title: [The role of autografts in severe or metastatic breast cancers].
abstract: Intensive treatment of poor prognosis breast cancer has included bone marrow autografts. A multicentric study was conducted from 1988 to 1992, including 105 patients with a minimal follow-up of 2 years after the autograft. Inclusion criteria were: age < 55 years, measurable metastasis, inflammatory breast cancer, breast cancer with major lymph node invasion (> 8 N+). Chemotherapy (6 to 8 cycles) was used initially. In responders, bone marrow was harvested and frozen. Medullary invasion had to be absent for bone marrow harvesting. Management then included cyclophosphamide: 60 mg/kg, D-7, D-6; mitoxantrone: 12 mg/m2, D-9 to D-5; alkeran: 140 mg/m2, D-2 followed D0 for bone marrow autograft. For the 105 patients, mean age was 40 years; inflammatory breast cancer: 33 patients; > or = 8 N+: 11 patients; metastasis: 61 patients. For the cases with metastasis, the main sites were: liver: 24 patients, lung: 14 patients, bone: 22 patients, central nervous system: 4 patients. Nineteen patients had at least two metastasis localizations. Responders alone were included although 7 patients had been stabilized before the autograft. For the metastatic forms, median survival was 41 +/- 9 months from the onset to diagnosis of metastasis, with 8 patients surviving over 5 years. Median survival without progression was 12 months with a 4-year probability of 17%. For inflammatory breast cancers, the probability of survival was 50% and survival without progression was 42%. For patients with lymph node invasion > or = 8 N+, it was 72%.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.forename: C
authors.initials: C
authors.lastname: Gisselbrecht
authors.forename: J M
authors.initials: JM
authors.lastname: Extra
authors.forename: J P
authors.initials: JP
authors.lastname: Loz
authors.forename: Y
authors.initials: Y
authors.lastname: Devaux
authors.forename: A M
authors.initials: AM
authors.lastname: Peny
authors.forename: L
authors.initials: L
authors.lastname: Guillevin
authors.forename: D
authors.initials: D
authors.lastname: Bremond
authors.forename: M
authors.initials: M
authors.lastname: Janvier
authors.forename: D
authors.initials: D
authors.lastname: Maraninchi
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D014182:Transplantation, Autologous
vernacular_title: La place de l'autogreffe dans les cancers du sein graves ou métastatiques.