Conditioning with total body irradiation for autologous bone marrow transplantation in patients with advanced neuroblastoma

We administered a combination of chemotherapy, autologous bone marrow purged with magnet immunobeads and total body irradiation (TBI) for advanced neuroblastoma (NB). The effect of TBI was retrospectively studied with regard to hematological recovery and complications after autologous bone marrow transplantation (A-BMT). The bone marrow was engrafted in all patients, both recipients and non-recipients of TBI. In patients receiving TBI, the average number or days after A-BMT required for the white blood cell count to exceed 1,000/μl, the neutrophile count to exceed 500/μl and the platelet count to exceed 5.0 x 104/μl was 15.0±6.5, 16.0±6.4 and 59.7±24.4, respectively. In patients not receiving TBI, the corresponding figures were 12.2±6.2, 12.9±6.9 and 43.2±17.8 days, respectively. During hematological recovery after A-BMT, there was no statistical difference between patients having received TBI and those who did not receive TBI. Hemolytic uremic syndrome (HUS) was observed in four patients while receiving TBI, but no HUS developed after shielding the kidney from TBI. In terms or engraftment and complications, A-BMT can be performed on patients receiving TBI as safely as on those patients not receiving TBI. (author)