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Busulfan and cyclophosphamide as a preparative regimen for bone marrow transplantation in patients with prior chest radiotherapy.

Publication ,  Journal Article
Van der Jagt, RH; Appelbaum, FR; Petersen, FB; Bigelow, CL; Fisher, LD; Schoch, GH; Buckner, CD; Sanders, JE; Storb, R; Sullivan, KM
Published in: Bone Marrow Transplant
September 1991

In a previous study, we reported that patients with hematologic malignancies who had received prior chest radiotherapy had a 32% risk of developing fatal interstitial pneumonia (IP) when prepared for bone marrow transplantation (BMT) with a regimen containing total body irradiation (TBI). To determine if avoidance of TBI would lessen the incidence of fatal IP, 37 patients who had received prior chest radiotherapy in excess of 2000 cGy were prepared with busulfan (BU, 4 mg/kg x 4 days) and cyclophosphamide (CY, 60 mg/kg x 2 days) followed by autologous (n = 15) or allogeneic (n = 22) BMT. Thirty-five of these patients had recurrent or refractory hematologic malignancies and most were heavily pretreated. Results were compared with the group of similar patients (n = 25) previously treated at our institution with a CY/TBI conditioning regimen. Among those treated with BU/CY, two patients (5%) developed fatal interstitial pneumonia, 12 (32%) died of other transplant related toxicities and 13 (35%) died of relapse. Seven (19%) patients remain alive and well. Among those treated with CY/TBI, eight (32%) died of pneumonia, six (24%) died of relapse, nine (36%) died of other causes and two (8%) remain alive and well. The 5% incidence of fatal interstitial pneumonitis in the chemotherapy conditioned group was significantly less than the 32% incidence in the previously treated CY/TBI group (p = 0.005). However, long-term survival and relapse probabilities were not significantly better than seen previously with CY/TBI, although a trend towards improved survival was observed in the BU/CY group. Avoidance of TBI appeared to lower the incidence of fatal pneumonitis in patients with prior chest radiotherapy.

Duke Scholars

Published In

Bone Marrow Transplant

ISSN

0268-3369

Publication Date

September 1991

Volume

8

Issue

3

Start / End Page

211 / 215

Location

England

Related Subject Headings

  • Whole-Body Irradiation
  • Thorax
  • Risk Factors
  • Pulmonary Fibrosis
  • Premedication
  • Middle Aged
  • Male
  • Leukemia
  • Incidence
  • Immunology
 

Citation

APA
Chicago
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MLA
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Van der Jagt, R. H., Appelbaum, F. R., Petersen, F. B., Bigelow, C. L., Fisher, L. D., Schoch, G. H., … Sullivan, K. M. (1991). Busulfan and cyclophosphamide as a preparative regimen for bone marrow transplantation in patients with prior chest radiotherapy. Bone Marrow Transplant, 8(3), 211–215.
Van der Jagt, R. H., F. R. Appelbaum, F. B. Petersen, C. L. Bigelow, L. D. Fisher, G. H. Schoch, C. D. Buckner, J. E. Sanders, R. Storb, and K. M. Sullivan. “Busulfan and cyclophosphamide as a preparative regimen for bone marrow transplantation in patients with prior chest radiotherapy.Bone Marrow Transplant 8, no. 3 (September 1991): 211–15.
Van der Jagt RH, Appelbaum FR, Petersen FB, Bigelow CL, Fisher LD, Schoch GH, et al. Busulfan and cyclophosphamide as a preparative regimen for bone marrow transplantation in patients with prior chest radiotherapy. Bone Marrow Transplant. 1991 Sep;8(3):211–5.
Van der Jagt, R. H., et al. “Busulfan and cyclophosphamide as a preparative regimen for bone marrow transplantation in patients with prior chest radiotherapy.Bone Marrow Transplant, vol. 8, no. 3, Sept. 1991, pp. 211–15.
Van der Jagt RH, Appelbaum FR, Petersen FB, Bigelow CL, Fisher LD, Schoch GH, Buckner CD, Sanders JE, Storb R, Sullivan KM. Busulfan and cyclophosphamide as a preparative regimen for bone marrow transplantation in patients with prior chest radiotherapy. Bone Marrow Transplant. 1991 Sep;8(3):211–215.

Published In

Bone Marrow Transplant

ISSN

0268-3369

Publication Date

September 1991

Volume

8

Issue

3

Start / End Page

211 / 215

Location

England

Related Subject Headings

  • Whole-Body Irradiation
  • Thorax
  • Risk Factors
  • Pulmonary Fibrosis
  • Premedication
  • Middle Aged
  • Male
  • Leukemia
  • Incidence
  • Immunology