title: High-dose sequential chemotherapy with stem cell support for non-metastatic breast cancer.
abstract: The importance of dose-intensity has been suggested in breast cancer. The aim of this study was to evaluate the feasibility of a high-dose intensity doxorubicin-cyclophosphamide regimen with supporting G-CSF and blood stem cells. Twenty-five patients with non-metastatic breast cancer received four cycles of doxorubicin (75 mg/m2) and cyclophosphamide (3000 mg/m2) at 3 week intervals. Apheresis was performed after the first cycle and if necessary after the second cycle. Stem cells were reinfused after the third and fourth cycles. G-CSF was started on day 3 of each cycle (5 microg/kg/day) and was stopped the day before the last apheresis or when absolute neutrophil count was above 0.5 x 10(9)/l. Median received dose-intensity was respectively 25 mg/m2/week (range 22-26) and 1000 mg/m2/week (range 904-1065) for doxorubicin and cyclophosphamide. Grade IV thrombocytopenia occurred in 8% of cycles. Two patients needed platelets and 12 red cell transfusion. Fifteen patients were readmitted for a median duration of 4 days (range 1-7). We have established a safe, outpatient, high-dose intensity doxorubicin-cyclophosphamide regimen with supporting G-CSF and blood stem cells which can be submitted for comparison with the current standards.
authors.affiliation: Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France.
authors.forename: P
authors.initials: P
authors.lastname: Viens
authors.forename: G
authors.initials: G
authors.lastname: Gravis
authors.forename: D
authors.initials: D
authors.lastname: Genre
authors.forename: F
authors.initials: F
authors.lastname: Bertucci
authors.forename: D
authors.initials: D
authors.lastname: Cowen
authors.forename: J
authors.initials: J
authors.lastname: Camerlo
authors.forename: M A
authors.initials: MA
authors.lastname: Cappiello
authors.forename: M
authors.initials: M
authors.lastname: Conte
authors.forename: M
authors.initials: M
authors.lastname: Finaud
authors.forename: C
authors.initials: C
authors.lastname: Chabannon
authors.forename: G
authors.initials: G
authors.lastname: Houvenaeghel
authors.forename: D
authors.initials: D
authors.lastname: Maraninchi
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome