, n = 42) and reduced intensity (RIC, n = 56) doses of TBI from 2003-2013, including BM cellularity, histologic features of injury and repair, hematologic and immunologic recovery. Results Following MA conditioning, a 30% decrease in the marrow cellularity persisted at 1 year post-transplant (p = 0.03). RIC HCT marrow cellularity transiently decreased but returned to baseline by 6 months even though the RIC group received mostly umbilical cord blood (UCB) grafts (82%, vs. 17% in the MA cohort, p < 0.01). There was no evidence of persistent marrow vascular damage or inflammation. Recipients of more intensive conditioning did not show more persistent cytopenias with the exception of a tendency for minimal thrombocytopenia. Immune recovery was similar between MA and RIC. Conclusions These findings suggest that TBI associated with MA conditioning leads to prolonged reductions in marrow cellularity, but does not show additional histological evidence of long-term injury, which is further supported by similar peripheral counts and immunologic recovery.
KW - Bone marrow transplantation
KW - Marrow cellularity
KW - Total body irradiation
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U2 - 10.1016/j.radonc.2015.11.012
DO - 10.1016/j.radonc.2015.11.012
M3 - Article
C2 - 26653357
AN - SCOPUS:84959258334
SN - 0167-8140
VL - 118
SP - 65
EP - 71
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -