High-dose BCNU therapy with autologous bone marrow infusion: preliminary observations

Nine patients with solid malignancies and extensive prior treatment received high-dose BCNU therapy (600--750 mg/m2) with autologous bone marrow support; following this treatment hematopoietic recovery was studied. The only significant nonhematopoietic toxicity was a probable case of BCNU-induced pulmonary toxicity in a patient who had received massive amounts of prior chemotherapy and chest irradiation. The marrow aspirations prior to cryopreservations had revealed a hypoplastic marrow in four of nine patients. Despite using marrow exposed to prior chemotherapy, neutropenia beyond Day 40 after BCNU therapy was not observed in any patient. One patient did not develop neutropenia of less than 1.5 X 10(9) cells/liter and five patients did not develop neutropenia of less than 0.5 X 10(9) cells/liter. A partial response was observed in one patient and less than partial responses were observed in two other patients. Autologous bone marrow infusion may modify the neutropenia of high-dose BCNU therapy.