{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:05:19Z","timestamp":1753869919890,"version":"3.41.2"},"reference-count":43,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T00:00:00Z","timestamp":1719532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Total body irradiation (TBI) is a pivotal part of conditioning prior to hematopoietic stem cell transplantation (HSCT) for childhood acute lymphoblastic leukemia (ALL), yet evidence is sparse regarding the effect of TBI delivery techniques on acute and late toxicities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>In a national cohort of pediatric HSCT\u2010recipients, we compared three TBI schedules; 12\u00a0Gray (Gy) delivered as (i) 4\u00a0Gy daily fractions from 2008 to 2011 (<jats:italic>n<\/jats:italic>\u00a0=\u00a012); (ii) 2\u00a0Gy fractions twice daily with two\u2010dimensional (2D) planning technology from 2012 to 2015 (<jats:italic>n<\/jats:italic>\u00a0=\u00a016); and (iii) 2\u00a0Gy twice daily with three\u2010dimensional (3D) planning intensity\u2010modulated radiotherapy (IMRT) from 2016 to 2020 (<jats:italic>n<\/jats:italic>\u00a0=\u00a014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 5\u2010year event\u2010free survival was 75.0%, 81.3%, and 81.3% in Cohorts 1, 2, and 3, respectively. Acute toxicity assessed as maximum ferritin and C\u2010reactive protein during the first 3\u00a0months post HSCT did not differ between cohorts, nor did the time to first hospital discharge (median 28, 32, and 31\u00a0days, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.25). The incidences of acute graft\u2010versus\u2010host disease (GvHD) (66%, 56%, 71%) and chronic GvHD (25%, 31%, 14%) were comparable. Pulmonary function assessed by spirometry did not differ significantly. The 5\u2010year cataract\u2010free survival was 33.3%, 79%, and 100% in Cohorts 1, 2, and 3, respectively. We found a nonsignificant tendency toward more endocrinopathies in Cohort 1 compared to Cohorts 2 and 3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The change of modality did not result in more relapses. More fractionation led to improvement with a lower incidence of cataract and a tendency toward fewer endocrinopathies. The effect of 3D\u2010planning\u2010IMRT technology requires further evaluation in larger studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31163","type":"journal-article","created":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T04:48:11Z","timestamp":1719636491000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Late effects following HSCT for childhood ALL: A national single\u2010center study using three different modalities of delivery of total body irradiation"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0389-3767","authenticated-orcid":false,"given":"Hilde Hylland","family":"Uhlving","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Copenhagen University Hospital Rigshospitalet  Copenhagen 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