{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:14:39Z","timestamp":1788966879412,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>Total body irradiation (TBI) is commonly used for myeloablative conditioning prior to allogeneic hematopoietic stem cell transplantation (HSCT) in high-risk, relapsed, or refractory hematologic malignancies. Pulmonary toxicity (PT)\u2014including pneumonia, diffuse alveolar hemorrhage, and interstitial pneumonitis\u2014is a serious complication after HSCT. Idiopathic pneumonia syndrome (IPS), defined as widespread alveolar injury without cardiogenic or infectious causes, represents a non-infectious form of PT. This study characterizes PT and IPS and explores associated factors following TBI-based HSCT in adults. We conducted a retrospective review of a prospectively collected database of adult patients treated with TBI-based HSCT from 2015 to 2022. Clinical records and chest imaging were reviewed to identify PT and IPS. IPS occurred in 20 patients (18%) of the cohort, with 8 patients (7%) within 100 days and 13 patients (13%) after 100 days. One patient experienced both early- and late-onset IPS and was counted once in the cumulative analysis. Early pulmonary infection was associated with reduced overall survival in both univariable (p = 0.002) and multivariable 100-day landmark analyses (p = 0.047). Acute graft-versus-host disease (GVHD) was independently associated with improved survival (p = 0.017), whereas chronic GVHD was not statistically significant in the landmark analyses. PT and IPS incidences were consistent with previously published adult TBI cohorts. While no significant clinical or radiation-related predictors of IPS were identified, pulmonary infection emerged as a predictor of inferior overall survival.<\/jats:p>","DOI":"10.3390\/curroncol33090545","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:02:48Z","timestamp":1788962568000},"page":"545","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Idiopathic Pneumonia Syndrome and Pulmonary Toxicity After Total Body Irradiation for Bone Marrow Transplantation in the Modern Transplant Era"],"prefix":"10.3390","volume":"33","author":[{"given":"Ruijia","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0921-8984","authenticated-orcid":false,"given":"Justin","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7311-8681","authenticated-orcid":false,"given":"Iman","family":"Baharmand","sequence":"additional","affiliation":[{"name":"Department of Family Practice, University of British Columbia, Vancouver, BC V6T 1Z3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-9068","authenticated-orcid":false,"given":"Matthew","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5871-8221","authenticated-orcid":false,"given":"Jessica","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Andrea C.","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6232-8666","authenticated-orcid":false,"given":"Cassidy","family":"Northway","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada"},{"name":"Department of Medical Physics, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Conrad","family":"Yuen","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"I. A.","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada"},{"name":"Department of Medical Physics, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"T. P. L.","family":"Nghiem","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Yasser Abou","family":"Mourad","sequence":"additional","affiliation":[{"name":"Leukemia\/BMT Program of BC, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada"},{"name":"Division of Hematology, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1341-5147","authenticated-orcid":false,"given":"Cheryl","family":"Duzenli","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada"},{"name":"Department of Medical Physics, BC Cancer, Vancouver, BC V5Z 4E6, Canada"},{"name":"Department of Clinical Research, BC Cancer, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1200\/JCO.20.02529","article-title":"Total body irradiation or chemotherapy conditioning in childhood ALL: A multinational, randomized, noninferiority phase III study","volume":"39","author":"Peters","year":"2021","journal-title":"J. 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