Deviation of the central endostat from the median line and changes in the distance between sources in ovoids were found to significantly influence formation of absorbed dose in points A and B. The results of the study permit taking the said circumstances into account.
A uniquely low incidence and death rate of interstitial pneumonia after allogeneic bone marrow transplantation for haemopoietic malignancy is described. Deduced from the comparison with results from a multicenter study, we conclude, that a) reduction of the dose rate to less than 5 rad/min, b) exclusion of CMV pos platelet donors and c) application of a CMV hyperimmune globulin are effectful means to reduce this most often deathly complication after BMT for haemopoietic malignancy.
Survival and quality of life are reported in 23 pretransfused patients with severe aplastic anemia (SAA) who underwent bone marrow transplantation (BMT). The projected survival is 76% with 18 of 23 patients being alive 332 to 1677 days post graft (median: 842). 5 patients died between day 4 and 416. 12 of 17 patients at risk developed chronic graft versus host disease (GVH-D). 4 of these patients have a diminished quality of life due GVH-D related disabling manifestations. Autologous haemopoietic recovery was excluded in all patients by the demonstration of haemopoietic chimerism. We recommand age-adapted rejection prophylaxis; such strategy may help to diminish disabling graft versus host disease in otherwise haematologically reconstituted survivors.
Between February 1982 and August 1986 14 patients with AML (median age 24 years, range 10-41) underwent allogeneic bone marrow transplantation. 9 patients were grafted in first complete remission, 4 in first relapse, 1 in second relapse and 1 patient with refractory AML. Conditioning consisted of cyclophosphamide (120 mg/kg) and total body irradiation (1000 rad). The patients received methotrexate (n = 12) or methotrexate and cyclosporine (n = 2) for prevention of graft versus host disease. Of the 14 patients, 7 are alive, 7 patients died. Causes of death were recurrence of leukaemia (n = 2), veno occlusive disease of the liver (n = 1), CMV-pneumonitis (n = 1), septicaemia (1), cerebral haemorrhage (1), acute graft versus host disease of the gut (1), necrotizing encephalopathy (n = 1). 7 patients are alive between 124 and 1784 days (median 671) in continuous complete remission. All patients but 1 have a Karnofsky-index of more than 80%.
La planification de la dose pour l'irradiation corporelle totale, y compris le blindage, doit etre realisee individuellement pour chaque malade. Proposition d'extrusions aux protocoles abrupts de Registre international des greffes de moelle osseuse (IBMTR)