Total body irradiation for marrow or stem-cell transplantation

Although the best TBI-containing regimen may not yet have been found, data suggest that for greatest leukemic cell kill with minimum morbidity, a highly fractionated TBI regimen (10-13 fractions) to a high total dose (14-15 Gy) may be optimum. Bu-Cy may be able to replace TBI for CML, but results reported in the literature are still of an early nature. The addition of boost radiation has proven useful for treatment of the testes in leukemia patients, the spleen in some CML patients, and probably of the IF for lymphoma patients with residual or refractory disease. In the future, newer techniques, such as radiolabeled antibodies for better targeting of tumor cells, may prove useful and enter the therapeutic armamentarium (58).