High-dose chemotherapy and autologous hematopoietic stem cell transplantation in patients with second primary malignancies.
We treated 500 patients with high-dose chemotherapy and autologous bone marrow or autologous peripheral blood stem cell transplantation. Treated conditions included leukemia, lymphoma, breast cancer, lung cancer, germ-cell carcinoma, and other solid tumors. 10/500 (2%) of patients were treated for a second malignancy diagnosed 12 months to 25 years after their initial neoplasm. Four of these ten patients are in complete remission (CR) of both malignancies at a median follow-up of 29+ months after high-dose chemotherapy and autotransplantation. None of these patients would have been eligible for high-dose chemotherapy and autotransplantation by conventional selection criteria which usually excluded patients with a history of prior malignancies. Conclusion. Conventional exclusion criteria for high-dose chemotherapy and autotransplantation may not adequately reflect the prognosis of patients with second or secondary malignancies treated with this therapeutic modality. High-dose chemotherapy and autologous hematopoietic stem cell transplantation may be of true benefit in selected cases of secondary malignancies.
Fetscher
S
S
Department of Internal Medicine I, University of Freiburg Medical Center, Freiburg im Breisgau, Germany.
Finke
J
J
Engelhardt
R
R
Mertelsmann
R
R
Lange
W
W
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery*; D018579:Patient Selection; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000970:Antineoplastic Agents