A ten year experience in total body irradiation in BMT patients

Total body irradiation is the popular treatment of lymphopoietic malignancies and preparation for bone marrow transplantation. Hyperfractionated radiation regimen was to deliver a total dose of 1200 cGy in 8 fractions, 3 fractions a day for 2.5 days. One HVL (half value layer ) alloy lung shield is being used to minimize pulmonary toxicity. Acute toxic effects included reversible gastroenteritis, mucositis, and myelosuppression. Delayed toxic effects include interstitial pneumonitis, cataract formation and GVHD. Interstitial pneumonitis is one of the major causes of morbidity and mortality after bone marrow transplantation. Pulmonary toxicity occurred in 26 ( 56.5% ) cases and 16 of them died from IP In 15 infected cases, 5 were classified as IP with infectious agent of cytomegalovirus. The other cases without infectious agent were classified as idiopathic IP ( IIP ), which occurred in 23.9% of the TBI patients