Safe application of a 13-Gy split dose total body irradiation schedule prior to bone marrow transplantation |
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| Authors: | H P Davis P Revell P Giangrande P Flanagan C H Poynton F Bampton R Phillips A J Barrett |
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| Affiliation: | Department of Haematology, Charing Cross and Westminster Medical School, London, UK. |
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| Abstract: | Two conditioning regimens for bone marrow transplantation for patients with acute lymphoblastic leukaemia were compared. Both regimens (VVRAPID and VVRAPID-X) incorporated the same cytotoxic chemotherapy but differed in the radiation dose; VVRAPID employed a single fraction of 10.5 Gy and VVRAPID-X employed 10.5 Gy followed 4 days later by a further dose of 2.5 Gy. The 13-Gy split-fraction schedule was well tolerated with no significant increase in infection or requirement for blood products. An increase in gastrointestinal toxicity occurred but responded to increased oral anti-diarrhoeal agents. Overall survival and relapse rates did not differ significantly between the two groups. There was a trend for the 13-Gy schedule to reduce the graft failure rate following T cell-depleted bone marrow transplants. |
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