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Myeloablative TBI is associated with increased risk of pulmonary GVHD in patients undergoing allogeneic hematopoietic stem cell transplant

Bone Marrow Transplantation volume 57, pages 1632–1634 (2022)Cite this article

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Conditioning regimens are an essential component of allogeneic hematopoietic cell transplantation (alloHCT). Total-body irradiation (TBI) can be included in myeloablative (MA), reduced-intensity (RIC) and non-myeloablative (NMA) conditioning regimens [1].

Bronchiolitis obliterans syndrome (BOS), considered a type of pulmonary chronic graft-versus-host disease in alloHCT, occurs as a mid- or late-phase alloHCT toxicity. Prior studies have suggested upto five-times increased risk of developing BOS with TBI and chemotherapy compared to chemotherapy alone [2, 3], however, some other studies have not shown any significant difference [4, 5]. Due to these inconsistencies, our primary study objective was to evaluate (1) potential association between TBI and pulmonary GVHD and (2) if such an association is dose-dependent.

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Fig. 1: Cumulative incidence of BOS with death and relapse as competing risk events.

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Data may be obtained from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Division of Hematology, Oncology and Cellular Therapy, Department of Medicine, Rush University Medical Center, Chicago, IL, USA

    Anmol Baranwal, John Byun, Anu Kadanagowd, Debra A. Marinovic, Deborah Katz, Ankur Varma, Sunita Nathan & Celalettin Ustun

  2. Division of Hematology and Medical Oncology, Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA

    Anmol Baranwal

  3. Rush Bioinformatics and Biostatistics Core, Rush University, Chicago, IL, USA

    Ethan Ritz

  4. Department of Pharmacy, Rush University Medical Center, Chicago, IL, USA

    Danielle Murphy

  5. Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, USA

    Dian Wang

  6. Division of Cardiology-Oncology, Department of Medicine, Rush University Medical Center, Chicago, IL, USA

    Tochukwu Okwuosa

Authors
  1. Anmol Baranwal
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  2. John Byun
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  12. Celalettin Ustun
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Contributions

CU conceptualized the study. AB, JB and AK contributed to data acquisition. AB, ER and CU contributed to study design and data analysis. AB and CU wrote the manuscript. DM, DAM, DW, TO, DK, AV and SN reviewed the manuscript and contributed to data analysis or interpretation. All authors approve the final version of the manuscript.

Corresponding author

Correspondence to Celalettin Ustun.

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Competing interests

CU has honoraria from Novartis and Blueprint for advisory meetings. No other conflicts of interest to disclose.

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Baranwal, A., Byun, J., Ritz, E. et al. Myeloablative TBI is associated with increased risk of pulmonary GVHD in patients undergoing allogeneic hematopoietic stem cell transplant. Bone Marrow Transplant 57, 1632–1634 (2022). https://doi.org/10.1038/s41409-022-01779-3

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