Etoposide with/without G-CSF with busulfan and cyclophosphamide as conditioning for bone marrow transplantation. The BMT Team

Am J Hematol. 1996 Apr;51(4):265-8. doi: 10.1002/(SICI)1096-8652(199604)51:4<265::AID-AJH3>3.0.CO;2-U.

Abstract

To increase the efficacy of bone marrow transplantation (BMT), we have tried to add etoposide (VP-16) to busulfan/cyclophosphamide (BU/CY). Twelve patients received 16 mg/kg of BU and 120 mg/kg of CY with 15-30 mg/kg of VP-16. Another two patients received 5 micrograms/kg of G-CSF with 30 mg/kg of VP-16. Patients tolerated escalating doses of VP-16 without any significant hepatotoxicity. Their maximal level of bilirubin was 37.6 micromol/L (2.2 mg/dl), and there was no significant skin toxicity or mucositis. By contrast, two patients who received G-CSF with 30 mg/kg of VP-16 developed hyperbilirubinemia and veno-occlusive disease, which terminated this phase I study. VP-16 can be safely combined with BU/CY < or = 30 mg/kg in three divided doses, and its effect on survival should be evaluated. G-CSF added to this regimen, however, should be used with great caution.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase I
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow / drug effects
  • Bone Marrow Transplantation*
  • Busulfan* / administration & dosage
  • Busulfan* / adverse effects
  • Busulfan* / pharmacology
  • Cyclophosphamide* / administration & dosage
  • Cyclophosphamide* / adverse effects
  • Cyclophosphamide* / pharmacology
  • Drug Administration Schedule
  • Drug Synergism
  • Etoposide* / administration & dosage
  • Etoposide* / adverse effects
  • Etoposide* / pharmacology
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / pharmacology
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Hematopoiesis / drug effects
  • Hepatic Veno-Occlusive Disease / chemically induced
  • Humans
  • Hyperbilirubinemia / chemically induced
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / pharmacology
  • Immunologic Factors / therapeutic use*
  • Leukemia, Myeloid / pathology
  • Leukemia, Myeloid / therapy
  • Leukopenia / chemically induced
  • Male
  • Middle Aged
  • Premedication*
  • Salvage Therapy

Substances

  • Immunologic Factors
  • Granulocyte Colony-Stimulating Factor
  • Etoposide
  • Cyclophosphamide
  • Busulfan