Toxicity of busulfan and cyclophosphamide (BU/CY2) in patients with hematologic malignancies.
Between July 1991 and January 1994, 52 patients with hematologic malignancies underwent BMT using BU/CY2 as conditioning regimen. Median patient age was 38 years. Eleven patients underwent autologous BMT, 22 HLA-identical allogeneic BMT, and 19 patients underwent a MUD or an allogeneic mismatched BMT. GVHD prophylaxis was with cyclosporine/methylprednisone in 26 patients; T cell depletion was used in 15 patients. VOD was observed in 7.5% of patients, IP in 12%, seizures in 4%. The overall incidence of grade II-IV acute GVHD was 35%. Delayed platelet engraftment was observed in seven of 11 patients who underwent autologous BMT. Graft failure was seen in seven of 19 (37%) patients who underwent MUD or allogeneic mismatched BMT. Six of the seven patients received T cell depletion as GVHD prophylaxis. BU/CY2 transplantation from an unrelated or family-mismatched donor with T cell depletion is associated with a high incidence of graft failure.
deMagalhaes-Silverman
M
M
Division of Hematology/Bone Marrow Transplantation, University of Pittsburgh Medical Center, PA 15213-2582, USA.
Bloom
E J
EJ
Donnenberg
A
A
Lister
J
J
Pincus
S
S
Rybka
W B
WB
Ball
E D
ED
D000293:Adolescent; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D016026:Bone Marrow Transplantation; D002066:Busulfan / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology; D006801:Humans; D007938:Leukemia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D011014:Pneumonia / Q000209:etiology; D012307:Risk Factors; D014652:Vascular Diseases / Q000139:chemically induced
D018906:Antineoplastic Agents, Alkylating; D003520:Cyclophosphamide; D002066:Busulfan