Stem cell transplantation for metastatic breast cancer: analysis of tumor contamination.

Autor: Stadtmauer, Edward, Tsai, Donald, Sickles, Cheryl, Mick, Rosemarie, Luger, Selina, Porter, David, Mangan, Patricia, Schuchter, Lynn, Schuster, Stephen, Loh, Elwyn, Magee, Deborah, Sachs, Robert, Wall, Mark, Moore, Jonni, Buzby, Gordon, Zaleta, Ellen, Kamoun, Malek, Silberstein, Leslie, Stadtmauer, E A, Tsai, D E
Zdroj: Medical Oncology; Dec1999, Vol. 16 Issue 4, p279-288, 10p
Abstrakt: The purpose of this study was to determine the efficacy, engraftment kinetics, effect of bone marrow tumor contamination, and safety of high-dose therapy and granulocyte-colony stimulating factor (G-CSF) mobilized peripheral blood progenitor cell (PBPC) support for patients with responding metastatic breast cancer. Forty two patients underwent G-CSF (10 microg/kg) stimulated PBPC harvest. PBPC and bone marrow aspirates were analyzed by histologic and immunocytochemical methods for tumor contamination. Thirty-seven patients received high-dose therapy consisting of cyclophosphamide 6 g/m2, thiotepa 500 mg/m2, and carboplatin 800 mg/m2 (CTCb) given as an infusion over 4 d followed by PBPC reinfusion and G-CSF (5 microg/kg) support. No transplant related deaths or grade 4 toxicity was recorded. CD34+ cells/kg infused was predictive of neutrophil and platelet recovery. With a median follow-up of 38 months, three year survival was 44% with relapse-free survival of 19%. Histological bone marrow involvement, found in 10 patients, was a negative prognostic factor and was associated with a median relapse-free survival of 3.5 months. Tumor contamination of PBPC by immunohistochemical staining was present in 22.5% of patients and found not to be correlated with decreased survival. G-CSF stimulated PBPC collection followed by a single course of high dose chemotherapy and stem cell infusion with G-CSF stimulated marrow recovery leads to rapid, reliable engraftment with low toxicity and promising outcome in women with responding metastatic breast cancer. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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