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Title: Modified total body irradiation as a planned second high-dose therapy with stem cell infusion for patients with bone-based malignancies

Abstract

Purpose: To estimate the maximum tolerated dose of hyperfractionated total marrow irradiation (TMI) as a second consolidation after high-dose chemotherapy with autologous or syngeneic blood stem cell transfusion for patients with bone/bone marrow-based malignant disease. Patients and Methods: Fifty-seven patients aged 3-65 years (median, 45 years), including 21 with multiple myeloma, 24 with breast cancer, 10 with sarcoma, and 2 with lymphoma, were treated with 1.5 Gy administered twice daily to a total dose of 12 Gy (n = 27), 13.5 Gy (n = 12), and 15 Gy (n = 18). Median time between the 2 transplants was 105 days (range, 63-162 days). Results: All patients engrafted neutrophils (median, Day 11; range, Day 9-23) and became platelet independent (median, Day 9; range, Day 7-36). There were 5 cases of Grade 3-4 regimen-related pulmonary toxicity, 1 at 12 Gy, and 4 at 15 Gy. Complete responses, partial responses, and stabilizations were achieved in 33%, 26%, and 41% of patients, respectively. Kaplan-Meier estimates of 5-year progression-free survival and overall survival for 56 evaluable patients are 24% and 36%, respectively. Median time of follow-up among survivors was 96 months (range, 77-136 months). Conclusion: Total marrow irradiation as a second myeloablative therapy is feasible.more » The estimated maximum tolerated dose for TMI in a tandem transplant setting was 13.5 Gy. Because 20% of patients are surviving at 8 years free of disease, further studies of TMI are warranted.« less

Authors:
 [1];  [1];  [2];  [1];  [1];  [1];  [1];  [1];  [3]
  1. Fred Hutchinson Cancer Research Center, University of Washington, Clinical Research Division, Seattle, WA (United States)
  2. The Swedish Hospital Medical Center, Cancer Institute, Seattle, WA (United States)
  3. Fred Hutchinson Cancer Research Center, University of Washington, Clinical Research Division, Seattle, WA (United States). E-mail: wbensing@fhcrc.org
Publication Date:
OSTI Identifier:
20788289
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2005.06.005; PII: S0360-3016(05)01010-2; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BONE MARROW; CHEMOTHERAPY; INFUSION; LYMPHOMAS; MAMMARY GLANDS; NEUTROPHILS; PATIENTS; RADIATION DOSES; SARCOMAS; SKELETON; STEM CELLS; TOXICITY; TRANSFUSIONS; TRANSPLANTS; WHOLE-BODY IRRADIATION

Citation Formats

Zaucha, Renata E., Buckner, Dean C., Barnett, Todd, Holmberg, Leona A., Gooley, Ted, Hooper, Heather A. P.A.-C., Maloney, David G., Appelbaum, Frederick, and Bensinger, William I. Modified total body irradiation as a planned second high-dose therapy with stem cell infusion for patients with bone-based malignancies. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Zaucha, Renata E., Buckner, Dean C., Barnett, Todd, Holmberg, Leona A., Gooley, Ted, Hooper, Heather A. P.A.-C., Maloney, David G., Appelbaum, Frederick, & Bensinger, William I. Modified total body irradiation as a planned second high-dose therapy with stem cell infusion for patients with bone-based malignancies. United States. doi:10.1016/J.IJROBP.2005.0.
Zaucha, Renata E., Buckner, Dean C., Barnett, Todd, Holmberg, Leona A., Gooley, Ted, Hooper, Heather A. P.A.-C., Maloney, David G., Appelbaum, Frederick, and Bensinger, William I. Sun . "Modified total body irradiation as a planned second high-dose therapy with stem cell infusion for patients with bone-based malignancies". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20788289,
title = {Modified total body irradiation as a planned second high-dose therapy with stem cell infusion for patients with bone-based malignancies},
author = {Zaucha, Renata E. and Buckner, Dean C. and Barnett, Todd and Holmberg, Leona A. and Gooley, Ted and Hooper, Heather A. P.A.-C. and Maloney, David G. and Appelbaum, Frederick and Bensinger, William I.},
abstractNote = {Purpose: To estimate the maximum tolerated dose of hyperfractionated total marrow irradiation (TMI) as a second consolidation after high-dose chemotherapy with autologous or syngeneic blood stem cell transfusion for patients with bone/bone marrow-based malignant disease. Patients and Methods: Fifty-seven patients aged 3-65 years (median, 45 years), including 21 with multiple myeloma, 24 with breast cancer, 10 with sarcoma, and 2 with lymphoma, were treated with 1.5 Gy administered twice daily to a total dose of 12 Gy (n = 27), 13.5 Gy (n = 12), and 15 Gy (n = 18). Median time between the 2 transplants was 105 days (range, 63-162 days). Results: All patients engrafted neutrophils (median, Day 11; range, Day 9-23) and became platelet independent (median, Day 9; range, Day 7-36). There were 5 cases of Grade 3-4 regimen-related pulmonary toxicity, 1 at 12 Gy, and 4 at 15 Gy. Complete responses, partial responses, and stabilizations were achieved in 33%, 26%, and 41% of patients, respectively. Kaplan-Meier estimates of 5-year progression-free survival and overall survival for 56 evaluable patients are 24% and 36%, respectively. Median time of follow-up among survivors was 96 months (range, 77-136 months). Conclusion: Total marrow irradiation as a second myeloablative therapy is feasible. The estimated maximum tolerated dose for TMI in a tandem transplant setting was 13.5 Gy. Because 20% of patients are surviving at 8 years free of disease, further studies of TMI are warranted.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 64,
place = {United States},
year = {Sun Jan 01 00:00:00 EST 2006},
month = {Sun Jan 01 00:00:00 EST 2006}
}