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High dose chemotherapy with autologous bone marrow transfusion
Experimental Hematology
|January 1, 1979
Summary
High-dose chemotherapy with autologous bone marrow transplant (ABMT) shows an 80% response rate but causes significant hematopoietic toxicity. Recovery is typically within 4-5 weeks, suggesting potential for selected tumor treatments.
Area of Science:
- Oncology
- Hematology
- Pharmacology
Background:
- High-dose chemotherapy followed by autologous bone marrow infusion (ABMT) is an intensive treatment strategy.
- Understanding treatment response and toxicity is crucial for optimizing ABMT protocols.
- Previous treatments can influence patient outcomes with high-dose chemotherapy and ABMT.
Purpose of the Study:
- To detail the response and toxicity of high-dose chemotherapy regimens preceding ABMT.
- To evaluate the efficacy and safety of specific chemotherapy agents like BCNU, cytoxan, and VP-16-23 in the context of ABMT.
- To present future strategies for utilizing high-dose chemotherapy with ABMT in selected cancers.
Main Methods:
- Patients received high-dose nitrosourea (BCNU) or combination chemotherapy (cytoxan, VP-16-23, +/- BCNU) followed by ABMT.
- Hematopoietic toxicity and recovery timelines were monitored.
- Response rates (CR, PR, less than PR) were assessed in evaluable patients, many with prior treatment history.
- Initial data on high-dose mitomycin and ABMT toxicity was also collected.
Main Results:
- High-dose BCNU (600-1000 mg/m2) primarily caused hematopoietic toxicity, with recovery in 4-5 weeks.
- Combination chemotherapy (cytoxan, VP-16-23, +/- BCNU) achieved an approximate 80% response rate in 18 evaluable patients (17 previously treated), though responses were often short-lived.
- Hematopoietic recovery was generally complete within 4 weeks post-chemotherapy.
- Initial experience with high-dose mitomycin and ABMT also indicated hematopoietic toxicity.
Conclusions:
- High-dose chemotherapy regimens, including BCNU and combination therapy, demonstrate significant response rates in patients undergoing ABMT, even those previously treated.
- Hematopoietic toxicity is a primary concern but appears manageable with recovery timelines within weeks.
- The findings support the rationale for exploring high-dose chemotherapy with ABMT in selected tumor types, warranting further investigation and strategic planning.