OBJECTIVE To observe the dose and the complicationsfrom total body irradiation before hematopoietic stem celltransplantation.METHODS This study involved 312 patients with total bodyirradiation before hematopoietic ste...OBJECTIVE To observe the dose and the complicationsfrom total body irradiation before hematopoietic stem celltransplantation.METHODS This study involved 312 patients with total bodyirradiation before hematopoietic stem cell transplantation. Theywere entered into the treated research from May 1999 to October2005. All patients had received the irradiation from ^(60)Co of anabsorbed dose rate of (5.2 ± 1.13) cGy/min. The total dose of TBIwas 7～12 Gy, 1 f/d × 2 d. A high-dose rate group (≥10 Gy) included139 cases and a low-dose rate group (< 10 Gy) included 173 cases.RESULTS The probability of acute gastrointestinal reactionsin the high-dose rate group was more compared with that in thelow-dose rate group. The differences for other reactions, such ashematopoietic reconstitution and graft survival rate, between thetwo groups were insignificant.CONCLUSION Using fractional total body irradiation at a doserate of 5 cGy/min, with a total dose of 7～12 Gy, 1 f/d × 2 d , withthe lung receiving under 7.5 Gy is a safe and effective pretreatmentfor hematopoietic stem cell transplantation.展开更多
Total body irradiation (TBI) is conditioning regimen in children with acute lymphoblastic leukemia (ALL) with a very high risk of relapse or in those who have not achieved remission and have relapsed and subsequently ...Total body irradiation (TBI) is conditioning regimen in children with acute lymphoblastic leukemia (ALL) with a very high risk of relapse or in those who have not achieved remission and have relapsed and subsequently received allogenic hematopoietic stem cell transplantation (HSCT). A retrospective evaluation of 33 ALL patients in full remission with an indication of HSCT was performed to evaluate overall survival (OS) and event-free survival (EFS). The inclusion criteria included a myeloablative conditioning regimen of TBI at a dose of 600 cGy. The observed OS at 5 years was 50%, and the EFS of 32% we observed difference in the EFS stem cell origin;the peripheral blood (PB) 60%, and the umbilical cord blood (UC) accounted for 40%. Overall, 45% had a documented chimerism. The OS at 5 years from patients with chimeras was 75%, while those without chimeras had an OS at 5 years of 25%. The mortality in the first 100 days was 24%. A total of 24.2% of children presented with acute graft versus-host disease (GVHD), while 33% had chronic GVHD. Currently, there is no general agreement among all international centers regarding the optimum TBI dose. Our study reports an acceptable range of adverse events with a relatively low dose of 600 cGy.展开更多
Background Radiation-induced injury after accidental or therapeutic total body exposure to ionizing radiation has serious pathophysiological consequences,and currently no effective therapy exists.This study was design...Background Radiation-induced injury after accidental or therapeutic total body exposure to ionizing radiation has serious pathophysiological consequences,and currently no effective therapy exists.This study was designed to investigate whether transplantation of allogeneic murine compact bone derived-mesenchymal stem cells （CB-MSCs） could improve the survival of mice exposed to lethal dosage total body irradiation （TBI）,and to explore the potential immunoprotective role of MSCs.Methods BALB/c mice were treated with 8 Gy TBI,and then some were administered CB-MSCs isolated from C57BL/6 mice.Survival rates and body weight were analyzed for 14 days post-irradiation.At three days post-irradiation,we evaluated IFN-Y and IL-4 concentrations; CD4＋CD25＋Foxp3＋ regulatory T cell （Treg） percentage; CXCR3,CCR5,and CCR7 expressions on CD3＋T cells; and splenocyte T-bet and GATA-3 mRNA levels.CB-MSC effects on bone marrow hemopoiesis were assessed via colony-forming unit granulocyte/macrophage （CFU-GM） assay.Results After lethal TBI,compared to non-transplanted mice,CB-MSC-transplanted mice exhibited significantly increased survival,body weight,and CFU-GM counts of bone marrow cells （P＜0.05）,as well as higher Treg percentages,reduced IFN-Y,CXCR3 and CCR5 down-regulation,and CCR7 up-regulation.CB-MSC transplantation suppressed Th1 immunity.Irradiated splenocytes directly suppressed CFU-GM formation from bone marrow cells,and CB-MSC co-culture reversed this inhibition.Conclusion Allogeneic CB-MSC transplantation attenuated radiation-induced hematopoietic toxicity,and provided immunoprotection by alleviating lymphocyte-mediated CFU-GM inhibition,expanding Tregs,regulating T cell chemokine receptor expressions,and skewing the Th1/Th2 balance toward anti-inflammatory Th2 polarization.展开更多
全身放疗(Total body irradiation,TBI)是对患者全身进行照射的一种特殊放疗技术,是血液系统疾病行造血干细胞移植前的一种预处理手段,其主要作用包括杀灭残存肿瘤细胞、抑制机体免疫应答、为造血干细胞移植排空骨髓空间等。目前,全身...全身放疗(Total body irradiation,TBI)是对患者全身进行照射的一种特殊放疗技术,是血液系统疾病行造血干细胞移植前的一种预处理手段,其主要作用包括杀灭残存肿瘤细胞、抑制机体免疫应答、为造血干细胞移植排空骨髓空间等。目前,全身放疗实施的主要实现方式包括长距离固定野照射、容积旋转调强和分段照射。在本文中,我们结合自身临床实践经验,综述了上述这些实现方式的技术特点和相关研究进展。展开更多
文摘OBJECTIVE To observe the dose and the complicationsfrom total body irradiation before hematopoietic stem celltransplantation.METHODS This study involved 312 patients with total bodyirradiation before hematopoietic stem cell transplantation. Theywere entered into the treated research from May 1999 to October2005. All patients had received the irradiation from ^(60)Co of anabsorbed dose rate of (5.2 ± 1.13) cGy/min. The total dose of TBIwas 7～12 Gy, 1 f/d × 2 d. A high-dose rate group (≥10 Gy) included139 cases and a low-dose rate group (< 10 Gy) included 173 cases.RESULTS The probability of acute gastrointestinal reactionsin the high-dose rate group was more compared with that in thelow-dose rate group. The differences for other reactions, such ashematopoietic reconstitution and graft survival rate, between thetwo groups were insignificant.CONCLUSION Using fractional total body irradiation at a doserate of 5 cGy/min, with a total dose of 7～12 Gy, 1 f/d × 2 d , withthe lung receiving under 7.5 Gy is a safe and effective pretreatmentfor hematopoietic stem cell transplantation.
