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Etoposide, cyclophosphamide and fractionated total body irradiation as a preparative regimen for marrow transplantation in patients with advanced hematological malignancies: a phase I study.

Publication ,  Journal Article
Petersen, FB; Buckner, CD; Appelbaum, FR; Sanders, JE; Bensinger, WI; Storb, R; Deeg, HJ; Witherspoon, RP; Sullivan, KM; Clift, RA
Published in: Bone Marrow Transplant
July 1992

Thirty-seven patients with advanced hematologic malignancy were entered into a phase I study designed to define a maximum tolerable dose (MTD) of etoposide (VP-16) and cyclophosphamide (CY) combined with 12 Gy fractionated total body irradiation (TBI) as preparation for marrow transplantation from an HLA-identical sibling (n = 13) or with cryopreserved autologous marrow (n = 24). Dose levels ranged from 36 mg/kg of VP-16 combined with 67 mg/kg of CY to 52 mg/kg of VP-16 combined with 103 mg/kg of CY followed by 12 Gy TBI. The MTD for allogeneic marrow recipients was 36 mg/kg of VP-16 + 52 mg/kg of CY followed by 12 Gy TBI and for autologous marrow recipients 44 mg/kg of VP-16 + 103 mg/kg CY followed by 12 Gy TBI. Pulmonary and liver toxicities were dose limiting. All of 31 evaluable patients transplanted in relapse achieved a complete remission. However, in all but three of these patients the disease relapsed 28-899 (median 110) days post-transplant. Currently, six of 24 autologous marrow recipients are surviving, three in remission 256, 340 and 764 days post-transplant. None of 12 allogeneic marrow recipients have survived. In conclusion, a preparative regimen combining 44 mg/kg of VP-16 + 103 mg/kg CY followed by 12 Gy TBI is well tolerated by autologous marrow recipients and 36 mg/kg VP-16 + 67 mg/kg CY followed by 12 Gy TBI is well tolerated by allogeneic marrow recipients.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

Bone Marrow Transplant

ISSN

0268-3369

Publication Date

July 1992

Volume

10

Issue

1

Start / End Page

83 / 88

Location

England

Related Subject Headings

  • Whole-Body Irradiation
  • Transplantation, Homologous
  • Transplantation, Autologous
  • Middle Aged
  • Lymphoma
  • Leukemia
  • Immunology
  • Humans
  • Graft vs Host Disease
  • Etoposide
 

Citation

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MLA
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Petersen, F. B., Buckner, C. D., Appelbaum, F. R., Sanders, J. E., Bensinger, W. I., Storb, R., … Clift, R. A. (1992). Etoposide, cyclophosphamide and fractionated total body irradiation as a preparative regimen for marrow transplantation in patients with advanced hematological malignancies: a phase I study. Bone Marrow Transplant, 10(1), 83–88.
Petersen, F. B., C. D. Buckner, F. R. Appelbaum, J. E. Sanders, W. I. Bensinger, R. Storb, H. J. Deeg, R. P. Witherspoon, K. M. Sullivan, and R. A. Clift. “Etoposide, cyclophosphamide and fractionated total body irradiation as a preparative regimen for marrow transplantation in patients with advanced hematological malignancies: a phase I study.Bone Marrow Transplant 10, no. 1 (July 1992): 83–88.
Petersen FB, Buckner CD, Appelbaum FR, Sanders JE, Bensinger WI, Storb R, et al. Etoposide, cyclophosphamide and fractionated total body irradiation as a preparative regimen for marrow transplantation in patients with advanced hematological malignancies: a phase I study. Bone Marrow Transplant. 1992 Jul;10(1):83–8.
Petersen FB, Buckner CD, Appelbaum FR, Sanders JE, Bensinger WI, Storb R, Deeg HJ, Witherspoon RP, Sullivan KM, Clift RA. Etoposide, cyclophosphamide and fractionated total body irradiation as a preparative regimen for marrow transplantation in patients with advanced hematological malignancies: a phase I study. Bone Marrow Transplant. 1992 Jul;10(1):83–88.

Published In

Bone Marrow Transplant

ISSN

0268-3369

Publication Date

July 1992

Volume

10

Issue

1

Start / End Page

83 / 88

Location

England

Related Subject Headings

  • Whole-Body Irradiation
  • Transplantation, Homologous
  • Transplantation, Autologous
  • Middle Aged
  • Lymphoma
  • Leukemia
  • Immunology
  • Humans
  • Graft vs Host Disease
  • Etoposide