Interstitial pneumonitis following bone marrow transplantation after low dose rate total body irradiation.

Important note: Information in this article was accurate in 1983. The state of the art may have changed since the publication date.

Interstitial pneumonitis following bone marrow transplantation after low dose rate total body irradiation.

Int J Radiat Oncol Biol Phys. 1983 Jul;9(7):1029-33. Unique Identifier : AIDSLINE MED/83237933
Barrett A; Depledge MH; Powles RL

Abstract: Idiopathic and infective interstitial pneumonitis (IPn) is a common complication after bone marrow transplantation (BMT) in many centers and carries a high mortality. We report here a series of 107 patients with acute leukemia grafted at the Royal Marsden Hospital in which only 11 (10.3%) developed IPn and only 5 died (5%). Only one case of idiopathic IPn was seen. Factors which may account for this low incidence are discussed. Sixty of 107 patients were transplanted in first remission of acute myeloid leukemia (AML) and were therefore in good general condition. Lung radiation doses were carefully monitored and doses of 10.5 Gy were not exceeded except in a group of 16 patients in whom a study of escalating doses of TBI (up to 13 Gy) was undertaken. The dose rate used for total body irradiation (TBI) was lower than that used in other centers and as demonstrated elsewhere by ourselves and others, reduction of dose rate to less than 0.05 Gy/min may be expected to lead to substantial reduction in lung damage. Threshold doses of approximately 8 Gy for IPn have been reported, but within the dose range of 8 to 10.5 Gy we suggest that dose rate may significantly affect the incidence. Data so far available suggest a true improvement in therapeutic ratio for low dose rate single fraction TBI compared with high dose rate.

Keywords: Acute Disease Adolescence Adult Bone Marrow/*TRANSPLANTATION *Bone Marrow Transplantation Child Cytomegalovirus Infections/ETIOLOGY Female Herpes Simplex/ETIOLOGY Human Leukemia/*THERAPY Male Middle Age Pneumonia, Pneumocystis carinii/*ETIOLOGY Pulmonary Fibrosis/*ETIOLOGY Radiotherapy Dosage Retrospective Studies Whole-Body Irradiation/*ADVERSE EFFECTS JOURNAL ARTICLE

831030
M83A0021

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