Marrow damage and hematopoietic recovery following allogeneic bone marrow transplantation for acute leukemias: Effect of radiation dose and conditioning regimen

Christopher Wilke, Shernan G. Holtan, Leslie Sharkey, Todd Defor, Mukta Arora, Priya Premakanthan, Sophia Yohe, Stefano Vagge, Daohong Zhou, Jennifer L. Holter Chakrabarty, Marc Mahe, Renzo Corvo, Kathryn Dusenbery, Guy Storme, Daniel J. Weisdorf, Michael R. Verneris, Susanta Hui

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)65-71
Number of pages7
JournalRadiotherapy and Oncology
Volume118
Issue number1
DOIs
StatePublished - Jan 1 2016

Bibliographical note

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.

Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.

Keywords

  • Bone marrow transplantation
  • Marrow cellularity
  • Total body irradiation

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