High-dose chemotherapy with busulphan and cyclophosphamide and bone-marrow transplantation for drug-sensitive malignancies in adults: a preliminary report

Med J Aust. 1989 Oct 2;151(7):379-86. doi: 10.5694/j.1326-5377.1989.tb101219.x.

Abstract

The technique of high-dose chemotherapy and bone-marrow transplantation takes advantage of any potential dose-response effect in the treatment of cancer and the ability of infused marrow to circumvent severe myelotoxicity. We report our initial experience of 20 high-dose chemotherapy procedures with busulphan and cyclophosphamide as the treatment regimen. Autologous (14 patients), human leukocyte antigen-matched, sibling-allogeneic (five patients) and identical-twin (one patient) transplantations were performed in patients with leukaemias (12 patients), lymphomas (seven patients) or a germ-cell tumour (one patient). One in-hospital and one late death occurred as a result of the toxicity of high-dose chemotherapy. All evaluable patients demonstrated bone-marrow engraftment and became independent of blood transfusions. Five of six patients who were treated in partial remission or relapse obtained a complete remission. Seven patients have relapsed. Eleven patients currently are alive and disease-free and nine patients have returned to their full-time occupations. High-dose chemotherapy can be undertaken with an over-all morbidity that is similar to that which is experienced during the induction chemotherapy of acute leukaemia.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation*
  • Busulfan / administration & dosage*
  • Busulfan / adverse effects
  • Busulfan / therapeutic use
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage*
  • Cyclophosphamide / adverse effects
  • Cyclophosphamide / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Follow-Up Studies
  • Hodgkin Disease / drug therapy
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy
  • Humans
  • Leukemia / drug therapy
  • Leukemia / mortality
  • Leukemia / therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / mortality
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / mortality
  • Leukemia, Myeloid, Acute / therapy
  • Lymphoma, Non-Hodgkin / drug therapy
  • Lymphoma, Non-Hodgkin / mortality
  • Lymphoma, Non-Hodgkin / therapy*
  • Male
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Prognosis
  • Prospective Studies
  • Testicular Neoplasms / drug therapy
  • Testicular Neoplasms / mortality
  • Testicular Neoplasms / secondary
  • Testicular Neoplasms / therapy

Substances

  • Cyclophosphamide
  • Busulfan