Transplantation of bone marrow and peripheral stem cells

This synthesis of the literature on radiotherapy related to bone marrow transplantation is based on 59 scientific articles, including 5 randomized studies and 20 retrospective studies. These studies involve 2563 patients. Bone marrow transplantation is a rapidly expanding treatment method where whole-body irradiation can play an important role. The literature review reveals that treatment methods for whole-body irradiation are highly heterogeneous. Standardization would be desirable. Fractionated and single-dose, whole-body irradiation are probably of equal value when the dose and technique are optimal. Cataracts seem to be more common following a single dose. Fractionated treatment is more resource intensive, but less burdensome for patients. For advanced-stage leukemia and some other diseases, eg, myeloma, international experience has shown that a combined treatment strategy (high-dose cyclophosphamide and whole-body irradiation) is probably superior to chemotherapy (cyclophosphamide and busulfan) alone. For many other hematological malignancies at less advanced stages, conditioning methods are probably of equal value.