High-dose chemotherapy with mitoxantrone + melphalan and autologous stem cell rescue in metastatic breast cancer patients: A study of feasibility and tolerability
| Autor: | Giuseppe Irrera, Giulia Pucci, Fortunato Morabito, Giovanni Cicero, Giuseppe Messina, Salvatore Palazzo, Antonia Condemi, Massimo Martino, Antonella Dattola, Giuseppe Console, Antonella Pontari, M. Nardi, Stefano Molica, Giuseppa Penna, Pasquale Iacopino, I. Callea |
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| Předmět: |
Oncology
Melphalan Adult Cancer Research medicine.medical_specialty Cyclophosphamide medicine.medical_treatment Breast Neoplasms ThioTEPA Gastroenterology Transplantation Autologous Drug Administration Schedule chemistry.chemical_compound Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Mitoxantrone Chemotherapy Dose-Response Relationship Drug business.industry General Medicine Middle Aged Carboplatin Treatment Outcome Docetaxel chemistry Feasibility Studies Female business medicine.drug Epirubicin Stem Cell Transplantation |
| Zdroj: | Scopus-Elsevier Europe PubMed Central |
| Popis: | Hematological and extra-hematological toxicity of mitoxantrone-containing regimens with autologous stem cell rescue was evaluated in 32 metastatic breast cancer patients. The schedule was the final part of two high-dose chemotherapy programs, including an induction phase with three courses of conventional chemotherapy with epirubicin (120 mg/m2) and cyclophosphamide (600 mg/m2) plus three courses of docetaxel (100 mg/m2) and a first high-dose chemotherapy consisting of cyclophosphamide (6000 mg/m2), thiotepa (500 mg/m2) and carboplatin (800 mg/m2) or melphalan (160 mg/m2) plus thiotepa (600 mg/m2). The final second autograft phase included mitoxantrone (60 mg/m2) associated with melphalan (160 mg/m2) and autologous stem cell rescue infusion. The median duration of severe neutropenia and thrombocytopenia was 9 (range, 7–13) and 11.5 (range, 9–29) days. The median number of units of erythrocytes and platelets transfused was 1 (0–11) and 4 (1–9), respectively. Fever for a median of 2 (0–8) days developed in 71.8% of the patients. Mucositis was observed in 81.2% (WHO grade 3–4 in 25%). No acute or late cardiac toxicity was observed. One patient died because of a transplant-unrelated cause. The response according to the program phase showed an increased rate of complete response, from 12.5% at the end of conventional chemotherapy to 21.9% after the first high-dose chemotherapy course, to increase to 43.9% after the treatment with mitoxantrone-melphalan. We conclude that a conditioning regimen with high dose mitoxantrone-melphalan fits well within the high-dose chemotherapy program. |
| Databáze: | OpenAIRE |
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