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

David S. Snyder, David O. Findley, Stephen J. Forman, Auayporn P. Nademanee, Margaret R. O'Donnell, Gerhard M. Schmidt, Philip J. Bierman, John L. Fahey, Robert A. Krance, Irena J. Sniecinski, Gottfried Doelken, James A. Lipsett, Kenneth H. Luk, Mudra B. Nathwani, L. Robert Hill, Karl G. Blume

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

We treated 73 patients with hematologic malignancies in first complete remission (acute lymphoblastic leukemia = 23 patients; acute nonlymphoblastic 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.

Original languageEnglish (US)
Pages (from-to)7-13
Number of pages7
JournalBlut
Volume57
Issue number1
DOIs
StatePublished - Jul 1988

Keywords

  • Acute lymphoblastic leukemia
  • Acute non-lymphoblastic leukemia
  • Bone marrow transplantation
  • Chronic myelogenous leukemia
  • High grade
  • Non-Hodgkin's lymphoma

ASJC Scopus subject areas

  • Hematology

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