Cataract-free interval and severity of cataract after total body irradiation and bone marrow transplantation: influence of treatment parameters
Purpose: To determine prospectively the cataract-free interval (latency time) after total body irradiation (TBI) and bone marrow transplantation (BMT) and to assess accurately the final severity of the cataract. Methods and Materials: Ninety-three of the patients who received TBI as a part of their...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2000-10, Vol.48 (3), p.807-815 |
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| creator | van Kempen-Harteveld, M.Loes Struikmans, Henk Kal, Henk B van der Tweel, Ingeborg Mourits, Maarten Ph Verdonck, Leo F Schipper, Jan Battermann, Jan J |
| description | Purpose: To determine prospectively the cataract-free interval (latency time) after total body irradiation (TBI) and bone marrow transplantation (BMT) and to assess accurately the final severity of the cataract.
Methods and Materials: Ninety-three of the patients who received TBI as a part of their conditioning regimen for BMT between 1982 and 1995 were followed with respect to cataract formation. Included were only patients who had a follow-up period of at least 23 months. TBI was applied in one fraction of 8 Gy or two fractions of 5 or 6 Gy. Cataract-free period was assessed and in 56 patients, who could be followed until stabilization of the cataract had occurred, final severity of the cataract was determined using a classification system. With respect to final severity, two groups were analyzed: subclinical low-grade cataract and high-grade cataract. Cataract-free period and final severity were determined with respect to type of transplantation, TBI dose, and posttransplant variables such as graft versus host disease (GVHD) and steroid treatment.
Results: Cataract incidence of the analyzed patients was 89%. Median time to develop a cataract was 58 months for autologous transplanted patients. For allogeneic transplanted patients treated or not treated with steroids, median times were 33 and 46 months, respectively. Final severity was not significantly different for autologous or allogeneic patients. In allogeneic patients, however, final severity was significantly different for patients who had or had not been treated with steroids for GVHD: 93% versus 35% high-grade cataract, respectively. Final severity was also different for patients receiving 1 × 8 or 2 × 5 Gy TBI, from patients receiving 2 × 6 Gy as conditioning therapy: 33% versus 79% high-grade cataract, respectively. The group of patients receiving 2 × 6 Gy comprised, however, more patients with steroid treatment for GVHD. So the high percentage of high-grade cataract in the 2 × 6 Gy group might also have been caused to a significant extent by steroid treatment. The percentage of patients with high-grade cataract was lower in allogeneic transplanted patients without steroid treatment for GVHD than in autologous transplanted patients: 35% versus 48%. An explanation for this could be pretransplant therapy containing high-dose steroids.
Conclusions: After high-dose-rate TBI in one or two fractions, steroids for GVHD influence latency time of a cataract and are of great importance for the severity t |
| doi_str_mv | 10.1016/S0360-3016(00)00669-6 |
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Methods and Materials: Ninety-three of the patients who received TBI as a part of their conditioning regimen for BMT between 1982 and 1995 were followed with respect to cataract formation. Included were only patients who had a follow-up period of at least 23 months. TBI was applied in one fraction of 8 Gy or two fractions of 5 or 6 Gy. Cataract-free period was assessed and in 56 patients, who could be followed until stabilization of the cataract had occurred, final severity of the cataract was determined using a classification system. With respect to final severity, two groups were analyzed: subclinical low-grade cataract and high-grade cataract. Cataract-free period and final severity were determined with respect to type of transplantation, TBI dose, and posttransplant variables such as graft versus host disease (GVHD) and steroid treatment.
Results: Cataract incidence of the analyzed patients was 89%. Median time to develop a cataract was 58 months for autologous transplanted patients. For allogeneic transplanted patients treated or not treated with steroids, median times were 33 and 46 months, respectively. Final severity was not significantly different for autologous or allogeneic patients. In allogeneic patients, however, final severity was significantly different for patients who had or had not been treated with steroids for GVHD: 93% versus 35% high-grade cataract, respectively. Final severity was also different for patients receiving 1 × 8 or 2 × 5 Gy TBI, from patients receiving 2 × 6 Gy as conditioning therapy: 33% versus 79% high-grade cataract, respectively. The group of patients receiving 2 × 6 Gy comprised, however, more patients with steroid treatment for GVHD. So the high percentage of high-grade cataract in the 2 × 6 Gy group might also have been caused to a significant extent by steroid treatment. The percentage of patients with high-grade cataract was lower in allogeneic transplanted patients without steroid treatment for GVHD than in autologous transplanted patients: 35% versus 48%. An explanation for this could be pretransplant therapy containing high-dose steroids.
