Renal toxicity in children undergoing total body irradiation for bone marrow transplant
Renal toxicity in children undergoing total body irradiation for bone marrow transplant
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DOI：
10.1016/j.radonc.2008.09.017
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发表时间：
2009-02-01
影响因子：
5.7
通讯作者：
Paulino, Arnold C.
中科院分区：
文献类型：
--
作者：
Esiashvili, Natia;Chiang, Kuang-Yueh;Paulino, Arnold C.
目的：全身照射（TBI）对接受骨髓移植（BMT）的儿童肾毒性的影响仍存在争议。我们报告我们的机构回顾性研究，评估使用全身照射（TBI）空调regions.Materials和方法后，儿童的急性和慢性肾功能不全的频率：在1995年和2003年之间，60名儿童恶性血液病进行TBI作为一个调理方案的一部分，在异体骨髓移植。患者接受4-14戈伊，1.75-2戈伊/次，分6 - 8次。在所有患者中使用肺屏蔽以将肺剂量限制在10戈伊以下：未使用肾屏蔽。所有患者均进行基线肾功能评估，BM后肾功能障碍主要根据急性期持续血清肌酐升高进行评估。（0-90天）和慢性结果：27例（45%）发生急性肾功能不全（ARD）;大多数患者同时诊断为静脉闭塞病（VOD）、移植物抗宿主病（GVHD）和其他潜在原因（败血症）。抗生素）。存活患者1年时迟发性肾功能不全（DRD）的风险接近25%。ARD与DRD的菲斯克密切相关。单变量和多变量分析均显示ARD、DRD与基础诊断、GVHD、VOD或TBI剂量之间无统计学显著相关性。年轻人（
Purpose: Contribution of total body irradiation (TBI) to renal toxicity in children undergoing the bone marrow transplant (BMT) remains controversial. We report our institutional retrospective study that evaluates the frequency Of acute and chronic renal dysfunction in children after using total body irradiation (TBI) conditioning regimens.Materials and methods: Between 1995 and 2003, 60 children with hematological malignancies underwent TBI as part Of a conditioning regimen before allogeneic BMT. Patients received 4-14 Gy at 1.75-2 Gy/fraction in six-eight fractions. Lung shielding was used in all patients to limit lung dose to less than 10 Gy: renal shielding was not utilized. All patients had baseline renal function assessment and renal dysfunction post-BM was mainly evaluated oil the basis of persistent serum creatinine elevation at acute (0-90 days) and chronic (>90 days) intervals after completion of BMT.Results: Acute renal dysfunction (ARD) was documented in 27 patients (45%); the majority had concurrent diagnosis of veno-occlusive disease (VOD) OF graft-versus-host disease (GVHD) and other potential Causes (sepsis. antibiotic). The risk for delayed renal dysfunction (DRD) at 1 year approached 25% for surviving patients. The ARD was strongly linked with the Fisk of the DRD. There was no statistically significant relationship between ARD, DRD and underlying diagnosis, GVHD, VOD or TBI doses with both univariate and multivariate analyses. The younger age (