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Eighteen patients with relapsed or refractory Hodgkin's disease (HD) have been treated with high-dose chemotherapy (BEAM regimen) followed by autologous peripheral stem cells and/or bone marrow rescue. There were no treatment-related deaths. Overall response rate was 82%. With a median follow-up of 10 months (3-24 months) overall survival and freedom from progression were 100 and 94% (95% confidence interval 58-97%), respectively. The use of peripheral stem cells in addition to bone marrow resulted in a significant shortening of the time to engraftment (p < 0.01). The BEAM regimen is an effective conditioning schedule which is well tolerated.

Twenty patients with resistant and relapsed Hodgkin's disease were included into this investigation. The treatment effectiveness and regimen-related toxicity of BEAM-protocol were evaluated. Stem cell transplantation (SCT) was carried out either as bone marrow transplantation (BMT) in 11 patients or peripheral blood stem cell transplantation (PBSCT) in 9 patients. A comparison of the results pointed to a significant decrease in neutropenia duration, fewer blood transfusions needed and shorter stay in hospital in the PBSCT group. Complete remission was observed in 90% of patients of the SCT group, 91%-in BMT and 89%-PBSCT groups. It was found that high-dose chemotherapy followed by SCT is more effective in the treatment of resistant and relapsed Hodgkin's disease and, in certain situations, it is a treatment of choice. As to the toxicity of BEAM-protocol, it does not exceed those of the other chemotherapy modalities used in SCT.

The authors propose their own system of assessment of high-dose polychemotherapy toxicity. The system was applied to toxic complications of high-dose polychemotherapy in 31 patients with hematological malignancies subjected to allogenic, autologous bone marrow transplantation and transplantation of stem cells from peripheral blood within the scope of different protocols of high-dose polychemotherapy in conditioning regimen. A special scale developed in the Belarus Center for Bone Marrow Transplantation basing on the above system provides prediction of survival in early post-transplantation period.

Investigators from Belarus Center for bone marrow transplantation examined the efficacy of preventing hemorrhagic cystitis induced by high-dose cyclophosphamide in preparation for hemopoiesis precursor transplantation in 22 patients with hematological diseases. The proposed preventive method implied administration of mesna (2-merkaptoetan-sulphonate) and alkaline forced diuresis. Its effectiveness was found high.

The first 10 bone marrow transplantations (BMT), 6 of the allogenic (allo-BMT) and 4 autologous (auto-BMT) were performed from February to June 1994 in Byelarus Center for Bone Marrow Transplantation. Two of the patients were experiencing the first complete remission of acute lymphoblastic leukemia (ALL), one of them - the first ALL recurrence, three patients with acute myeloblastic leukemia had the first complete remission, four patients had a chronic phase of chronic myeloid leukemia. In auto-BMT bone marrow (BM) was stored in liquid hydrogen after programmed freezer. An average yield of nucleated cells (NC) after taking and separation of allo-BM made up 3.0 x 10(8) cell/kg and 2.7 x 10(8) cell/kg in auto-BMT. After thawing of BM NC yield reached 1.5 x 10(8) cell/kg (0.8-2.3) x 10(8) cell/kg. CFU concentrations persisted at 24.7 x 10(4) (5.0-40.4) x 10(4) cell/kg body weight. The mean duration of leukocyte, neutrophil and platelet rise to the levels of over 1.0 x 10(9)/l, 0.5 x 10(9)/l, 20 x 10(9) cell/l, respectively, and the last time red cells were transfused were 23 (19-33), 23 (19-31), 22 (9-51), 4.5 (0-19), respectively. One ALL (first complete remission) patient died on day 52 after allo BMT of severe hepatic venous-occlusive disease. The other ALL patient (the first relapse) developed another relapse on day 112 after BMT. The rest 8 patients are in satisfactory condition.