The long-term efficacy of allogeneic marrow transplantation for hemotologic malignancies is limited by the posttransplant relapse rate and the toxicities of the regimens employed. The goals of this research project are to develop and evaluate treatment regimens with better therapeutic indices. Chemotherapeutic agents in escalating doses will be evaluated in patients receiving a standard TBI regimen of 12.0 Gy (subproject I.A.) and a variety of total body irradiation (TBI) regimens will be evaluated in patients receiving a standard dose of cyclophosphamide, 120 mg/kg (subproject I.B.). In subprojects C-F we will test specific strategies for treating patients with acute nonlymphoblastic leukemia (ANL), acute lymphoblastic leukemia (ALL), chronic myelogenous leukemia (CML) and malignant lymphoma (ML). In these subprojects we seek to identify the optimal treatment regimen for each disease and phase of disease by performing phase III trials of treatment regimens developed as outlined in subprojects A and B or developed at other institutions.
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