title: High-dose carmustine and autologous bone marrow reinfusion in the treatment of refractory or relapsed small cell lung carcinoma.
abstract: Fourteen patients with small cell carcinoma of the lung in relapse or with disease refractory to chemotherapy were treated with carmustine (BCNU) at doses of 600 to 1000 mg/m2 intravenously followed by autologous bone marrow transplantation. All patients previously were treated with cyclophosphamide, doxorubicin, vincristine, and etoposide. Seven of the 14 patients responded to the high-dose BCNU (50% response with 95% confidence limits ranging from 23% to 77%). Three patients had a complete response, and four had a partial response. Regrowth of tumor occurred within 60 days of treatment in the responding patients. Death occurred in six patients before the recovery of the platelet count to 50,000 cells/microliters. Although the response rate was high, the toxicity was excessive. In the dosage range of 600 to 1000 mg/m2 in heavily pretreated patients, BCNU is not recommended, but additional investigation may be warranted in patients with central nervous system metastases who previously were treated with radiation therapy.
authors.affiliation: Department of Oncology, Marshfield Clinic, WI 54449.
authors.forename: D A
authors.initials: DA
authors.lastname: Rushing
authors.forename: W R
authors.initials: WR
authors.lastname: Friedenberg
authors.forename: M C
authors.initials: MC
authors.lastname: Baldauf
authors.forename: S
authors.initials: S
authors.lastname: Broste
authors.forename: J A
authors.initials: JA
authors.lastname: Gehlsen
authors.forename: D H
authors.initials: DH
authors.lastname: Kriesel
authors.forename: D P
authors.initials: DP
authors.lastname: Koontz
authors.forename: K A
authors.initials: KA
authors.lastname: Rodvold
mesh_terms: D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation; D018288:Carcinoma, Small Cell / Q000097:blood / Q000628:therapy*; D002330:Carmustine / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D008175:Lung Neoplasms / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count / Q000187:drug effects; D012074:Remission Induction; D014182:Transplantation, Autologous
chemical_list: D002330:Carmustine