Feasibility of total body irradiation in chronic lymphocytic leukemia and low-grade non-hodgkin's lymphomas

Mario Roncadin, Mauro Arcicasa, Roberto Bortolus, Mauro G. Trovó, Antonino Carbone, Umberto Tirelli, Antonino De Paoli, Giovanni Franchin, Eligio Grigoletto

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Combined total body irradiation (TBI) and Prednimustine were prospectively evaluated in 30 patients affected either with chronic lymphocytic leukemia (CLL) or with low-grade non-Hodgkin's lymphoma (NHL) eleven patients were previously treated. Between January 1984 and May 1987, 20 evaluable patients with CLL, median age 66 years (range 43-82), classified according to Rai (4 in stage I, 10 in stage II, 4 in stage III, 2 in stage IV) and 10 evaluable patients with NHL low-grade malignancy according to the Working Formulation, Stages III and IV, median age 54 years (range 32-71) were treated using a 6 MeV Linear Accelerator, applying two opposite alternating fields including total body, with a fraction of 15 cGy, 2 fractions weekly (3-day interval) for a total dose of 150 cGy given over 5 weeks. Prednimustine (100 mg/m2, orally, for 5 consecutive days, every 3-4 weeks, for 6-9 courses) was administered 2 months after TBI treatment, as consolidation therapy. By May 1989, a total of 85% hematological responses (defined as normalization of the differential white cell count, of the total blood cell count and of bone marrow infiltration) were obtained after combined treatment in CLL patients; moreover 3 CR (according to the WHO criteria), 75% with splenomegaly reduction and 40% with lymphadenopathy reduction were seen. Ninety percent objective responses (5 CR and 4 PR) were observed in the NHL patients, with 50% having splenomegaly reduction and 67% lymphadenopathy reduction. The median response time in the two groups was, respectively, 14 and 23 months. The overall toxicity (WHO grades 1,2,3,4) after combined treatment was 65% and 70% in the two patient groups. WHO grade III toxicity, completely reversible, was verified in only 16.6% of the cases; all cases, except one, were previously treated. Additionally, 1 toxic death (grade IV thrombocytopenia and leukopenia) was observed in a heavily pretreated patient affected with CLL after TBI alone. Prednimustine regimen was generally well tolerated. The high response rate and acceptable toxicity, confirms the feasibility and the usefulness of TBI in the context of a combined treatment for CLL and low-grade NHL patients. However in order to further reduce the severe toxic side effects, observed in one patient, white blood cells and platelet count should be plotted and monitored carefully, particularly in pretreated patients.

Original languageEnglish
Pages (from-to)403-407
Number of pages5
JournalCancer Investigation
Volume9
Issue number4
DOIs
Publication statusPublished - 1991

Fingerprint

Whole-Body Irradiation
B-Cell Chronic Lymphocytic Leukemia
Non-Hodgkin's Lymphoma
Prednimustine
Poisons
Splenomegaly
Therapeutics
Particle Accelerators
Blood Cell Count
Leukopenia
Platelet Count
Leukocyte Count
Thrombocytopenia
Reaction Time
Cell Count
Bone Marrow

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Feasibility of total body irradiation in chronic lymphocytic leukemia and low-grade non-hodgkin's lymphomas. / Roncadin, Mario; Arcicasa, Mauro; Bortolus, Roberto; Trovó, Mauro G.; Carbone, Antonino; Tirelli, Umberto; De Paoli, Antonino; Franchin, Giovanni; Grigoletto, Eligio.

In: Cancer Investigation, Vol. 9, No. 4, 1991, p. 403-407.

