Fractionated total body irradiation and high dose cyclophosphamide: a preparative regimen for bone marrow transplantation for patients with hematologic malignancies in first complete remission

Blut. 1988 Jul;57(1):7-13. doi: 10.1007/BF00320628.

Abstract

We treated 73 patients with hematologic malignancies in first complete remission (acute lymphoblastic leukemia = 23 patients; acute non-lymphoblastic leukemia = 25 patients; chronic myelogenous leukemia in first chronic phase = 20 patients, and high grade lymphoma = five patients) with a uniform preparative regimen consisting of fractionated total body irradiation (1,320 cGy) and high dose cyclophosphamide (100 mg/kg), followed by allogeneic bone marrow transplantation. By radiation dosimetry we demonstrated that the calculated doses were delivered accurately and reproducibly. Actuarial survival rates (+/- SEM) in complete remission were as follows: Acute lymphoblastic leukemia = 74 +/- 9%; acute nonlymphoblastic leukemia = 50 +/- 11%; and chronic myelogenous leukemia = 55 +/- 11%. Actuarial relapse rates for these three diagnoses were 19 +/- 9%, 17 +/- 11%, and 0% respectively. Three of the five lymphoma patients are alive in complete remission at 22+, 28+, and 54+ months. Overall probability of survival for the 73 patients was 59 +/- 7%. Interstitial pneumonia, usually associated with cytomegalovirus infection and graft-versus-host disease, and relapse of the underlying malignancy were the major causes of death.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation*
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage*
  • Drug Administration Schedule
  • Female
  • Humans
  • Leukemia / drug therapy
  • Leukemia / radiotherapy
  • Leukemia / therapy*
  • Leukemia, Lymphoid / drug therapy
  • Leukemia, Lymphoid / radiotherapy
  • Leukemia, Lymphoid / therapy
  • Leukemia, Myeloid / drug therapy
  • Leukemia, Myeloid / radiotherapy
  • Leukemia, Myeloid / therapy
  • Lymphoma / drug therapy
  • Lymphoma / radiotherapy
  • Lymphoma / therapy
  • Male
  • Preoperative Care
  • Radiotherapy Dosage
  • Remission Induction
  • Whole-Body Irradiation / methods*

Substances

  • Cyclophosphamide