Pulmonary complications of bone marrow transplantation: a comparison of total body irradiation and cyclophosphamide to busulfan and cyclophosphamide

International Journal of Radiation Oncology, Biology, Physics
W F HartsellH Kaizer

Abstract

To retrospectively compare the acute and long-term pulmonary toxicities of total body irradiation and busulfan in bone marrow transplantation. From March 1984 through February 1991, 144 patients received high-dose therapy with cyclophosphamide plus either total body irradiation (TBI-CY) or busulfan (BU-CY) followed by bone marrow rescue. Treatment protocols were based on disease type. Cyclophosphamide dose was 120-200 mg/kg, given in 2-4 days. Total body irradiation was given as 12 Gy in four fractions over 4 days, or 14.4 Gy in eight fractions over 4 days. Busulfan dose was 16 mg/kg given over 4 days. Seventy-nine patients were treated with TBI-CY and 65 patients with BU-CY. More patients in the TBI group had allogeneic transplants (40 vs. 18). Pulmonary events occurred in 48 patients, 19 in BU-CY and 29 in TBI-CY. Of the 58 patients with allogeneic transplants, 21 (36%) developed chronic graft-vs.-host disease (GVHD), and 10 of those patients developed pulmonary complications (including 2 with obliterative bronchitis and 1 with asthma). Interstitial pneumonitis (IP) occurred in 14 patients, 12 in the TBI-CY group and 2 in the BU-CY group. Cytomegalovirus and pneumocystis infections were associated with IP in 11 of those patie...Continue Reading

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Citations

Oct 4, 2005·International Journal of Radiation Oncology, Biology, Physics·Sagus SampathJeffrey Wong
Feb 13, 2001·International Journal of Radiation Oncology, Biology, Physics·O ThomasJ Cuillière
Aug 1, 1996·International Journal of Radiation Oncology, Biology, Physics·E M GoreR J Lipchik
Apr 9, 2004·American Journal of Respiratory and Critical Care Medicine·Robert M KotloffStephen W Crawford
May 17, 2005·American Journal of Respiratory and Critical Care Medicine·Tanyalak ParimonJason W Chien
Apr 28, 2004·The Tohoku Journal of Experimental Medicine·Murat BeyzadeogluYucel Pak
May 13, 2005·The British Journal of Dermatology·A TostiC Misciali
Apr 2, 2011·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Betty T TranJason W Chien
Sep 10, 2011·Journal of Radiation Research·Hiromi IzawaKeisuke Sasai
Jun 17, 2006·Journal of Korean Medical Science·Do Hyoung LimKeunchil Park
May 21, 1998·Antimicrobial Agents and Chemotherapy·J A Fishman

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