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December 8, 2025BloodOpen Access

Tailoring TBI for vulnerable patients: 8 gy TBI shows comparable outcomes to 12 gy TBI in adult ALL allo-HSCT

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Authors

KYKyosuke YamaguchiKKKosei KageyamaKIKazuya Ishiwata

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Overview

Retrospective analysis shows comparable overall survival in older ALL patients receiving 8 Gy TBI versus 12 Gy TBI, suggesting potential for reduced intensity.

Key Points

  • To investigate the outcomes of reduced-intensity 8 Gy total body irradiation compared to standard 12 Gy in adult ALL patients undergoing allo-HSCT.
  • Retrospective analysis of adult ALL patients who underwent allo-HSCT at Toranomon Hospital from 2000 to 2025.
  • Endpoints included overall survival, leukemia-free survival, relapse incidence, and graft-versus-host disease analysis.
  • Comparison of baseline characteristics and different conditioning regimens between 8 Gy and 12 Gy TBI groups.
  • Two-year overall survival rates were comparable between 8 Gy TBI (66.5%) and 12 Gy TBI (66.3%).
  • Two-year leukemia-free survival rates also showed no significant differences (64.3% for 8 Gy vs. 57.0% for 12 Gy).
  • Higher non-relapse mortality was observed in the 8 Gy TBI group (17.3% vs. 10.5%, p = 0.045).

Cite This Study

Yamaguchi et al. (2025) studied this question.

synapsesocial.com/papers/69362f5a4fa91c937236db93https://doi.org/10.1182/blood-2025-5971
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Reduced‐dose versus standard‐dose total body irradiation before allogeneic haematopoietic stem cell transplantation in adults with acute lymphoblastic leukaemia2026
  2. 2Reduced intensity conditioning with 8 Gy total body irradiation in adult patients with acute lymphoblastic leukemia2025 · 3 citations
  3. 3Impact of Total Body Irradiation Dose in Reduced-Intensity Conditioning for Allogeneic Hematopoietic Cell Transplantation in Acute Myeloid Leukemia.2026
  4. 4Total body irradiation versus chemotherapy before stem cell transplantation in children aged two to four with acute lymphoblastic leukemia—an EBMT pediatric diseases working party study2026
  5. 5Incorporation of 8Gy total body irradiation into reduced intensity conditioning does not improve allogeneic transplant outcomes for high-risk adult acute lymphoblastic leukemia: Results from the randomised prospective phase 2 UK multicentre ALL-RIC impact study2025