The toxicity of busulphan and cyclophosphamide as the preparative regimen for bone marrow transplantation

Abstract

Summary. The toxicity of the conditioning regimen of high dose busulphan (Bu) (16 mg/kg) and cyclophosphamide (Cy) (120 mg/kg) has been compared to cyclophosphamide (Cy) (120 mg/kg) and fractionated total body irradiation (TBI) 12‐14 Gy. Since 1985, 67 patients have received conditioning of Bu and Cy for HLA‐identical sibling bone marrow transplants. 166 patients have received Cy and TBI since 1981. Veno‐occlusive disease of the liver occurred in 19% in the Bu‐Cy group and was fatal in 1/12 cases, but only in 1·3% of Cy‐TBI group (P<0·0005) and was fatal in 1/2. 30% of evaluable patients developed haemorrhagic cystitis in the Bu‐Cy group and 14% in the Cy‐TBI group (P=0·008). A multiple logi..