PMID- 24094072
OWN - NLM
STAT- MEDLINE
DCOM- 20150129
LR  - 20211021
IS  - 1607-8454 (Electronic)
IS  - 1024-5332 (Print)
IS  - 1024-5332 (Linking)
VI  - 19
IP  - 5
DP  - 2014 Jul
TI  - Radiation exposure from diagnostic procedures following allogeneic stem cell 
      transplantation--how much is acceptable?
PG  - 275-9
LID - 10.1179/1607845413Y.0000000131 [doi]
AB  - BACKGROUND: Frequent diagnostic radiology procedures in allogeneic stem cell 
      transplantation (SCT) recipients raise concern about the potential harm from 
      incidental radiation. OBJECTIVES: To determine the cumulative radiation dose from 
      diagnostic studies in allogeneic SCT and its impact on clinical outcome. PATIENTS 
      AND METHODS: This retrospective cohort study was conducted to determine the 
      cumulative radiation dose from diagnostic studies following SCT. Sixty-four 
      consecutive patients with hematological malignancies in a single tertiary care 
      institution underwent total body irradiation (TBI)-based myeloablative 
      conditioning followed by six of six human leukocyte antigen (HLA)-identical 
      sibling allogeneic SCT. The median follow-up was 3 years. The cumulative 
      effective dose in mSv from diagnostic radiological studies in the peri-transplant 
      period from day -30 to day +200 was calculated for each patient and its impact on 
      overall survival and non-relapse mortality was determined. RESULTS: The median 
      cumulative radiation exposure from diagnostic radiological procedures was 92 mSv 
      (range 1.2-300), representing about 30x the normal annual background radiation 
      for the population and 10% of the 1200 cGy TBI dose used in conditioning. 
      Sixty-five percent of the cumulative radiation exposure was delivered between day 
      +1 and day 100 and computed tomography scans contributed 88%. In multivariate 
      analysis, diagnostic procedures did not significantly impact clinical outcomes. 
      CONCLUSIONS: While radiation exposure from diagnostic procedures did not impact 
      clinical outcomes the risk of secondary cancers in long-term survivors is likely 
      to be increased. Our results indicate that patients who are acutely ill for 
      prolonged periods can receive clinically significant radiation doses during their 
      hospital care. Our findings should prompt attempts to limit radiation exposure 
      from diagnostic procedures in post-SCT recipients.
FAU - Battiwalla, Minoo
AU  - Battiwalla M
FAU - Fakhrejahani, Farhad
AU  - Fakhrejahani F
FAU - Jain, Natasha A
AU  - Jain NA
FAU - Klotz, Jeffrey K
AU  - Klotz JK
FAU - Pophali, Priyanka A
AU  - Pophali PA
FAU - Draper, Debbie
AU  - Draper D
FAU - Haggerty, Janice
AU  - Haggerty J
FAU - McIver, Zachariah
AU  - McIver Z
FAU - Jelinek, James
AU  - Jelinek J
FAU - Chawla, Kamna
AU  - Chawla K
FAU - Ito, Sawa
AU  - Ito S
FAU - Barrett, John
AU  - Barrett J
LA  - eng
GR  - Z99 HL999999/Intramural NIH HHS/United States
GR  - ZIA HL006105-03/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Intramural
DEP - 20131125
PL  - England
TA  - Hematology
JT  - Hematology (Amsterdam, Netherlands)
JID - 9708388
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Hematologic Neoplasms/diagnosis/mortality/therapy
MH  - *Hematopoietic Stem Cell Transplantation/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - *Radiation Dosage
MH  - *Radiation Effects
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Tomography, X-Ray Computed
MH  - Transplantation Conditioning/*adverse effects
MH  - Transplantation, Homologous
MH  - Whole-Body Irradiation/*adverse effects
MH  - X-Rays
MH  - Young Adult
PMC - PMC4155497
MID - NIHMS568765
OTO - NOTNLM
OT  - CT
OT  - Diagnostic
OT  - HSCT
OT  - Outcome
OT  - Radiation
COIS- Financial disclosure: All authors declare no conflicts of interest.
EDAT- 2013/10/08 06:00
MHDA- 2015/01/30 06:00
PMCR- 2014/09/05
CRDT- 2013/10/08 06:00
PHST- 2013/10/08 06:00 [entrez]
PHST- 2013/10/08 06:00 [pubmed]
PHST- 2015/01/30 06:00 [medline]
PHST- 2014/09/05 00:00 [pmc-release]
AID - hem279_1380781679314 [pii]
AID - 10.1179/1607845413Y.0000000131 [doi]
PST - ppublish
SO  - Hematology. 2014 Jul;19(5):275-9. doi: 10.1179/1607845413Y.0000000131. Epub 2013 
      Nov 25.