Hyperfractionated total body irradiation for bone marrow transplantation. Results in seventy leukemia patients with allogeneic transplants

Journal Article · Tue Nov 01 04:00:00 EST 1983 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(83)90412-1· OSTI ID:5245266

Shank, B; Chu, F C.H.; Dinsmore, R; Kapoor, N; Kirkpatrick, D; Teitelbaum, H; Reid, A; Bonfiglio, P; Simpson, L; O'Reilly, R J

From May, 1979 to March, 1981, 76 leukemia patients were prepared for bone marrow transplantation (BMT) with a new hyperfractionated total body irradiation (TBI) regimen (1320 cGy in 11 fractions, 3x/day), followed by cyclophosphamide, 60 mg/kg, for two days. Partial lung shielding was done on each treatment, with supplemental electron beam treatments of the chest wall to compensate, and of the testes, a sanctuary site. This regimen was initiated to potentially reduce fatal interstitial pneumonitis as well as decrease leukemic relapse. Overall actuarial survival at 1 year for acute non-lymphocytic leukemia (ANLL) patients is 63%, while relapse-free survival at 1 year is 53%. On the other hand, for acute lymphocytic leukemia (ALL) patients, there is no significant difference between relapse or remission patients with regard to overall survival or relapse-free survival, when relapse is defined as > 5% blasts in the marrow at the time of cytoreduction. Overall actuarial survival at 1 year for ALL is 61% and relapse-free survival is 45% at 1 year. Fatal interstitial pneumonitis has dropped to 18% compared with 50% in our previous single-dose TBI regimen (1000 cGy), in which the same doses of cyclophosphamide were given prior to TBI. In conclusion, not only has fatal interstitial pneumonitis been reduced by hyperfractionation and partial lung blocking, but there may be a survival advantage in ALL patients in relapse, who have a survival equal to that of remission patients. This may indicate a greater cell kill with the higher dose (1320 cGy) attained with this regimen, in these patients with a higher leukemic cell burden.

• Research Organization: Memorial Sloan-Kettering Cancer Center, New York, NY
• OSTI ID: 5245266
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 9:11; ISSN IOBPD
• Country of Publication: United States
• Language: English

Related Subjects

550603 -- Medicine-- External Radiation in Therapy-- (1980-)
560151* -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ALKYLATING AGENTS
ANIMAL TISSUES
BEAMS
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BONE MARROW
DELAYED RADIATION EFFECTS
DISEASES
DRUGS
ELECTRON BEAMS
ENDOXAN
EXTERNAL IRRADIATION
FRACTIONATED IRRADIATION
HEMATOPOIETIC SYSTEM
HEMIC DISEASES
IMMUNOSUPPRESSIVE DRUGS
IRRADIATION
LEPTON BEAMS
LEUKEMIA
LUNGS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PARTICLE BEAMS
PATIENTS
PNEUMONITIS
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SIDE EFFECTS
THERAPY
TISSUES
TRANSPLANTS
WHOLE-BODY IRRADIATION