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Sequential High-Dose Alkylating Therapy and Stem Cell Support for High-Risk Stage III Breast Cancer

Authors :
Carol Staugaard-Hahn
Elizabeth D'Andrea
Bruce G. Haffty
Barbara Burtness
Michal G. Rose
Josette Bou-Khalil
Edward A. Snyder
Dennis L. Cooper
John Pezzimente
Michael Reiss
Susan Gran
Erin Medoff
Christine Holtkamp
Amanda Psyrri
Source :
The Breast Journal. 9:472-477
Publication Year :
2003
Publisher :
Hindawi Limited, 2003.

Abstract

Patients who receive neoadjuvant chemotherapy for locally advanced breast cancer and have four or more ipsilateral axillary lymph nodes involved at surgery are at high risk for recurrence, with a median time to relapse of 18 months. We offered such patients high-dose chemotherapy with stem cell rescue. Patients received cyclophosphamide or paclitaxel and granulocyte colony-stimulating factor (G-CSF) to mobilize stem cells. Melphalan 140 mg/m2 was then given with stem cell rescue. Twenty-four to 35 days later, thiotepa 900 mg/m2 was given with stem cell rescue. Patients with hormone receptor-positive tumors received tamoxifen. We treated 14 patients in this fashion from 1995 to 1998. The mean age was 46.7 years. The majority of cancers were stage IIIB (79%). Thirteen women underwent mastectomy after anthracycline-containing chemotherapy and 50% had more than seven positive lymph nodes. Hospitalization was principally for neutropenic fever. Other morbidities were pneumonitis, cardiomyopathy, and grade 3/4 white blood cell (WBC) toxicity. No patient died of a treatment-related complication. Seven of 14 relapsed at 10, 12

Details

ISSN :
15244741 and 1075122X
Volume :
9
Database :
OpenAIRE
Journal :
The Breast Journal
Accession number :
edsair.doi.dedup.....75730a5e1f577a4d6b6e3f47277f8ce1
Full Text :
https://doi.org/10.1046/j.1524-4741.2003.09604.x