Research output: Contribution to journalArticle

Roncadin, Mario ; Arcicasa, Mauro ; Bortolus, Roberto ; Trovó, Mauro G. ; Carbone, Antonino ; Tirelli, Umberto ; De Paoli, Antonino ; Franchin, Giovanni ; Grigoletto, Eligio. / Feasibility of total body irradiation in chronic lymphocytic leukemia and low-grade non-hodgkin's lymphomas. In: Cancer Investigation. 1991 ; Vol. 9, No. 4. pp. 403-407.
@article{cbb657e73a1d4ec78fe40326b502f7da,
title = "Feasibility of total body irradiation in chronic lymphocytic leukemia and low-grade non-hodgkin's lymphomas",
abstract = "Combined total body irradiation (TBI) and Prednimustine were prospectively evaluated in 30 patients affected either with chronic lymphocytic leukemia (CLL) or with low-grade non-Hodgkin's lymphoma (NHL) eleven patients were previously treated. Between January 1984 and May 1987, 20 evaluable patients with CLL, median age 66 years (range 43-82), classified according to Rai (4 in stage I, 10 in stage II, 4 in stage III, 2 in stage IV) and 10 evaluable patients with NHL low-grade malignancy according to the Working Formulation, Stages III and IV, median age 54 years (range 32-71) were treated using a 6 MeV Linear Accelerator, applying two opposite alternating fields including total body, with a fraction of 15 cGy, 2 fractions weekly (3-day interval) for a total dose of 150 cGy given over 5 weeks. Prednimustine (100 mg/m2, orally, for 5 consecutive days, every 3-4 weeks, for 6-9 courses) was administered 2 months after TBI treatment, as consolidation therapy. By May 1989, a total of 85{\%} hematological responses (defined as normalization of the differential white cell count, of the total blood cell count and of bone marrow infiltration) were obtained after combined treatment in CLL patients; moreover 3 CR (according to the WHO criteria), 75{\%} with splenomegaly reduction and 40{\%} with lymphadenopathy reduction were seen. Ninety percent objective responses (5 CR and 4 PR) were observed in the NHL patients, with 50{\%} having splenomegaly reduction and 67{\%} lymphadenopathy reduction. The median response time in the two groups was, respectively, 14 and 23 months. The overall toxicity (WHO grades 1,2,3,4) after combined treatment was 65{\%} and 70{\%} in the two patient groups. WHO grade III toxicity, completely reversible, was verified in only 16.6{\%} of the cases; all cases, except one, were previously treated. Additionally, 1 toxic death (grade IV thrombocytopenia and leukopenia) was observed in a heavily pretreated patient affected with CLL after TBI alone. Prednimustine regimen was generally well tolerated. The high response rate and acceptable toxicity, confirms the feasibility and the usefulness of TBI in the context of a combined treatment for CLL and low-grade NHL patients. However in order to further reduce the severe toxic side effects, observed in one patient, white blood cells and platelet count should be plotted and monitored carefully, particularly in pretreated patients.",
author = "Mario Roncadin and Mauro Arcicasa and Roberto Bortolus and Trov{\'o}, {Mauro G.} and Antonino Carbone and Umberto Tirelli and {De Paoli}, Antonino and Giovanni Franchin and Eligio Grigoletto",
year = "1991",
doi = "10.3109/07357909109084637",
language = "English",
volume = "9",
pages = "403--407",
journal = "Cancer Investigation",
issn = "0735-7907",
publisher = "Informa Healthcare",
number = "4",

}

TY - JOUR

T1 - Feasibility of total body irradiation in chronic lymphocytic leukemia and low-grade non-hodgkin's lymphomas

AU - Roncadin, Mario

AU - Arcicasa, Mauro

AU - Bortolus, Roberto

AU - Trovó, Mauro G.

