High-dose chemotherapy without autologous bone marrow transplantation in XXXX .

@entity1 @entity137 @entity5 @entity1891 @entity236 @entity320
High-dose chemotherapy with BCNU, melphalan, or both, followed by autologous bone marrow transplantation (ABMT) has been reported to produce response rates in excess of 60% in @entity1 with advanced @entity320 . We tested doses of BCNU associated with reversible @entity236 and acceptable extramedullary @entity137 without the use of ABMT in 19 @entity1 with a diagnosis of advanced @entity320 . All @entity1 were evaluable for @entity137 and 18 were evaluable for response; one @entity1 had a new @entity5 . The @entity1 population had a median age of 44 years (range, 16 to 71) and a median Karnofsky performance status of 80 (range, 50 to 100). Ten were @entity1 and nine were @entity1 , all had visceral dominant disease, and none had received previous chemotherapy. Our purpose was to test the feasibility of treatment without ABMT, its @entity137 and efficacy, and the possibility of administering sequential repeated courses of therapy. @entity1891 was added to the regimen to potentially increase efficacy. Treatment consisted of BCNU (750 mg/m2) and @entity1891 (2 mg days 1 and 8). Six @entity1 who recovered bone marrow function received melphalan (60 mg/m2) and @entity1891 (2 mg days 1 and 8). Twenty-two percent (95% confidence limits, 3% to 39%) of @entity1 had remissions (all partial) and these were of short duration. @entity137 was substantial with 16% early lethality and 29% incidence of lethal drug-related complications. Two @entity1 (11%) died toxic after a second course of BCNU. Our results suggest that there is no practical role for high-dose BCNU in the treatment of @entity320 .
