Etoposide, cyclophosphamide, total-body irradiation, and allogeneic bone marrow transplantation for hematologic malignancies.

Abstract

The combination of cyclophosphamide, etoposide, and TBI is a relatively safe and effective preparative regimen for patients with early hematologic malignancies. Controlled trials are needed to evaluate critically this combination versus other standard preparative regimens. Greater toxicity was observed in patients with advanced disease, and this program does not appear to offer any advantage over other regimens.

Cyclosporine in combination with mycophenolate mofetil versus methotrexate for graft versus host disease prevention in myeloablative HLA‐identical sibling donor allogeneic hematopoietic cell transplantation

“…The reduced dose schema of 5 mg/m 2 days 1, 3, 6, and 11 was originally developed at the M.D. Anderson Cancer Center [33] specifically to decrease the risk of mucosal and hepatic complications, and has been widely used and shown to be effective in combination with CSA or tacrolimus as GVHD prophylaxis with historically similar outcomes as standard doses [33][34][35][36]. Reduced doses of MTX, however, have not been directly compared to standard doses of MTX.…”

Pulmonary function following total body irradiation (with or without lung shielding) and allogeneic peripheral blood stem cell transplant

“…[1][2][3][4][5][6][7][8][9] Although regimens employing chemotherapy alone may be effective, evidence suggests that TBI improves post transplant survival compared to the use of chemotherapy alone. [10][11][12] The addition of TBI has several advantages including the absence of cross-resistance of host marrow cells to different chemotherapeutic agents and the ability to sterilize disease in 'sanctuary' sites which are not easily penetrated by chemotherapeutic agents.…”

Long-term follow-up of a prospective randomized trial comparing CYA and MTX with CYA and mycophenolate mofetil for GVHD prophylaxis in myeloablative sibling donor hematopoietic cell transplantation

“…While most institutions use MTX at 15 mg/m 2 on day þ 1, followed by 10 mg/ m 2 on days þ 3, þ 6 and þ 11, this study used a 'mini' dose of MTX consisting of 5 mg/m 2 on days þ 1, þ 3, þ 6 and þ 11. This reduced dose was originally developed to decrease the risk of mucosal and hepatic complications, 3 and has been shown to be effective as GVHD prophylaxis with historically similar outcomes as standard doses. [4][5][6] The reduced dose of MTX, however, has never been directly compared with the standard dose of MTX, and in our study, mucositis was unfortunately still more common and severe with the 'mini' MTX than with MMF.…”