Side Effects of Conditioning Regimens

  • H. Joachim Deeg
  • Hans-Georg Klingemann
  • Gordon L. Phillips


Despite the reconstitutive effects of marrow transplantation on hematopoiesis, severe hematologic and non-hematologic toxicity is produced by the myeloablative conditioning regimens commonly used to condition patients. Specific toxicities depend on the agents employed, their dose and schedule as well as the patient’s overall clinical condition, co-morbid illness, prior treatment, disease status, excretory-organ function, concomitant medications, etc. Disease status is a particularly important prognostic factor for toxicity, as it is a rough but useful gauge of the extent of prior therapy and the resultant degree of organ damage. Moreover, patients with advanced disease status will tend to tolerate therapy less well for other reasons related to the presence of advanced disease.


Bone Marrow Transplantation Conditioning Regimen Total Body Irradiation Interstitial Pneumonitis Hemorrhagic Cystitis 
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  1. Atkinson K, Biggs JC, Golovsky D, Concannon A, Dodds A, Downs K, Ashby M (1991) Bladder irrigation does not prevent haemorrhagic cystitis in bone marrow transplant recipients. Bone Marrow Transplant 7:351PubMedGoogle Scholar
  2. Baker BW, Wilson CL, Davis AL, Spearing RL, Hart DNJ, Heatin DC, Beard MEJ (1991) Busulphan/cyclophosphamide conditioning for bone marrow transplantation may lead to failure of hair regrowth. Bone Marrow Transplant 7:43PubMedGoogle Scholar
  3. Bearman SI, Appelbaum FR, Buckner CD, Petersen FB, Fisher LD, Clift RA, Thomas ED (1988) Regimen-related toxicity in patients undergoing bone marrow transplantation. J Clin Oncol 6:1562PubMedGoogle Scholar
  4. Bearman SI, Appelbaum FR, Back A, Petersen FB, Buckner CD, Sullivan KM, Schoch HG, Fisher LD, Thomas ED (1989) Regimen-related toxicity and early posttransplant survival in patients undergoing marrow transplantation for lymphoma. J Clin Oncol 7:1288PubMedGoogle Scholar
  5. Bianco JA, Appelbaum FR, Nemunaitis J, Almgren J, Andrews F, Kettner P, Shields A, Singer JW (1991) Phase I–II trial of pentoxifylline for the prevention of transplant-related toxicities following bone marrow transplantation. Blood 78:1205PubMedGoogle Scholar
  6. Braverman AC, Antin JH, Plappert MT, Cook EF, Lee RT (1991) Cyclophosphamide cardiotoxicity in bone marrow transplantation: A prospective evaluation of new dosing regimens. J Clin Oncol 9:1215PubMedGoogle Scholar
  7. Chao NJ, Duncan SR, Long GD, Horning SJ, Blume KG (1991) Corticosteroid therapy for diffuse alveolar hemorrhage in autologous bone marrow transplant recipients. Ann Intern Med 114:145PubMedGoogle Scholar
  8. Deeg HJ, Spitzer TR, Cottier-Fox M, Cahill R, Pickle LW (1991) Conditioning-related toxicity and acute graft-versus-host disease in patients given methotrexate/cyclosporine prophylaxis. Bone Marrow Transplant 7:193PubMedGoogle Scholar
  9. Gottdiener JS, Appelbaum FR, Ferrans VJ, Deisseroth A, Ziegler J (1981) Cardiotoxicity associated with high-dose cyclophosphamide therapy. Arch Intern Med 141:758PubMedCrossRefGoogle Scholar
  10. Grigg AP, Shepherd JD, Phillips GL (1989) Busulphan and phenytoin. Ann Intern Med 111:1049 [Correction in: Ann Intern Med 112:313 (1990)]PubMedGoogle Scholar
  11. Grochow LB, Jones RJ, Brundrett RB, Braine HG, Chen T-L, Saral R, Santos GW, Colvin OM (1989) Pharmacokinetics of busulfan: Correlation with veno-occlusive disease in patients undergoing bone marrow transplantation. Cancer Chemother Pharmacol 25:55PubMedCrossRefGoogle Scholar
  12. Herbetko J, Grigg A, Buckley AR, Phillips GL (in press) Veno-occlusive liver disease after bone marrow transplantation: Findings at duplex sonograph. AJR Am J RoentgenolGoogle Scholar
  13. Jones RJ, Lee KSK, Beschorner WE, Vogel VG, Grochow LB, Braine HG, Vogelsang GB, Sensenbrenner LL, Santos GW, Saral R (1987) Venoocclusive disease of the liver following bone marrow transplantation. Transplantation 44:778PubMedCrossRefGoogle Scholar
  14. Juckett M, Perry EH, Daniels BS, Weisdorf DJ (1991) Hemolytic uremic syndrome following bone marrow transplantation. Bone Marrow Transplant 7:405PubMedGoogle Scholar
  15. Nevill TJ, Barnett MJ, Klingemann H-G, Reece DE, Shepherd JD, Phillips GL (1991) Regimen-related toxicity of a busulfan-cyclophosphamide conditioning regimen in 70 patients undergoing allogeneic bone marrow transplantation. J Clin Oncol 9:1224PubMedGoogle Scholar
  16. Pecego R, Hill R, Appelbaum FR, Amos D, Buckner CD, Fefer A, Thomas ED (1986) Interstitial pneumonitis following autologous bone marrow transplantation. Transplantation 42:515PubMedCrossRefGoogle Scholar
  17. Powles R, Pedrazzini A, Crofts M, Clink H, Millar J, Bhattia G, Perez D (1984) Mismatched family bone marrow transplantation. Semin Hematol 21:182PubMedGoogle Scholar
  18. Shepherd JD, Pringle LE, Barnett MJ, Klingemann H-G, Reece DE, Phillips GL (1991) Mesna versus hyperhydration for the prevention of cyclophosphamide-induced hemorrhagic cystitis in bone marrow transplantation. J Clin Oncol 9:2016PubMedGoogle Scholar
  19. Szeluga DJ, Stuart RK, Brookmeyer R, Utermohlen V, Santos GW (1987) Nutritional support of bone marrow transplant recipients: A prospective, randomized clinical trial comparing total parenteral nutrition to an enterai feeding program. Cancer Res 47:3309PubMedGoogle Scholar
  20. Weiner RS, Bortin MM, Gale RP, Gluckman E, Kay HEM, Kolb H-J, Hartz AJ, Rimm AA (1986) Interstitial pneumonitis after bone marrow transplantation: Assessment of risk factors. Ann Intern Med 104:168PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • H. Joachim Deeg
    • 1
  • Hans-Georg Klingemann
    • 2
  • Gordon L. Phillips
    • 3
  1. 1.Clinical Research DivisionFred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.Department of MedicineThe University of British ColumbiaVancouverCanada
  3. 3.Division of HematologyThe University of British ColumbiaVancouverCanada

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