AU - Carbone, Antonino

AU - Tirelli, Umberto

AU - De Paoli, Antonino

AU - Franchin, Giovanni

AU - Grigoletto, Eligio

PY - 1991

Y1 - 1991

N2 - Combined total body irradiation (TBI) and Prednimustine were prospectively evaluated in 30 patients affected either with chronic lymphocytic leukemia (CLL) or with low-grade non-Hodgkin's lymphoma (NHL) eleven patients were previously treated. Between January 1984 and May 1987, 20 evaluable patients with CLL, median age 66 years (range 43-82), classified according to Rai (4 in stage I, 10 in stage II, 4 in stage III, 2 in stage IV) and 10 evaluable patients with NHL low-grade malignancy according to the Working Formulation, Stages III and IV, median age 54 years (range 32-71) were treated using a 6 MeV Linear Accelerator, applying two opposite alternating fields including total body, with a fraction of 15 cGy, 2 fractions weekly (3-day interval) for a total dose of 150 cGy given over 5 weeks. Prednimustine (100 mg/m2, orally, for 5 consecutive days, every 3-4 weeks, for 6-9 courses) was administered 2 months after TBI treatment, as consolidation therapy. By May 1989, a total of 85% hematological responses (defined as normalization of the differential white cell count, of the total blood cell count and of bone marrow infiltration) were obtained after combined treatment in CLL patients; moreover 3 CR (according to the WHO criteria), 75% with splenomegaly reduction and 40% with lymphadenopathy reduction were seen. Ninety percent objective responses (5 CR and 4 PR) were observed in the NHL patients, with 50% having splenomegaly reduction and 67% lymphadenopathy reduction. The median response time in the two groups was, respectively, 14 and 23 months. The overall toxicity (WHO grades 1,2,3,4) after combined treatment was 65% and 70% in the two patient groups. WHO grade III toxicity, completely reversible, was verified in only 16.6% of the cases; all cases, except one, were previously treated. Additionally, 1 toxic death (grade IV thrombocytopenia and leukopenia) was observed in a heavily pretreated patient affected with CLL after TBI alone. Prednimustine regimen was generally well tolerated. The high response rate and acceptable toxicity, confirms the feasibility and the usefulness of TBI in the context of a combined treatment for CLL and low-grade NHL patients. However in order to further reduce the severe toxic side effects, observed in one patient, white blood cells and platelet count should be plotted and monitored carefully, particularly in pretreated patients.

AB - Combined total body irradiation (TBI) and Prednimustine were prospectively evaluated in 30 patients affected either with chronic lymphocytic leukemia (CLL) or with low-grade non-Hodgkin's lymphoma (NHL) eleven patients were previously treated. Between January 1984 and May 1987, 20 evaluable patients with CLL, median age 66 years (range 43-82), classified according to Rai (4 in stage I, 10 in stage II, 4 in stage III, 2 in stage IV) and 10 evaluable patients with NHL low-grade malignancy according to the Working Formulation, Stages III and IV, median age 54 years (range 32-71) were treated using a 6 MeV Linear Accelerator, applying two opposite alternating fields including total body, with a fraction of 15 cGy, 2 fractions weekly (3-day interval) for a total dose of 150 cGy given over 5 weeks. Prednimustine (100 mg/m2, orally, for 5 consecutive days, every 3-4 weeks, for 6-9 courses) was administered 2 months after TBI treatment, as consolidation therapy. By May 1989, a total of 85% hematological responses (defined as normalization of the differential white cell count, of the total blood cell count and of bone marrow infiltration) were obtained after combined treatment in CLL patients; moreover 3 CR (according to the WHO criteria), 75% with splenomegaly reduction and 40% with lymphadenopathy reduction were seen. Ninety percent objective responses (5 CR and 4 PR) were observed in the NHL patients, with 50% having splenomegaly reduction and 67% lymphadenopathy reduction. The median response time in the two groups was, respectively, 14 and 23 months. The overall toxicity (WHO grades 1,2,3,4) after combined treatment was 65% and 70% in the two patient groups. WHO grade III toxicity, completely reversible, was verified in only 16.6% of the cases; all cases, except one, were previously treated. Additionally, 1 toxic death (grade IV thrombocytopenia and leukopenia) was observed in a heavily pretreated patient affected with CLL after TBI alone. Prednimustine regimen was generally well tolerated. The high response rate and acceptable toxicity, confirms the feasibility and the usefulness of TBI in the context of a combined treatment for CLL and low-grade NHL patients. However in order to further reduce the severe toxic side effects, observed in one patient, white blood cells and platelet count should be plotted and monitored carefully, particularly in pretreated patients.

UR - http://www.scopus.com/inward/record.url?scp=0025740401&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025740401&partnerID=8YFLogxK

U2 - 10.3109/07357909109084637

DO - 10.3109/07357909109084637

M3 - Article

VL - 9

SP - 403

EP - 407

JO - Cancer Investigation

JF - Cancer Investigation

SN - 0735-7907

IS - 4

ER -