title: High-dose chemotherapy with autologous bone marrow transplantation for refractory metastatic gestational trophoblastic disease.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Hopital Arnaud de Villeneuve, Montpellier, France.
authors.forename: P L
authors.initials: PL
authors.lastname: Giacalone
authors.forename: P
authors.initials: P
authors.lastname: Benos
authors.forename: D
authors.initials: D
authors.lastname: Donnadio
authors.forename: F
authors.initials: F
authors.lastname: Laffargue
mesh_terms: 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*
chemical_list: D005047:Etoposide; D003520:Cyclophosphamide; D008558:Melphalan