Blood, 1960, Vol. 16, No. 2, pp. 1089-1103.
© 1960 American Society of Hematology, Inc.
Massive Nitrogen Mustard Therapy in Hodgkin’s Disease
with Protection of Bone Marrow by Tourniquets
MARCEL E. CONRAD JR. 1 and
WILLIAM H. CROSBY 1
1 Department of Hematology, Walter Reed Army Institute of Research, Washington, D. C.
1. Eight patients with far advanced Hodgkin’s disease were treated with
massive single doses of nitrogen mustard (0.95-1.5 mg. /Kg.) with tumor regression in each case.
2. An attempt was made to protect the bone marrow of the extremities from
the effects of the nitrogen mustard by applying orthopedic tourniquets during
the injection. There was definite evidence that the marrow was protected by
this procedure. Marrow in the tibia became progressively more cellular during
the time that the marrow in the torso degenerated to almost complete aplasia.
During the period of recovery, radioactive iron was given and more of it
localized in the protected arm than in the unprotected, evidence of greater
erythropoietic activity.
3. Neurologic complications occurred at the doses employed.
4. Serious gastrointestinal pathology was not demonstrated at these doses.
5. Prior extensive radiation therapy prolonged the hemopoietic depression
due to nitrogen mustard. This was not produced by previous mustard therapy.
6. Color change in ecchymotic areas may be used to predict bone marrow
recovery.
7. Dividing the massive dose seems to result in less toxicity.
Submitted on December 14, 1959
Accepted on March 8, 1960
