[Bone marrow transplantation for girls with aplastic anemia utilizing modified field of total lymphoid irradiation and cyclophosphamide: with emphasis on the field of pelvic cavity].
A preparative regimen for allogeneic bone marrow transplantation, consisting of total lymphoid irradiation (TLI) with 750 cGy and cyclophosphamide (CY), was used in five girls with aplastic anemia. All patients received bone marrow from HLA matched/mixed lymphocyte culture negative siblings. In our regimen the "inverted Y" field to irradiate the pelvic nodes was modified, which did not include the whole pelvic cavity in an attempt to protect the ovaries from irradiation. Although some of the pelvic nodes was supported not to be irradiated in order to protect the ovaries, engraftment occurred in all five patients including four who had been transfused prior to transplantation. All five are alive from 47 days to 1378 days (median 285 days) after transplantation without transplantation-associated complications. The calculated dose to the ovaries was sixteen percent of the entire dose of the regimen. Both of the two evaluable patients that had received transplantation just before or during the puberty are developing normal sex maturity including menstruation. This study suggests that our preparative regimen is effective not only for engraftment of the donor marrow but also for protecting the ovaries from irradiation.
Hanada
R
R
Department of Hematology/Oncology, Saitama Children's Medical Center.
Kawakami
T
T
Akuta
N
N
Moriwaki
K
K
Kato
S
S
Inaba
T
T
Hayashi
Y
Y
Yamamoto
K
K
D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage; D000741:Anemia, Aplastic / Q000532:radiotherapy / Q000601:surgery*; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015182:Lymphatic Irradiation / Q000379:methods*; D010388:Pelvis / Q000528:radiation effects; D011112:Polymyxin B / Q000008:administration & dosage; D011379:Prognosis; D014640:Vancomycin / Q000008:administration & dosage
D014640:Vancomycin; D000666:Amphotericin B; D003520:Cyclophosphamide; D011112:Polymyxin B