文摘Total body irradiation (TBI) is conditioning regimen in children with acute lymphoblastic leukemia (ALL) with a very high risk of relapse or in those who have not achieved remission and have relapsed and subsequently received allogenic hematopoietic stem cell transplantation (HSCT). A retrospective evaluation of 33 ALL patients in full remission with an indication of HSCT was performed to evaluate overall survival (OS) and event-free survival (EFS). The inclusion criteria included a myeloablative conditioning regimen of TBI at a dose of 600 cGy. The observed OS at 5 years was 50%, and the EFS of 32% we observed difference in the EFS stem cell origin;the peripheral blood (PB) 60%, and the umbilical cord blood (UC) accounted for 40%. Overall, 45% had a documented chimerism. The OS at 5 years from patients with chimeras was 75%, while those without chimeras had an OS at 5 years of 25%. The mortality in the first 100 days was 24%. A total of 24.2% of children presented with acute graft versus-host disease (GVHD), while 33% had chronic GVHD. Currently, there is no general agreement among all international centers regarding the optimum TBI dose. Our study reports an acceptable range of adverse events with a relatively low dose of 600 cGy.
基金This study was supported by the National Natural Science Foundation of China （No.30940030,No.81070448,and No.81370667）.
文摘Background Radiation-induced injury after accidental or therapeutic total body exposure to ionizing radiation has serious pathophysiological consequences,and currently no effective therapy exists.This study was designed to investigate whether transplantation of allogeneic murine compact bone derived-mesenchymal stem cells （CB-MSCs） could improve the survival of mice exposed to lethal dosage total body irradiation （TBI）,and to explore the potential immunoprotective role of MSCs.Methods BALB/c mice were treated with 8 Gy TBI,and then some were administered CB-MSCs isolated from C57BL/6 mice.Survival rates and body weight were analyzed for 14 days post-irradiation.At three days post-irradiation,we evaluated IFN-Y and IL-4 concentrations; CD4＋CD25＋Foxp3＋ regulatory T cell （Treg） percentage; CXCR3,CCR5,and CCR7 expressions on CD3＋T cells; and splenocyte T-bet and GATA-3 mRNA levels.CB-MSC effects on bone marrow hemopoiesis were assessed via colony-forming unit granulocyte/macrophage （CFU-GM） assay.Results After lethal TBI,compared to non-transplanted mice,CB-MSC-transplanted mice exhibited significantly increased survival,body weight,and CFU-GM counts of bone marrow cells （P＜0.05）,as well as higher Treg percentages,reduced IFN-Y,CXCR3 and CCR5 down-regulation,and CCR7 up-regulation.CB-MSC transplantation suppressed Th1 immunity.Irradiated splenocytes directly suppressed CFU-GM formation from bone marrow cells,and CB-MSC co-culture reversed this inhibition.Conclusion Allogeneic CB-MSC transplantation attenuated radiation-induced hematopoietic toxicity,and provided immunoprotection by alleviating lymphocyte-mediated CFU-GM inhibition,expanding Tregs,regulating T cell chemokine receptor expressions,and skewing the Th1/Th2 balance toward anti-inflammatory Th2 polarization.
文摘全身放疗(Total body irradiation,TBI)是对患者全身进行照射的一种特殊放疗技术,是血液系统疾病行造血干细胞移植前的一种预处理手段,其主要作用包括杀灭残存肿瘤细胞、抑制机体免疫应答、为造血干细胞移植排空骨髓空间等。目前,全身放疗实施的主要实现方式包括长距离固定野照射、容积旋转调强和分段照射。在本文中,我们结合自身临床实践经验,综述了上述这些实现方式的技术特点和相关研究进展。
