title: High-dose chemotherapy with autologous stem cell support in patients with responding stage IV breast cancer.
abstract: Ninety-four patients underwent high-dose chemotherapy with stem cell support for stage IV breast cancer. The high-dose chemotherapy consisted of the Stamp V regimen in all patients comprising cyclophosphamide, thiotepa and carboplatin (CTCb). Twenty-three patients received sequential high-dose therapies with the first consisting of high-dose melphalan and the second of Stamp V. Two patients died from chemotherapy-related complications resulting in a transplant-related mortality at 100 days of 2.2%. The progression-free survival at 3 years was 36% in patients with no evidence of disease at the first course of high-dose therapy compared with 17% in patients with remaining disease at time of the high-dose therapy (P = 0.03). There was no difference in overall survival between patients with no evidence of disease and other patients. The source of stem cells, single or double courses of high-dose therapy, positive selection of CD34+ cells, or number of involved sites had no influence on either progression-free survival or overall survival. Further studies of more intensive induction chemotherapy followed by high-dose therapy with stem cell support are indicated.
authors.affiliation: Dept. of Hematology, Huddinge University Hospital, Karolinska Institutet, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
authors.forename: B
authors.initials: B
authors.lastname: Björkstrand
authors.forename: T
authors.initials: T
authors.lastname: Fornander
authors.forename: M
authors.initials: M
authors.lastname: Höglund
authors.forename: G
authors.initials: G
authors.lastname: Juliusson
authors.forename: H
authors.initials: H
authors.lastname: Lindman
authors.forename: A
authors.initials: A
authors.lastname: Malmström
authors.forename: S
authors.initials: S
authors.lastname: Rotstein
authors.forename: M
authors.initials: M
authors.lastname: Söderberg
authors.forename: N
authors.initials: N
authors.lastname: Wilking
authors.forename: K
authors.initials: K
authors.lastname: Villman
authors.forename: J
authors.initials: J
authors.lastname: Bergh
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008875:Middle Aged; D014182:Transplantation, Autologous