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To the Editor: In their article on allogeneic bone marrow transplantation in children, Brochstein et al. (Dec. 24 issue)1 comment that the conventional treatment with cyclophosphamide followed by total-body irradiation for cytoreduction before transplantation may not be as beneficial as the use of these same methods in the reverse order. It has been known for some time that there is an unacceptable graft-rejection rate of 25 to 60 percent after pretransplantation treatment with cyclophosphamide alone.2 For that reason, total-body irradiation in various dosages has been added to cyclophosphamide at most institutions as part of the conditioning regimen.34 Recently, I had. © 1988, Massachusetts Medical Society. All rights reserved. |