TRANSPLANTATION OF BONE-MARROW AND PERIPHERAL STEM-CELLS

This synthesis of the literature on radiotherapy related to bone marro w transplantation is based on 59 scientific articles, including 5 rand omized studies and 20 retrospective studies. These studies involve 256 3 patients. Bone marrow transplantation is a rapidly expanding treatme nt method where whole-body irradiation can play an important role. The literature review reveals that treatment methods for whole-body irrad iation are highly heterogeneous. Standardization would be desirable. F ractionated and single-dose, whole-body irradiation are probably of eq ual value when the dose and technique are optimal. Cataracts seem to b e more common following a single dose. Fractionated treatment is more resource intensive, but less burdensome for patients. For advanced-sta ge leukemia and some other diseases, eg, myeloma, international experi ence has shown that a combined treatment strategy (high-dose cyclophos phamide and whole-body irradiation) is probably superior to chemothera py (cyclophosphamide and busulfan) alone. For many other hematological malignancies at less advanced stages, conditioning methods are probab ly of equal value.