Conclusions: After high-dose-rate TBI in one or two fractions, steroids for GVHD influence latency time of a cataract and are of great importance for the severity the cataract finally attains. Although a cataract will develop in all patients, a clinically important high-grade cataract is relatively infrequent in patients not treated with steroids. Pretransplant therapy might also influence final severity of cataract.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/S0360-3016(00)00669-6</identifier><identifier>PMID: 11020578</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; BMT ; Bone Marrow Transplantation - adverse effects ; Cataract ; Cataract - etiology ; Cyclophosphamide - therapeutic use ; Cyclosporine - therapeutic use ; Female ; Follow-Up Studies ; Graft vs Host Disease - prevention & control ; GVHD ; Humans ; Immunosuppressive Agents - therapeutic use ; Lens diseases ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Ophthalmology ; Prospective Studies ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Severity of Illness Index ; Steroid treatment ; TBI ; Transplantation Conditioning - adverse effects ; Transplantation, Autologous ; Transplantation, Heterologous ; Whole-Body Irradiation - adverse effects</subject><ispartof>International journal of radiation oncology, biology, physics, 2000-10, Vol.48 (3), p.807-815</ispartof><rights>2000 Elsevier Science Inc.</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c420t-32243db0a6ab79ec2c5949da2b94a9fa38d4d5630c81deb385e53b53d5b6f8493</citedby><cites>FETCH-LOGICAL-c420t-32243db0a6ab79ec2c5949da2b94a9fa38d4d5630c81deb385e53b53d5b6f8493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0360-3016(00)00669-6$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=815751$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11020578$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Kempen-Harteveld, M.Loes</creatorcontrib><creatorcontrib>Struikmans, Henk</creatorcontrib><creatorcontrib>Kal, Henk B</creatorcontrib><creatorcontrib>van der Tweel, Ingeborg</creatorcontrib><creatorcontrib>Mourits, Maarten Ph</creatorcontrib><creatorcontrib>Verdonck, Leo F</creatorcontrib><creatorcontrib>Schipper, Jan</creatorcontrib><creatorcontrib>Battermann, Jan J</creatorcontrib><title>Cataract-free interval and severity of cataract after total body irradiation and bone marrow transplantation: influence of treatment parameters</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose: To determine prospectively the cataract-free interval (latency time) after total body irradiation (TBI) and bone marrow transplantation (BMT) and to assess accurately the final severity of the cataract.
Methods and Materials: Ninety-three of the patients who received TBI as a part of their conditioning regimen for BMT between 1982 and 1995 were followed with respect to cataract formation. Included were only patients who had a follow-up period of at least 23 months. TBI was applied in one fraction of 8 Gy or two fractions of 5 or 6 Gy. Cataract-free period was assessed and in 56 patients, who could be followed until stabilization of the cataract had occurred, final severity of the cataract was determined using a classification system. With respect to final severity, two groups were analyzed: subclinical low-grade cataract and high-grade cataract. Cataract-free period and final severity were determined with respect to type of transplantation, TBI dose, and posttransplant variables such as graft versus host disease (GVHD) and steroid treatment.
Results: Cataract incidence of the analyzed patients was 89%. Median time to develop a cataract was 58 months for autologous transplanted patients. For allogeneic transplanted patients treated or not treated with steroids, median times were 33 and 46 months, respectively. Final severity was not significantly different for autologous or allogeneic patients. In allogeneic patients, however, final severity was significantly different for patients who had or had not been treated with steroids for GVHD: 93% versus 35% high-grade cataract, respectively. Final severity was also different for patients receiving 1 × 8 or 2 × 5 Gy TBI, from patients receiving 2 × 6 Gy as conditioning therapy: 33% versus 79% high-grade cataract, respectively. The group of patients receiving 2 × 6 Gy comprised, however, more patients with steroid treatment for GVHD. So the high percentage of high-grade cataract in the 2 × 6 Gy group might also have been caused to a significant extent by steroid treatment. The percentage of patients with high-grade cataract was lower in allogeneic transplanted patients without steroid treatment for GVHD than in autologous transplanted patients: 35% versus 48%. An explanation for this could be pretransplant therapy containing high-dose steroids.
