PRELIMINARY-RESULTS OF HIGH-DOSE BUSULFAN AND CYCLOPHOSPHAMIDE WITH SYNGENEIC OR AUTOLOGOUS BONE-MARROW RESCUE

  • 1 January 1984
    • journal article
    • research article
    • Vol. 68  (5) , 711-717
Abstract
The toxic effects of high-dose busulfan (16 mg/kg) and cyclophosphamide (200 mg/kg) with autologous or syngeneic bone marrow rescue were evaluated in 19 patients (11 with acute myelocytic leukemia, 1 with acute lymphocytic leukemia, 1 with acute myelofibrosis, 2 with chronic myelocytic leukemia, 1 with Hodgkin''s disease, and 3 with non-Hodgkin''s lymphoma). Their mean age was 26 yr (range, 6-50); 9 patients had syngeneic and 10 had autologous bone marrow rescue (6 of whom had in vitro bone marrow incubation with 4-hydroxyperoxycyclophosphamide). Severe myelosuppression was expected and was seen in all patients; leukocyte and platelet count recovery occurred at a median of 19 days (range, 11-59) and 30 days (range, 20-89), respectively. Nausea, vomiting and diarrhea were frequent but readily managed with vigorous medical therapy. Stomatitis was severe in 14 patients. Skin, renal, cardiac, pulmonary and CNS complications directly attributable to drug-related toxic effects were transient and non-life-threatening. Hepatic function abnormalities were common but tended to be transient. Most patients tolerated high-dose busulfan and cyclophosphamide with manageable side effects. Hepatic venoocclusive disease was fatal in 2 patients, while diffuse interstitial pneumonitis with disseminated herpes virus infection was fatal in 3 patients with lymphoma. All patients treated in relapse or without previous therapy had a complete tumor response.