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Efficacy of etoposide, cyclophosphamide, and total body irradiation in allogeneic bone marrow transplantation for adult patients with hematological malignancies.
- Source :
-
Clinical transplantation [Clin Transplant] 2004 Oct; Vol. 18 (5), pp. 552-7. - Publication Year :
- 2004
-
Abstract
- Introduction: A combination of fractionated total body irradiation (TBI) with etoposide (VP-16) and cyclophosphamide (CY) as a preconditioning regimen (VP/CY/TBI) has been reported to be safe and effective for both adults and children undergoing allogeneic bone marrow transplantation (allo-BMT). However, the reported doses of VP-16 were different. We evaluated the efficacy and safety of a VP-16 (at less than the usual dose)/CY/TBI regimen for adults with hematological malignancies who are required to receive allo-BMT.<br />Patients and Methods: Thirty-eight patients received VP-16, CY and TBI (VP/CY/TBI) as a preconditioning regimen for allo-BMT. Twenty-one patients were in first complete remission (1CR), six patients were in second remission (2CR) and 11 patients were in non-remission status (non-CR) before allo-BMT. These patients received allo-BMT from related donors (n=14) and unrelated donors (n=24). The preconditioning regimen consisted of VP-16 (15 mg/kg/d for 2 d), CY (60 mg/kg/d for 2 d) and 12 Gy TBI in six fractions for 3 d.<br />Results: Two patients died on day 30 after transplantation. The median follow-up period for all patients was 35.0 months (range 0.8-159.6 months). At the time of analysis, 10 patients had died. Seven of those 10 patients died because of relapse. The estimated 5-yr disease-free survival (DFS) rates for all cases and acute myelogenous leukemia and acute lymphoblastic leukemia cases were 73.6, 66.7 and 100%, respectively. The estimated 5-yr DFS rates for 1CR, 2CR and non-CR cases were 90.5, 83.3 and 40.9%, respectively (p < 0.05).<br />Conclusion: Based on these findings, we suggest that a VP/CY/TBI regimen is effective and safe for adult patients with hematological malignancies in 1CR and 2CR.
- Subjects :
- Adolescent
Adult
Antineoplastic Agents, Phytogenic administration & dosage
Cause of Death
Disease-Free Survival
Etoposide administration & dosage
Female
Follow-Up Studies
Graft Survival
Graft vs Host Disease prevention & control
Humans
Male
Middle Aged
Remission Induction
Retrospective Studies
Safety
Survival Rate
Treatment Outcome
Antineoplastic Agents, Phytogenic therapeutic use
Bone Marrow Transplantation
Cyclophosphamide therapeutic use
Etoposide therapeutic use
Hematologic Neoplasms therapy
Immunosuppressive Agents therapeutic use
Transplantation Conditioning
Whole-Body Irradiation
Subjects
Details
- Language :
- English
- ISSN :
- 0902-0063
- Volume :
- 18
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 15344959
- Full Text :
- https://doi.org/10.1111/j.1399-0012.2004.00225.x