Effects of total body irradiation combined with high-dose chemotherapy on hematopoietic stem cell transplantation

Objective To explore the effects of total body irradiation (TBI) combined with high-dose chemotherapy as conditioning regimen on the whole body and hematopoietic system of patients undergoing hematopoietic stem cell transplantation,and to sum up the clinical experiences in diagnosis and treatment of acute radiation syndrome.Methods A total of 64 patients underwent TBI and high-dose chemotherapy and then received hematopoietic stem cell transplantation.The hematologic changes and clinical toxicity after TBI were observed and the characteristics of bone marrow reconstitution analyzed.Results The transplantation related mortality was 3.12%.Follow-up was carried out post transplantation for 9-72 months (the median follow-up time was 26 months).1,3,5-year overall survival rates were (95.8 ± 3.3)%,(89.8 ± 4.7)% and (81.7 ± 6.9)%,respectively.All patients suffered fromhematologic toxicity.The white blood cells and platelets were obviously decreased.The minimum total number of white blood cells was (0.18 ± 0.13) × 109/L,and the minimum platelet was (14.48 ±8.85) × 109/ L.In addition,gastrointestinal reactions,infection,liver damage,bleeding and other adverse reactions occurred to some extent.Conclusions TBI combined with high-dose chemotherapy as conditioning regimen followed by hematopoietic stem cell transplantation might be effective for treatment of malignant hematological diseases.The clinic conditions after TBI and high-dose chemotherapy could simulate the clinical course of acute accidental radiation syndrome and provide the clinical experience for acute radiation syndrome. Key words: Whole body irradiation; Hematopoietic stem cell transplantation; Acute radiation syndrome