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REGIMEN-RELATED TOXICITY IN PATIENTSUNDERGOING BONE MARROW TRANSPLANTATION

Xu Lanping;Guo Nailan;Zheng Huan;et al (Institue of Hematology, Beijing Medical University,Beijing,100044)  
reparative regimen with high dose chemoradio-thera py before allogeneic bone marrow tran splantation(allo-BMT ) is toxic to marrow recipients。Our prepara-tive regimen consists of cyclophosphamide l.8g·m ̄(-2)/dfor 2 days,CCNU 200 mg·m ̄(-2)/d or me-CCNU250mg·m ̄(-2)/d for one day and total hixly irradiation(TBI)of 6.6~7.7 Gy, To evaluate regimen-related tox-icity,we carried Out a retrospective study concerning100 patients conditioned with this regimen. All patientsreceived graft versus host disease(GVHD) prophylaxis.Regimen-related toxicity was graded according to theseattle's transplantation toxicity system. Morbidity wasassessed in eight organs:heart,bladder,kidneys,lungs,liver,mucosa,centraI nervous system and gut.Toxicity was graded on days 0,7,14 and 28 after trans-plantation,from grade 0(no toxicity)to grade IV(fataltoxicity).Fifteen patients did not show any toxicity.Grades III-IV toxicity were uncommon(10%).The in-dividual organ toxicity was stomatitis(52%),gastroin-testinaI toxicity(36%),cardiac toxicity(25%),bladdertoxicity(20%),hepatic toxicity(19%),central ner-vous system(CNS)toxicity(9%)and pulmonary andrenal toxicity(0%).Bladder toxicity occlired more com-mon in patients who received cyclophosphamide and/orbulsulfan before BMT. Cardiac toxicity was frequent a-mong recipients who received DNR before BMT.Prostaglandin E_1 could reduce the incidence of bladdertoxicity.
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