Total-Body Irradiation with a High-Dose-Rate Linear Accelerator for Bone-Marrow Transplantation in Aplastic Anemia and Neoplastic Disease

Radiology ◽  
1977 ◽  
Vol 122 (2) ◽  
pp. 523-526 ◽  
Author(s):  
Tae H. Kim ◽  
John Kersey ◽  
Wilfred Sewchand ◽  
Mark E. Nesbit ◽  
William Krivit ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Aplastic Anemia ◽  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Linear Accelerator ◽  
High Dose Rate ◽  
High Dose ◽  
Neoplastic Disease ◽  
Total Body

Normal Neurodevelopment in Four Young Children Treated With Bone Marrow Transplantation for Acute Leukemia or Aplastic Anemia

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 753-757
Author(s):  
Thomas A. Kaleita ◽  
W. Donald Shields ◽  
Alan Tesler ◽  
Stephen A. Feig
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Young Children ◽  
Acute Leukemia ◽  
Aplastic Anemia ◽  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Motor Coordination ◽  
High Dose ◽  
Total Body

Longitudinal neurodevelopmental studies of four consecutive young children treated by bone marrow transplantation for acute leukemia or aplastic anemia are presented. The children, the only four children less than 2 years of age who have received bone marrow transplants for these diseases at UCLA Medical Center, ranged in age from 36 weeks to 24 months at the time of transplantation. Conditioning involved high-dose cyclophosphamide treatment; three also had total body irradiation prior to bone marrow transplantation. Their respective outcomes after follow-up times of 28 months to 71 months posttransplantation are remarkable for normal somatic growth and normal development of intelligence, language, perception, and motor coordination. These findings indicate that future therapeutic studies of infants and young children with acute leukemia or aplastic anemia using total body irradiation, cyclophosphamide, and bone marrow transplantation are not contraindicated by risks of debilitating neurodevelopmental sequelae.

scholarly journals Total body irradiation and high-dose etoposide: a new preparatory regimen for bone marrow transplantation in patients with advanced hematologic malignancies [published erratum appears in Blood 1987 Jun;69(6):1789]

Blood ◽  
1987 ◽  
Vol 69 (4) ◽  
pp. 1015-1020 ◽  
Author(s):  
KG Blume ◽  
SJ Forman ◽  
MR O'Donnell ◽  
JH Doroshow ◽  
RA Krance ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Acute Leukemia ◽  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Disease Free Survival ◽  
Hematologic Malignancies ◽  
High Dose ◽  
Pharmacokinetic Studies ◽  
Total Body

In a phase I/II study, 47 patients (median age, 24 years) with hematologic malignancies (33 patients with acute leukemia not in first remission and 14 patients with other advanced malignant hematologic disorders) were treated with total body irradiation and high doses of etoposide (VP16–213) followed by bone marrow transplantation. At the time of analysis, 21 patients were alive, and 19 of them were in continued complete remission for 101 days to greater than 40 months (median, 12 months). The actuarial disease-free survival rate of the 33 acute leukemia patients is 43% (2 SEM, 18%) and the actuarial relapse rate is 32% (2 SEM, 20%). Five of the 14 patients with the other hematologic malignancies are alive, and four of them continue to be free of disease for 8 to 27 months. Pharmacokinetic studies established a strong correlation between the administered drug doses and their plasma levels and also demonstrated complete drug clearance prior to marrow grafting. An etoposide dose of 60 mg/kg body weight was found to be the maximum tolerated dose. This new preparatory regimen was well tolerated and was not associated with specific acute or long-term regimen-related toxicities. Our data suggest that total body irradiation with high-dose etoposide presents a viable alternative to other preparatory regimens. The role of this novel combination remains to be defined by future prospective randomized trials.

scholarly journals Fractionated total-body irradiation and high-dose etoposide as a preparatory regimen for bone marrow transplantation for 94 patients with chronic myelogenous leukemia in chronic phase

Blood ◽  
1994 ◽  
Vol 84 (5) ◽  
pp. 1672-1679
Author(s):  
DS Snyder ◽  
RS Negrin ◽  
MR O'Donnell ◽  
NJ Chao ◽  
MD Amylon ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Chronic Myelogenous Leukemia ◽  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Chronic Phase ◽  
Myelogenous Leukemia ◽  
High Dose ◽  
Allogeneic Bone ◽  
Total Body

Ninety-four consecutive patients with chronic myelogenous leukemia in first clinical chronic phase, median age of 34.0 years (range, 6.8 to 52.4 years), with a histocompatible sibling donor, were treated with fractionated total body irradiation (1,320 cGy) and high-dose etoposide (60 mg/kg) followed by allogeneic bone marrow transplantation (BMT). The median time from diagnosis to BMT was 7.0 months (range, 2.3 to 72.0 months). Sixty patients were treated before BMT with hydroxyurea alone, four patients with busulfan alone, one patient with interferon alone, and the other 29 patients were treated with various combinations of these drugs. Cumulative probabilities of overall survival, event- free survival, and relapse at 5 years were 73%, 64%, and 14%, respectively. The median follow-up time for surviving patients was 38 months, ranging from 12 to 88 months. By stepwise Cox regression analysis, significant prognostic variables were age at transplant, acute graft-versus-host disease > or = grade II, cytomegalovirus- associated interstitial pneumonitis, and years from diagnosis to BMT.

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