Summary:The purpose of the study was to determine the toxicities and effectiveness of a novel preparative regimen of busulfan (Bu) 14 mg/kg, etoposide 50 or 60 mg/kg, and cyclophosphamide (Cy) 120 mg/kg in non-Hodgkin's lymphoma (NHL) and to analyze results using doses based on different body weight parameters and the two different etoposide doses. Three hundred and eightytwo patients aged 16 to 72 underwent first autologous transplantation with mobilized peripheral blood progenitor cells between August 1992 and December 1998 at either of two transplant centers. Mucositis was the most common toxicity. Hepatic toxicity was the most common life-threatening toxicity; severe hepatic VOD occurred in 11 patients (2.9%). Ten patients (2.6%) died from treatment-related toxicity. The 3-year progressionfree survival (PFS) for the entire group was 46.9% (95% CI, 40.5-53.3%). Elevated LDH, resistance to chemotherapy, and intermediate/aggressive histology were significant adverse prognostic factors. For patients in sensitive first relapse PFS was 47.0% (95% CI, 37-57%). Neither etoposide dose nor body weight parameter utilized significantly affected outcome. In conclusion, the novel preparative regimen of Bu, etoposide and Cy results in a low incidence of treatment-related mortality and is effective in the treatment of patients with NHL. Bone Marrow Transplantation (2000) 25, 1243-1248. Keywords: autotransplantation; non-Hodgkin's lymphoma; busulfan High-dose chemotherapy followed by autologous transplantation of hematopoietic progenitor cells is curative in many patients with NHL who fail primary therapy. [1][2][3][4] The superiority of this approach over standard chemotherapy has been proven in patients with chemotherapy-sensitive, relapsed intermediate and high-grade NHL. 5 Autotransplantation is also commonly performed in patients with more advanced

Summary:Prognostic factors in 42 patients aged 11 to 62 (median 46) years, with myelodysplastic syndrome (MDS) or after leukemic transformation, who underwent allogeneic marrow transplantation between 1984 and 1999 were analyzed. Thirty-six had advanced disease morphology; 19 had leukemic transformation. Twenty-nine received a preparative regimen of BuCy 2 and 13 busulfan 14 mg/kg, etoposide 50 mg/kg and cyclophosphamide 120 mg/kg. Severe hepatic veno-occlusive disease (VOD) occurred in three patients all of whom received anti-leukemic chemotherapy prior to transplantation. Fifteen patients (36%) died from early transplantrelated complications; nine patients relapsed. The estimated 4 year disease-free survival (DFS) was 35% (95% CI 26-44%). Older age was the most significant adverse prognostic factor. Patients with leukemic transformation who underwent early transplantation had significantly better DFS than those treated first with chemotherapy (P = 0.002). Delayed toxicity was rare in these patients; no late relapses occurred. Bone Marrow Transplantation (2000) 25, 1219-1222. Keywords: myelodysplastic syndrome; BuCy; allogeneic transplantation Allogeneic marrow transplantation is the only curative treatment for the myelodysplastic syndrome (MDS). 1-3 Sustained disease-free survival has been reported to be in excess of 50% in selected patients. 4,5 However, patients with advanced disease morphology, ie refractory anemia with excess blasts (RAEB), refractory anemia with excess blasts in transformation (RAEB-T), chronic myelomonocytic leukemia (CMML), and acute leukemia evolving from myelodysplasia, have experienced high relapse rates and poorer rates of disease-free survival (DFS) compared to patients with less advanced disease. [2][3][4]6 Attempts to intensify preparative regimens, such as the addition of busulfan to cyclophosphamide and total body irradiation (TBI), have resulted in lower relapse rates, but also an increase in nonrelapse mortality. 6 Regimens using busulfan without total body irradiation have yielded favorable results for patients with MDS. 5,7 The present study analyzed long-term results and prognostic factors in patients with MDS, most with advanced disease, who received busulfan-based preparative therapy.