{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:48:41Z","timestamp":1777510121182,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Hubei Provincial Natural Science Foundation of China","award":["2025AFB519"],"award-info":[{"award-number":["2025AFB519"]}]},{"name":"Hubei Provincial Natural Science Foundation of China","award":["2025AFD499"],"award-info":[{"award-number":["2025AFD499"]}]},{"name":"Medical Youth Top Talent Program of Hubei Province of China","award":["Chen Yu"],"award-info":[{"award-number":["Chen Yu"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370220"],"award-info":[{"award-number":["82370220"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research Grant of Key Laboratory of Molecular Biological Targeted Therapies of the Ministry of Education","award":["2024SWBS002"],"award-info":[{"award-number":["2024SWBS002"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cell Transplant"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Currently, there is very limited large-scale real-world data on the use of total marrow irradiation (TMI) as conditioning for allogeneic hematopoietic stem cell transplantation (allo-HSCT). The primary objective of this study was to evaluate the real-world feasibility, efficacy, and safety of TMI-based conditioning in a large multicenter cohort. We retrospectively included consecutive patients undergoing allo-HSCT with TMI-based conditioning across four Chinese centers (2017\u20132024). The primary endpoint was overall survival (OS); secondary endpoints included disease-free survival (DFS), graft-versus-host disease\u2013free\/relapse-free survival (GRFS), nonrelapse mortality (NRM), graft-versus-host disease (GVHD), and safety. Among 205 patients, acute lymphoblastic leukemia (ALL) was the predominant diagnosis (81.5%). With a median follow-up of 19.3 months among survivors, 2-year OS, DFS, and GRFS were 71.7%, 60.0%, and 37.8%, respectively. One-year cumulative incidences of relapse and NRM were 20.2% and 13.8%. Day-100 grade II\u2013IV acute GVHD occurred in 32.9%, and 1-year moderate-to-severe chronic GVHD in 19.1%. In multivariable analyses, acute myeloid leukemia (AML) diagnosis, haploidentical donor, and Eastern Cooperative Oncology Group (ECOG) performance status &gt;1 were associated with inferior outcomes. Exploratory dose-stratified analyses were performed. Severe toxicities within 100 days were infrequent, predominantly infections (21.46%). In this large multicenter cohort, TMI-based conditioning demonstrated real-world feasibility with encouraging survival and manageable safety outcomes.<\/jats:p>","DOI":"10.1177\/09636897261440297","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T11:16:54Z","timestamp":1776424614000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Total marrow irradiation-based conditioning for allogeneic hematopoietic stem cell transplantation in patients with hematologic malignancies: A multicenter real-world study"],"prefix":"10.1177","volume":"35","author":[{"given":"Yi","family":"Zhang","sequence":"first","affiliation":[{"name":"Institute of Hematology, Union Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, China"},{"name":"Key Laboratory of Biological Targeted Therapy (Huazhong University of Science and Technology), Ministry of Education, 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marrow lymphoid irradiation and cyclophosphamide is associated with low toxicity and good outcomes in patients undergoing hematopoietic stem cell transplantation for acute lymphoblastic leukemia and chronic myeloid leukemia in lymphoid blast crises\u2013a phase I study","volume":"37","author":"George B","year":"2023","unstructured":"George B, Balakrishnan R, S P, Lionel S, Selvarajan S, Devasia AJ, Korula A, Lakshmi KM, Aboobacker FN, Kulkarni U, Godson HF, et al. Total marrow lymphoid irradiation and cyclophosphamide is associated with low toxicity and good outcomes in patients undergoing hematopoietic stem cell transplantation for acute lymphoblastic leukemia and chronic myeloid leukemia in lymphoid blast crises\u2013a phase I study. Clin Transplant. 2023;37(9):e15010.","journal-title":"Clin Transplant"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2024.10.007"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.774348"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2022.03.025"},{"key":"e_1_3_3_25_2","article-title":"Intensified conditioning with high-dose total marrow irradiation and myeloablative chemotherapy reduces risk of relapse without increasing toxicity in allogeneic hematopoietic stem cell transplant for high-risk myeloid malignancies: a phase II study","volume":"111","author":"Maahs L","year":"2025","unstructured":"Maahs L, Avila AM, Koshy M, Sweiss K, Ahn KH, Chen Z, Uzoka C, Galvez C, Sanchez M, Rubinstein P, Quigley J, et al. Intensified conditioning with high-dose total marrow irradiation and myeloablative chemotherapy reduces risk of relapse without increasing toxicity in allogeneic hematopoietic stem cell transplant for high-risk myeloid malignancies: a phase II study. 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