[Autologous hematopoietic stem cell transplantation--application to recurrent breast cancer].
High-dose chemotherapy with autologous hematopoietic stem cell transplantation (HD-CT with AHSCT) has been studying to overcome drug resistance and to obtain higher antitumor efficacy on hematological malignancies and solid tumors. The annual rate of transplants is increasing steadily. This method has boon now performed safely owing to the development of researches about hematopoietic growth factors and stem cells. It was demonstrated that the administration of recombinant human granulocyte colony stimulating factor (rhG-CSF) and granulocyte Macrophage colony stimulating factor (rhGM-CSF) could shortened the duration of leukopenia. Autologous peripheral stem cell transplantation has the advantage for the earlier bone marrow reconstitution and the unnecessary of purging. Recently, it was found that rhG-CSF and rhGM-CSF could increase the number of peripheral blood stem cells, so further studies are expected. For recurrent breast cancers resistant to conventional chemotherapy, response rates of 60-80% may be achieved using HD-CT with AHSCT, but the duration of response is generally short. So, trials consisted of induction conventional chemotherapy followed by HD-CT with AHSCT in the earlier course of the illness have conducted to obtain higher complete response (CR) rate and survival rate. Although the observed duration is short, higher CR rate has been achieved in several clinical studies. There are still remaining with many problems to be settled, HD-CT with AHSCT may have the potentiality to cure not only recurrent breast cancer but also another malignancies.
Dept. of Clinical Oncology, Cancer Institute Hospital.
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Mukaiyama
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Ogawa
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007970:Leukopenia / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000601:surgery* / Q000628:therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012074:Remission Induction
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor