High-dose chemotherapy with autologous bone marrow transplantation for refractory metastatic gestational trophoblastic disease.
A patient with gestational trophoblastic disease failed to respond to all standard multiple-agent chemotherapy and had progressive uterine disease. Total hysterectomy also proved ineffective. We therefore administered high-dose cyclophosphamide, etoposide, and melphalan with autologous bone marrow support. Severe marrow suppression followed but a complete remission was achieved and the patient remains free of disease 3 years after the completion of therapy. This result seems to confirm the value of using high-dose multiagent therapy to optimize the dose-effect of therapy regimens on drug-refractory gestational trophoblastic disease.
Giacalone
P L
PL
Department of Obstetrics and Gynecology, Hopital Arnaud de Villeneuve, Montpellier, France.
Benos
P
P
Donnadio
D
D
Laffargue
F
F
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002822:Choriocarcinoma / Q000556:secondary / Q000628:therapy*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008558:Melphalan / Q000008:administration & dosage; D011247:Pregnancy; D014182:Transplantation, Autologous; D018245:Trophoblastic Tumor, Placental Site / Q000556:secondary / Q000628:therapy*; D014594:Uterine Neoplasms / Q000556:secondary / Q000628:therapy*
D005047:Etoposide; D003520:Cyclophosphamide; D008558:Melphalan