17565 Total Body Irradiation

Overview

Total body irradiation (TBI) is not a disease. It is a specialised radiotherapy treatment that gives radiation to the whole body in carefully planned small sessions. It is used as part of preparation for a stem cell transplant or bone marrow transplant. The aim is to clear diseased bone marrow and quiet the immune system so donor cells can settle and grow.

TBI is not common in general practice. It is used only in specialist centres for selected people who are having a stem cell transplant.

It can affect adults and children with certain blood cancers, bone marrow failure, or immune system disorders who are being considered for a stem cell transplant. Your age, general health, and underlying condition help the team decide whether TBI is suitable.

Symptoms

Common symptoms

• Tiredness that may build up during and after treatment
• Feeling sick or being sick
• Dry mouth, mouth sores, or changed taste
• Red, dry, itchy, or sensitive skin
• Hair loss
• Loose stools or diarrhoea
• Loss of appetite
• Low blood counts, which can raise the risk of infection, bruising, or bleeding

Symptoms in children

• Children may become more tired, clingy, or upset during treatment.
• Eating and drinking can be harder because of mouth sores, sickness, or changed taste.
• Skin reactions and tiredness may make play and sleep more difficult.
• The team may involve play specialists, dietitians, and extra family support.
• Long-term follow-up checks growth, hormone levels, and learning or development needs.

Symptoms in older adults

• Older adults may feel more tired and are more at risk of dehydration.
• Skin may be more fragile and slower to recover.
• Existing heart, lung, kidney, or liver conditions need careful review before treatment.
• Confusion or falls need prompt checking, especially if drinking or eating is difficult.
• Support at home and help with daily tasks may be needed during recovery.

Causes

Main causes

• TBI is not caused by anything; it is a planned medical treatment.
• It is used when the transplant team decides that whole-body radiation is the best way to prepare your body for a stem cell transplant.
• The underlying reason for TBI is the blood, bone marrow, or immune condition that needs transplant treatment.

Risk factors

• Factors that can raise the chance of side effects include older age, poor general health, and previous chemotherapy or radiotherapy.
• Problems with the heart, lungs, kidneys, or liver may affect how safely TBI can be given.
• The total amount of radiation and the schedule used are chosen carefully by the radiation team.
• Children and older adults may need extra monitoring and support.

When to see a doctor

See a doctor urgently if:

• A fever, shaking chills, or feeling very unwell
• Vomiting or diarrhoea that stops you keeping fluids down
• Mouth sores that make eating or drinking very hard
• A new or worsening rash, especially blistering or peeling
• Shortness of breath, a new cough, chest pain, confusion, or fainting
• Unusual bruising, bleeding that will not stop, or blood in urine or stools

Book a routine appointment if:

• Tiredness that is getting worse
• Mild nausea, poor appetite, or changed taste
• Dry mouth, mouth soreness, or skin dryness and itching
• Hair loss or scalp tenderness
• Worry, low mood, or sleep problems

Diagnosis

TBI is not a condition that is diagnosed. Your doctor diagnoses the underlying illness, and the transplant team decides whether TBI should be part of your preparation.

Tests that may be done

• Blood tests to check blood counts, kidney, liver, and infection status
• Imaging scans such as X-rays, CT, or MRI
• Heart tests, including an echocardiogram, which is an ultrasound of the heart
• Lung function tests
• Dental check before treatment
• Fertility counselling and sperm or egg storage discussion where relevant
• Transplant workup and planning scans for radiotherapy

What to expect at your appointment

You will discuss the benefits and risks and sign a consent form. A planning session maps your body and may use shields to protect parts such as the lungs. Treatment itself is painless and usually lasts a few minutes per session. You may be alone in the treatment room, but staff watch and talk to you. Most courses are given over several days.

Treatment

TBI is itself a treatment. It is planned by the radiation team together with your transplant team. The schedule is chosen to give the best chance of successful transplant while limiting harm to healthy tissues.

Self-care at home

• Follow your team's advice on skin care, mouth care, food safety, and avoiding crowds.
• Rest when tired, but keep gently active if your team agrees.
• Drink fluids regularly and check your temperature as told.
• Tell your team early about new symptoms, especially fever, rash, or diarrhoea.
• Do not start any new medicine, supplement, or herbal product without checking with your team.

Medical treatments

Supportive care is used to manage side effects. This can include medicines to prevent sickness, fluids into a vein, nutrition support, pain relief, mouth and skin care, blood tests, and prompt treatment of infection. The radiation and transplant teams adjust the plan if side effects are hard to manage.

When is surgery considered?

Surgery is not used for TBI. The stem cell transplant itself is usually given through a vein like a blood transfusion, not as an operation.

Living with this condition

You may need to stay near the hospital during treatment. Days can be tiring, with appointments, blood tests, and rest. Mouth care, skin care, and food safety become part of your daily routine. Your team will tell you when it is safe to be around crowds, garden, or travel.

Lifestyle tips

• Wash hands often and ask visitors to do the same.
• Avoid close contact with people who are unwell.
• Do not share towels, cups, or toothbrushes.
• Ask when you can return to work, school, or travel.
• Protect your skin from strong sun and avoid shaving over sore areas unless told otherwise.

Diet and exercise

A dietitian may advise safe food handling and high-calorie, high-protein foods if appetite is low. Gentle walking and stretching can help if approved. Avoid heavy lifting or strenuous exercise until your team says it is safe.

Mental health and emotional wellbeing

It is normal to feel anxious, low, or isolated. Fertility worries, body changes, and time away from family can be hard. If you have thoughts of harming yourself or feel in crisis, contact your local emergency number or a local crisis service straight away.

Prevention

TBI cannot be prevented because it is a planned treatment. The aim is to prepare your body for transplant. Your team will explain why it is recommended and whether other preparation options are suitable.

Vaccines

Vaccines are planned around transplant. Live vaccines are usually avoided while immunity is low, and timing is decided by your transplant team. Ask them before having any vaccine.

Screening programmes

Before TBI you have checks for infection and organ health. After TBI, long-term follow-up looks for effects on hormones, thyroid, lungs, heart, eyes, teeth, and bones, and for rare longer-term risks. Attend the appointments you are offered.

Complications

If left untreated

• The underlying blood or bone marrow condition may get worse.
• The planned transplant may be less likely to succeed without the preparation your team recommends.
• Symptoms and complications of the underlying condition may continue.

Long-term outlook

Many people get through TBI with support. Most early side effects improve over time, and long-term effects are watched for. Your outlook depends on the underlying disease, the type of transplant, your age, and your general health. Ask your team what is most likely in your case.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.