title: Safe application of a 13-Gy split dose total body irradiation schedule prior to bone marrow transplantation.
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.
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000401:mortality / Q000601:surgery; D011292:Premedication / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012008:Recurrence; D014182:Transplantation, Autologous / Q000401:mortality; D014184:Transplantation, Homologous / Q000401:mortality; D014916:Whole-Body Irradiation / Q000009:adverse effects / Q000379:methods / Q000401:mortality