AUTHOR=Kerbauy Mariana Nassif , Arcuri Leonardo Javier , Favareto Sergio Leonardo , de Rezende Ana Carolina Pires , Hamerschlak Nelson 

TITLE=Total marrow irradiation in hematopoietic stem cell transplantation for hematologic malignancies

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1155954

DOI=10.3389/fmed.2023.1155954

ISSN=2296-858X

ABSTRACT=<p>Total body irradiation (TBI) has been an essential component of the conditioning regimen in hematopoietic cell transplantation for many years. However, higher doses of TBI reduce disease relapse at the expense of more significant toxicities. Therefore, total marrow irradiation and total marrow and lymphoid irradiation have been developed to deliver organ-sparing targeted radiotherapy. Data from different studies show that TMI and TMLI can be safely administered in escalating doses in association with different chemotherapy conditioning regimen protocols, in situations with unmet needs, such as multiple myeloma, high-risk hematologic malignancies, relapsed or refractory leukemias, and elderly or frail patients, with low rates of transplant-related mortality. We reviewed the literature on applying TMI and TMLI techniques in autologous and allogeneic hematopoietic stem cell transplantation in different clinical situations.</p>