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Thirteen patients with advanced (Stage III) malignant melanoma have been treated with high-dose chemotherapy (nitrogen mustard or a combination of BCNU and melphalan) combined with autologous, nonfrozen, bone marrow transplantation. Three patients (24%) achieved a complete remission and are currently alive and free of disease without further therapy at 26, 60, and 73 weeks. Five patients (38%) achieved partial remissions and five patients (38%) had no response. There was no difference in the response rate to nitrogen mustard and the BCNU-melphalan combination. Severe side effects to nitrogen mustard, however, precluded its further use in this study. The major cause of death in patients was intracerebral metastases, raising the question of prophylactic brain irradiation in future studies. Studies of the recovery rate of peripheral blood neutrophil, platelet, and peripheral blood and bone marrow CFU-C suggest that autologous bone marrow infusion may be of benefit in shortening hematopoietic recovery following intensive chemotherapy.
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