OUTPATIENT TOTAL-BODY IRRADIATION FOR BONE-MARROW TRANSPLANTATION

Five selected patients entering a BMT program were included in a prosp ective feasibility study to evaluate the tolerance to total body irrad iation (TBI) on an outpatient basis. Four fractions of 3 Gy in 4 conse cutive days (8 Gy lung total dose) were given. Ondansetron 8 mg/8 h or ally was used without sedation as anti-emetic regimen. After each trea tment dose, patients went home where they remained in close telephone contact with the BMT team. After the last TBI fraction, patients were hospitalized and treated with cyclophosphamide 60 mg/g/day for 2 conse cutive days. The outpatient TBI regimen was well tolerated in four cas es. Only one patient presented with nausea and vomiting after the seco nd treatment day. She was admitted to the hospital and treated with ch lorpromazine. During the conditioning and hematological recovery perio d, no complications related to the outpatient TBI could be identified. We conclude that TBI can be given on an outpatient basis with safety. Additionally, it represents a cost saving of US$ 1160 per patient.