Safe application of a 13-Gy split dose total body irradiation schedule prior to bone marrow transplantation
Davis, H.P.; Revell, P.; Giangrande, P.; Flanagan, P.; Poynton, C.H.; Bampton, F.; Phillips, R.; Barrett, A.J.
Bone Marrow Transplantation 3(4): 349-356
1988
ISSN/ISBN: 0268-3369 PMID: 3048497 Document Number: 320495
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.