Irradiation total body

Clinically, GM-CSF or G-CSF have been used to accelerate recovery after chemotherapy and total body or extended field irradiation, situations that cause neutropenia and decreased platelets, and possibly lead to fatal septic infection or diffuse hemorrhage, respectively. G-CSF and GM-CSF reproducibly decrease the period of granulocytopenia, the number of infectious episodes, and the length of hospitalization in such patients (152), although it is not clear that dose escalation of the cytotoxic agent and increased cure rate can be rehably achieved. One aspect of the effects of G-CSF and GM-CSF is that these agents can activate mature cells to function more efficiently. This may, however, also lead to the production of cytokines, such as TNF- a, that have some toxic side effects. In general, both cytokines are reasonably well tolerated. The side effect profile of G-CSF is more favorable than that of GM-CSF. Medullary bone pain is the only common toxicity. 

Fig. 1. Hypothetical kinetics of depletion of bone marrow (BM) stem cells following exposure to a lethal total-body irradiation (TBI) of 10 Gy (1000 rad) of...

Bacq ZM, Fischer P (1957) The action of various drugs on the suprarenal response of the rat to total-body x-irradiation. Radiat Res 7 365-372... 

Male infertility may result from cancer surgery, radiotherapy, hormonal imbalances, or damage of germinal stem cells. Testicular damage from radiotherapy depends on the treatment field, total dose, and fractionation schedule. Depending on the radiation, sperm counts may return to pretreatment levels in 10 to 24 months after therapy or maybe permanent in 80% of men after total-body irradiation for transplant. 

AS is a 65-year-old woman with relapsed acute myelogenous leukemia. PMH is significant for type II diabetes and renal insufficiency (CrCI 20 mL/minute). She is day +1 from a nonmyeloablative HCT with fludarabine (30 mg/m2 per day IV for 3 days) and total-body irradiation preparative regimen and a graft from a full HLA-matched sibling. 

Total-body irradiation Number of vomiting episodes, nausea by patient self-report, sudden weight changes (SOS), total bilirubin... 

TBI Total-body irradiation, traumatic brain injury yr Year... 

Patients receiving single-exposure, high-dose radiation therapy to the upper abdomen, or total- or hemibody irradiation, should receive prophylactic antiemetics. Preventive therapy with an SSRI and dexamethasone is recommended in patients receiving total-body irradiation. 

Radiation (total body irradiation or fractionated abdominal radiation) Adult dose of 2 mg once daily. Two 1 mg tablets or 10 mL of oral solution are taken within 1 hour of radiation. 

Total body irradiation 8 mg 1 to 2 hours before each fraction of radiotherapy administered each day. 

B.5.3 Effective Dose Equivalent and Effective Dose Equivalent Rate. The absorbed dose is usually defined as the mean absorbed dose within an organ or tissue. This represents a simplification of the actual problem. Normally when an individual ingests or inhales a radionuclide or is exposed to external radiation that enters the body (gamma), the dose is not uniform throughout the whole body. The simplifying assumption is that the detriment will be the same whether the body is uniformly or nonuniformly irradiated. In an attempt to compare detriment from absorbed dose of a limited portion of the body with the detriment from total body dose, the ICRP (1977) has derived a concept of effective dose equivalent. 

Prevention of radiation-induced nausea and vomiting PO (Total body irradiation) 8 mg 1-2 hours daily before each fraction of radiotherapy. (Single high-dose radio-t herapy to abdomen) 8 mg 1-2 hours before irradiation, t hen 8 mg q8h after first dose for 1-2 days after completion of radiotherapy. (Daily fractionated radiotherapy to abdomen) 8 mg 1-2 hours before irradiation, then 8 mg 8 hours after first dose for each day of radiotherapy. 

Brochstein JA, Keman NA, Groshen S, Cirricione C, et al. 1987. Allogenic bone marrow transplantation after hyperfractionated total body irradiation and cyclophosphamide in children with acute leukemia. NEJM. 317 1618-1624. 

Ferry C, Socie G. 2003. Busulfan-cyclophosphamide versus total body irradiation-cyclophosphamide as preparative regimen before allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia What have we learned Exp Hematol. 31 1182-1186. 

Socie G, Clift RA, Blaise D, Devergie A, et al. 2001. Busulfan plus cyclophosphamide compared with total-body irradiation plus cyclophosphamide before marrow transplantation for myeloid leukemia Long term followup of four randomized studies. Blood. 98 3569-3574. 

Total body irradiation, a routine preconditioning procedure for treatment of leukemia and aplastic anemia before bone marrow transplantation, decreased TAC of blood plasma by 36%, as estimated by cyclic voltammetry (C26). TAC was found to decrease by about 40% during chemotherapy of patients with various hematologic malignancies with busuflan, VP-16, and cyclophosphamide (D12). The controversial procedure of blood ozonation was reported to decrease blood plasma TAC by 20% (B17). Treatment of hypercholesterolemic patients with bezafibrate (600 mg/day) for 1 month decreased TAC of their blood serum (G16). Propofol anesthesia decreased TAC of blood plasma of patients by 9.5% this effect was caused by hemodilution because mean hemoglobin concentration of the blood decreased accordingly (S26). 

The most notable feature of the dynamic response of the process to large perturbations in the number of blood cells is that the system rings, displaying an oscillatory behavior in the number of cells in the blood and other compartments of the system, as a function of time. Such large perturbations are produced by leukopheresis or exposure of the system to disease, which depletes the number of blood cells, and in total body irradiation experiments or some drug treatments as chemotherapy, which deplete the total number of cells in the production process of neutrophil granulocytes. 

Matthews DC, Appelbaum FR, Eary JF, et al. Phase I study of (131)I-anti-CD45 antibody plus cyclophosphamide and total body irradiation for advanced acute leukemia and myelodysplastic syndrome. Blood 1999 94(4) 1237 47. 

Miller, G.M., Kim, D.W., Andres, M.L., Green, L.M., Gridley, D.S. (2003). Changes in the activation and reconstitution of lymphocytes resulting from total-body irradiation correlate with slowed tumor growth. Oncology 65 229 1. 

A 10-year-old bone marrow recipient was given ABLC 7 mg/kg/day for prolonged periods of time. Ablation therapy before transplantation included cytosine arabinoside, cyclophosphamide, and total body irradiation. He developed progressive parkinsonian features an MRI scan showed non-specific frontal cortex white matter abnormalities, and brain MR spectroscopy was consistent with significant neuronal loss in the left insular cortex, left basal ganglia, and... 

---