Bone marrow transplant or stem cell transplant is a crucial procedure that can save live of a patient. Considering the criticality of the treatment, every step of this treatment should be done rightly. Total body irradiation is an important therapy that prepares the patient for transplant to reduce the risk of bone marrow rejection and compromise the immunity of the receiver. Thus, total body irradiation is an extremely important process. In this article, Dr. Vikash Kumar, MD, Senior Consultant, Radiation Oncology, Asian Hospital, Faridabad explains everything related to TBI, how it is done, what are the possible side-effects and many more related information that can help patient out there.
Total Body Irradiation Procedure
Total body irradiation (TBI) is a modality of radiation in which, the entire body is exposed to a low dose of radiation. TBI is often used with high-dose anticancer drugs for preparing a patient for a stem cell transplant the process is called conditioning. Although, the cancerous cells also can be damaged through TBI, but its primary goal is to suppress the patient’s immune system, which can increase the probability of a acceptance of a successful transplant.
However, it is not used in the same way as most other types of radiation treatment. Rather than delivering the highest possible dose of radiation to a tumor site over a period of 6-7 weeks, you usually have TBI treatment is generally fractionated, twice a day separated by a gap of at least 6 hours for 3 days or it may be just 1 or 2 radiotherapy treatments depending upon your transplant conditioning regimen decided by your hematologist or oncologist.
Also Read: What Are The Side Effects Of Radiation Therapy? Know From An Expert
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Importance of Total Body Irradiation Treatment
Total body irradiation followed by transplantation can be an effective treatment for several types of cancer, the common indications are:
- Lymphoma
- Leukaemia
- Multiple Myeloma
The exact timing of TBI during transplant is depends on the conditioning regimen planned. Patients who are being considered for the TBI followed by a stem cell or bone marrow transplant are seen by a team of radiation oncologists, physicists and radiation therapists and provide a fully individualized treatment plan. The treatment planning is computerized and done over whole body CT images of the patient. The CT based planning gives us advantages of achieving the uniform desired dose all over the body without going beyond the tolerance of organs at risk.
As per Dr. Kumar, they consider numerous factors to find out the proper total body irradiation dosage and delivery schedule for the patient. To handle the effects of whole-body radiation exposure, it is needed to prepare the patient’s body through various techniques including lung-sparing technique and several others. This step ensures best positive results with minimum damage and guaranteed improved quality of life.
Also Read: How Bone Marrow Transplant Can Cure Paediatric Blood Disorders
Total Body Irradiation Side effects
Most of the treatments are safe but there might be slight side-effects that only a fraction of patients might suffer. The possible side effects depend on a number of factors, the most important being the combination of chemotherapy drugs in the conditioning regimen and the dose of TBI and you had.
Here are some of the short term side effects of TBI for bone marrow or stem cell transplant:
- Sickness
- Tiredness
- Diarrhoea
- Redness of skin
- Low blood count that increases potential risk of bleeding, anemia and infection.
In addition to this, there are a few long-term side effects as well that patients should watch out for. These include:
- Changes in Lungs: TBI procedure can cause changes in the lung including breathlessness, wheezing, coughing, and fibrosis.
- Cataract or clouding of the eye lenses that hamper vision
- Fertility problems:If you have underwent TBI along with high dose chemotherapy, you are highly likely to face fertility issues wherein you might not be able to embrace parenthood after treatment.
- A second cancer: TBI treatment for Bone marrow and stem cell transplants is found out to increase the risk of getting cancer again in future. However, the chances are very low but it is important to take all the necessary precautions to avert the risk.
Before getting the treatment, talk to your doctor about any complications you might e having. Analyse all the risks involved to avert any catastrophic conclusion that you are not prepared for.
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