Conclusions: After high-dose-rate TBI in one or two fractions, steroids for GVHD influence latency time of a cataract and are of great importance for the severity the cataract finally attains. Although a cataract will develop in all patients, a clinically important high-grade cataract is relatively infrequent in patients not treated with steroids. Pretransplant therapy might also influence final severity of cataract.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>BMT</subject><subject>Bone Marrow Transplantation - adverse effects</subject><subject>Cataract</subject><subject>Cataract - etiology</subject><subject>Cyclophosphamide - therapeutic use</subject><subject>Cyclosporine - therapeutic use</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft vs Host Disease - prevention & control</subject><subject>GVHD</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Lens diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Ophthalmology</subject><subject>Prospective Studies</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Severity of Illness Index</subject><subject>Steroid treatment</subject><subject>TBI</subject><subject>Transplantation Conditioning - adverse effects</subject><subject>Transplantation, Autologous</subject><subject>Transplantation, Heterologous</subject><subject>Whole-Body Irradiation - adverse effects</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU-r1DAUxYMovvHpR1ACguiietM0afs2IoP_4IELFdyF2-QWIm0zJpmR-RR-ZTMz5bl0lUB-5-Tecxh7KuC1AKHffAWpoZLl-hLgFYDWfaXvsY3o2r6SSv24zzZ3yBV7lNJPABCibR6yKyGgBtV2G_Znixkj2lyNkYj7JVM84MRxcTzRgaLPRx5GbleM41gInkMu0BDckfsY0XnMPixn1RAW4jPGGH7zHHFJuwmXfH6_Kf7jtKfF0skzR8I805L5rnjPVIzTY_ZgxCnRk_W8Zt8_vP-2_VTdfvn4efvutrJNDbmSdd1INwBqHNqebG1V3_QO66FvsB9Rdq5xSkuwnXA0yE6RkoOSTg167JpeXrMXF99dDL_2lLKZfbI0lVkp7JMRbau0EF0B1QW0MaQUaTS76Mt6RyPAnJow5ybMKWYDYM5NGF10z9YP9sNM7p9qjb4Az1cAk8VpLFFZn-64TqhWiUK9vVBUwjh4iiZZfwrQ-Ug2Gxf8fwb5C_U8qGM</recordid><startdate>20001001</startdate><enddate>20001001</enddate><creator>van Kempen-Harteveld, M.Loes</creator><creator>Struikmans, Henk</creator><creator>Kal, Henk B</creator><creator>van der Tweel, Ingeborg</creator><creator>Mourits, Maarten Ph</creator><creator>Verdonck, Leo F</creator><creator>Schipper, Jan</creator><creator>Battermann, Jan J</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope></search><sort><creationdate>20001001</creationdate><title>Cataract-free interval and severity of cataract after total body irradiation and bone marrow transplantation: influence of treatment parameters</title><author>van Kempen-Harteveld, M.Loes ; Struikmans, Henk ; Kal, Henk B ; van der Tweel, Ingeborg ; Mourits, Maarten Ph ; Verdonck, Leo F ; Schipper, Jan ; Battermann, Jan J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c420t-32243db0a6ab79ec2c5949da2b94a9fa38d4d5630c81deb385e53b53d5b6f8493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>BMT</topic><topic>Bone Marrow Transplantation - adverse effects</topic><topic>Cataract</topic><topic>Cataract - etiology</topic><topic>Cyclophosphamide - therapeutic use</topic><topic>Cyclosporine - therapeutic use</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft vs Host Disease - prevention & control</topic><topic>GVHD</topic><topic>Humans</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Lens diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Ophthalmology</topic><topic>Prospective Studies</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Severity of Illness Index</topic><topic>Steroid treatment</topic><topic>TBI</topic><topic>Transplantation Conditioning - adverse effects</topic><topic>Transplantation, Autologous</topic><topic>Transplantation, Heterologous</topic><topic>Whole-Body Irradiation - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Kempen-Harteveld, M.Loes</creatorcontrib><creatorcontrib>Struikmans, Henk</creatorcontrib><creatorcontrib>Kal, Henk B</creatorcontrib><creatorcontrib>van der Tweel, Ingeborg</creatorcontrib><creatorcontrib>Mourits, Maarten Ph</creatorcontrib><creatorcontrib>Verdonck, Leo F</creatorcontrib><creatorcontrib>Schipper, Jan</creatorcontrib><creatorcontrib>Battermann, Jan J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Kempen-Harteveld, M.Loes</au><au>Struikmans, Henk</au><au>Kal, Henk B</au><au>van der