[Bone marrow transplantation with preparation involving total body irradiation of leukemia and malignant lymphoma].

The records of 225 patients with leukemia and 25 patients with malignant lymphoma who underwent bone marrow transplantation (BMT) from 1975 through June 1985 were collected by national survey in Japan. For acute leukemia patients, one-year survivals by year of BMT were 8%, 46% and 56% for groups I (-1980), II (-June, 1983) and III (-June, 1985), respectively. The corresponding one-year probabilities of developing interstitial pneumonia were 93%, 45% and 27%, respectively. Survivals after BMT in the first remission in ALL and ANL patients as well as in the chronic phase in CML were better than in the remaining conditions. On the basis of the high relapse rate in syngeneic BMT for acute leukemia, it was indicated that a more aggressive treatment schedule would be necessary before and after transplantation. Despite extensive disease in cases of malignant lymphoma (all clinical stages III and IV), 5-year survival was 36%. The present analysis indicated that changes in the selection of patients, e.g., those in the first remission without infection at the time of BMT, as well as low dose-rate fractionated TBI and selection of platelet donors with negative CMV titer, had resulted in a significant improvement of survival and a decreased incidence of interstitial pneumonia after BMT for leukemia in Japan.