Skip to main content

High-dose cyclophosphamide, carmustine, and etoposide followed by autologous bone marrow transplantation in patients with lymphoid malignancies who have received dose-limiting radiation therapy.

Publication ,  Journal Article
Weaver, CH; Appelbaum, FR; Petersen, FB; Clift, R; Singer, J; Press, O; Bensinger, W; Bianco, J; Martin, P; Anasetti, C
Published in: J Clin Oncol
July 1993

PURPOSE: To evaluate high-dose chemotherapy followed by autologous bone marrow transplantation (ABMT) in patients with lymphoid malignancy who had received prior radiation therapy. PATIENTS AND METHODS: Fifty-seven patients with non-Hodgkin's lymphoma (NHL; n = 23), Hodgkin's disease (HD, n = 32), or acute lymphoblastic leukemia (ALL; n = 2) with a history of previous radiation therapy were treated with cyclophosphamide (Cy; 7.2 g/m2), carmustine (300 mg/m2 or 600 mg/m2), and etoposide (2,400 mg/m2) (CBV) followed by ABMT. RESULTS: The projected 2-year probabilities of survival, event-free survival (EFS), and relapse were .31, .24, and .76, respectively. For patients with intermediate- and high-grade lymphoma and HD the probabilities were .27, .10, and .14 for EFS and .57, .90, and .77 for relapse. The probability of nonrelapse mortality in the first 100 days post-ABMT was 33%. Idiopathic pneumonia syndrome (IPS) was observed in no patients who received carmustine 300 mg/m2 and 23% of patients who received carmustine 600 mg/m2 (P = .05). Eight-three percent of patients who received mediastinal radiation therapy less than 3 months before transplant developed IPS, compared with 13% who received radiation therapy more than 3 months before transplant (P = .001). CONCLUSION: ABMT following high-dose CBV resulted in long-term disease-free survival in 25% of patients with lymphoid malignancies who had previously received dose-limiting radiation therapy. Fatal IPS and a high relapse rate were major factors limiting successful outcome following ABMT. The morbidity and mortality rates associated with the administration of carmustine 600 mg/m2 were prohibitively high, especially in patients who received mediastinal radiation immediately before ABMT, and were not associated with a decrease in post-ABMT relapse.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

July 1993

Volume

11

Issue

7

Start / End Page

1329 / 1335

Location

United States

Related Subject Headings

  • Transplantation, Autologous
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Oncology & Carcinogenesis
  • Male
  • Lymphoma
  • Humans
  • Female
  • Etoposide
  • Cyclophosphamide
  • Combined Modality Therapy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Weaver, C. H., Appelbaum, F. R., Petersen, F. B., Clift, R., Singer, J., Press, O., … Anasetti, C. (1993). High-dose cyclophosphamide, carmustine, and etoposide followed by autologous bone marrow transplantation in patients with lymphoid malignancies who have received dose-limiting radiation therapy. J Clin Oncol, 11(7), 1329–1335. https://doi.org/10.1200/JCO.1993.11.7.1329
Weaver, C. H., F. R. Appelbaum, F. B. Petersen, R. Clift, J. Singer, O. Press, W. Bensinger, J. Bianco, P. Martin, and C. Anasetti. “High-dose cyclophosphamide, carmustine, and etoposide followed by autologous bone marrow transplantation in patients with lymphoid malignancies who have received dose-limiting radiation therapy.J Clin Oncol 11, no. 7 (July 1993): 1329–35. https://doi.org/10.1200/JCO.1993.11.7.1329.
Weaver CH, Appelbaum FR, Petersen FB, Clift R, Singer J, Press O, Bensinger W, Bianco J, Martin P, Anasetti C. High-dose cyclophosphamide, carmustine, and etoposide followed by autologous bone marrow transplantation in patients with lymphoid malignancies who have received dose-limiting radiation therapy. J Clin Oncol. 1993 Jul;11(7):1329–1335.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

July 1993

Volume

11

Issue

7

Start / End Page

1329 / 1335

Location

United States

Related Subject Headings

  • Transplantation, Autologous
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Oncology & Carcinogenesis
  • Male
  • Lymphoma
  • Humans
  • Female
  • Etoposide
  • Cyclophosphamide
  • Combined Modality Therapy