title: [High-dose therapy and hematopoietic cell autotransplantation in the treatment of adult gynecologic tumors].
abstract: Autologous bone marrow transplantation for the treatment of gynecologic tumors in adults remains an uncommon therapeutic approach. The feasibility of such high-dose therapies is clearly proved, especially with the advent of hematopoietic growth factors and the rescue by the peripheral stem cells to reduce the duration of the chemotherapy-induced myeloid aplasia. The question is to exactly define the place of high-dose therapy in the land of solid tumors. In the treatment of poor prognosis breast cancer, high-dose therapy with autologous bone marrow transplantation or with peripheral stem cells support is able to convert some patients with partial response into complete responders. However, the consequences on overall survival and disease-free survival are not convincing. For metastatic breast cancer and for poor-prognosis tumors (inflammatory breast cancer, axillary metastatic nodes > or = 8), the interest of high-dose therapy has to be determined by randomized studies. These studies are ongoing in USA and in France. For the treatment of poor-prognosis ovarian cancer, the situation is more difficult to appraise. Randomized studies have to be done to precisely define the interest of high-dose therapy in terms of response and disease-free survival for the treatment of ovarian carcinomas.
authors.affiliation: Service d'Oncologie Médicale, Hôpital Tenon, Paris.
authors.forename: J P
authors.initials: JP
authors.lastname: Lotz
authors.forename: F
authors.initials: F
authors.lastname: Pene
authors.forename: C
authors.initials: C
authors.lastname: Bouleuc
authors.forename: T
authors.initials: T
authors.lastname: André
authors.forename: J
authors.initials: J
authors.lastname: Gligorov
authors.forename: D
authors.initials: D
authors.lastname: Avenin
authors.forename: A
authors.initials: A
authors.lastname: Esteso
authors.forename: A
authors.initials: A
authors.lastname: Bellaiche
authors.forename: C
authors.initials: C
authors.lastname: Macovei
authors.forename: Z
authors.initials: Z
authors.lastname: Merad
authors.forename: A
authors.initials: A
authors.lastname: Laadem
authors.forename: R
authors.initials: R
authors.lastname: Vanica
authors.forename: V
authors.initials: V
authors.lastname: Izrael
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001804:Blood Transfusion, Autologous; D016026:Bone Marrow Transplantation / Q000379:methods; D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D010051:Ovarian Neoplasms / Q000628:therapy*; D011379:Prognosis; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome
vernacular_title: Intensification thérapeutique et autotransplantation de cellules souches hématopoïétiques dans le traitement des tumeurs gynécologiques de l'adulte.