Interstitial pneumonitis is one of the most serious complications in patients after bone marrow transplantation, and irradiation plays the main role in its etiology. A total of 44 patients with blood diseases were subjected to total-body irradiation before bone marrow transplantation. Chemotherapy, cyclophosphamide in a dose of 60 mg/kg/day, was conducted during two successive days. Group I patients (n-23) were subjected to irradiation in a total dose of 12 Gy used as 6 fractions of 2 Gy twice a day, during 3 successive days. Group II patients, after irradiation with 6 Gy, were protected with lung shields that inhibited 50% of irradiation thus reducing the irradiation dose in the area of the lung up to 9 Gy. Then the patients received a total dose of 6 Gy during two days. Radiation pneumonitis developed in 6 out of 23 patients, 3 of them died. No non-infectious complications of the lungs were observed in group II patients with partial protection of the lung tissue. The data obtained have evidenced that thoroughly developed radiotherapeutic program with a special attention to the prevention of excessive irradiation of the lung tissue can reduce incidence of radiation pneumonitis in patients after bone marrow transplantation.
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