Positive selection and ex vivo expansion of hematopoietic progenitors as autografts for high-dose chemotherapy, potential importance in patients with bone metastases.
The phase I trial in breast cancer conducted by Peters et al. defined a regimen of high-dose chemotherapy consisting of cyclophosphamide, cisplatinum and BCNU (CPA/cDDP/BCNU). In chemotherapy-resistant metastatic disease, 23% of patients achieved complete remission followed by early relapse. In a phase II study, 53% of stage IV patients with no prior treatment achieved complete response (CR) with 16% progression-free at five to nine years post-transplant. Chemically debulking with an Adriamycin, 5FU, and Methotrexate regimen (AFM) to minimal tumor burden achieved 68% CR, with approximately 20% disease-free patients at 36 months. Other high dose chemotherapy regimens have been developed, again demonstrating in stage IV patients complete remissions in excess of 65% and progression-free survival rates of 20-30%.
Purdy
M H
MH
Division Hematology/Oncology, University of New Mexico, Albuquerque, USA.
D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D002330:Carmustine / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D009367:Neoplasm Staging; D012074:Remission Induction; D014182:Transplantation, Autologous
D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D005472:Fluorouracil; D002330:Carmustine; D008727:Methotrexate