Autologous bone marrow transplantation after supralethal dose of total body irradiation in a case of mycosis fungoides
Chen, Y.C.; Wang, C.H.; Huang, S.C.; Lee, E.F.; Lin, D.T.; Shen, M.C.; Liu, M.C.; Tien, H.F.; Lin, K.S.
Journal of the Formosan Medical Association 85(3): 304-314
1986
ISSN/ISBN: 0371-7682 PMID: 3528386 Document Number: 278930
A case of atypical, rapidly progressing, OKT-negative, stage IVB or V (NCI classification) mycosis fungoides was treated with supralethal dose (900 rads within 12 hours) of total body irradiation (TBI) and autologous bone marrow transplantation (ABMT) with nonfrozen marrow. The diagnosis of mycosis fungoides was made from histopathological features, electron-microscopic findings of typical convoluted nuclei and positive acid-phosphatase (polar pattern) as well as alpha-naphthyl acetate esterase stains. The patient tolerated the procedures well except for a transient cardiac arrhythmia manifested with sinoatrial and atrioventricular conduction disturbances, which was possibly related to TBI. The cardiac arrhythmia was easily converted to normal sinus rhythm by the administration of methylprednisolone. Complete remission was achieved in 5 days after TBI. However, the remission period was very short (6 weeks). The neoplasm was later demonstrated to be very refractory to both conventional chemotherapy, ultraviolet light phototherapy and retinoic acid therapy. The patient died of respiratory failure on day + 111 of post-BMT. The potential use of TBI and marrow rescue in the treatment of mycosis fungoides or other types of lymphoma is discussed.