Tweel, Ingeborg</au><au>Mourits, Maarten Ph</au><au>Verdonck, Leo F</au><au>Schipper, Jan</au><au>Battermann, Jan J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cataract-free interval and severity of cataract after total body irradiation and bone marrow transplantation: influence of treatment parameters</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2000-10-01</date><risdate>2000</risdate><volume>48</volume><issue>3</issue><spage>807</spage><epage>815</epage><pages>807-815</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose: To determine prospectively the cataract-free interval (latency time) after total body irradiation (TBI) and bone marrow transplantation (BMT) and to assess accurately the final severity of the cataract.
Methods and Materials: Ninety-three of the patients who received TBI as a part of their conditioning regimen for BMT between 1982 and 1995 were followed with respect to cataract formation. Included were only patients who had a follow-up period of at least 23 months. TBI was applied in one fraction of 8 Gy or two fractions of 5 or 6 Gy. Cataract-free period was assessed and in 56 patients, who could be followed until stabilization of the cataract had occurred, final severity of the cataract was determined using a classification system. With respect to final severity, two groups were analyzed: subclinical low-grade cataract and high-grade cataract. Cataract-free period and final severity were determined with respect to type of transplantation, TBI dose, and posttransplant variables such as graft versus host disease (GVHD) and steroid treatment.
Results: Cataract incidence of the analyzed patients was 89%. Median time to develop a cataract was 58 months for autologous transplanted patients. For allogeneic transplanted patients treated or not treated with steroids, median times were 33 and 46 months, respectively. Final severity was not significantly different for autologous or allogeneic patients. In allogeneic patients, however, final severity was significantly different for patients who had or had not been treated with steroids for GVHD: 93% versus 35% high-grade cataract, respectively. Final severity was also different for patients receiving 1 × 8 or 2 × 5 Gy TBI, from patients receiving 2 × 6 Gy as conditioning therapy: 33% versus 79% high-grade cataract, respectively. The group of patients receiving 2 × 6 Gy comprised, however, more patients with steroid treatment for GVHD. So the high percentage of high-grade cataract in the 2 × 6 Gy group might also have been caused to a significant extent by steroid treatment. The percentage of patients with high-grade cataract was lower in allogeneic transplanted patients without steroid treatment for GVHD than in autologous transplanted patients: 35% versus 48%. An explanation for this could be pretransplant therapy containing high-dose steroids.
Conclusions: After high-dose-rate TBI in one or two fractions, steroids for GVHD influence latency time of a cataract and are of great importance for the severity the cataract finally attains. Although a cataract will develop in all patients, a clinically important high-grade cataract is relatively infrequent in patients not treated with steroids. Pretransplant therapy might also influence final severity of cataract.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11020578</pmid><doi>10.1016/S0360-3016(00)00669-6</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Biological and medical sciences BMT Bone Marrow Transplantation - adverse effects Cataract Cataract - etiology Cyclophosphamide - therapeutic use Cyclosporine - therapeutic use Female Follow-Up Studies Graft vs Host Disease - prevention & control GVHD Humans Immunosuppressive Agents - therapeutic use Lens diseases Male Medical sciences Middle Aged Miscellaneous Ophthalmology Prospective Studies Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Severity of Illness Index Steroid treatment TBI Transplantation Conditioning - adverse effects Transplantation, Autologous Transplantation, Heterologous Whole-Body Irradiation - adverse effects |
| title | Cataract-free interval and severity of cataract after total body irradiation and bone marrow transplantation: influence of treatment parameters |
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