High-dose chemotherapy with autologous stem cell rescue in stage IIIB inflammatory breast cancer.
BACKGROUND
Despite the advances in breast cancer care, inflammatory breast cancer (IBC) has a poor prognosis. The purpose of this study was to determine the efficacy of high-dose chemotherapy (HDCT) with thiotepa, mitoxantrone and carboplatin (TMJ regimen) in women with TNM stage IIIB IBC.


METHODS
Between 1991 and 1998, twenty-eight patients with stage IIIB IBC underwent an autologous stem cell transplant after undergoing chemotherapy, surgery and/or radiation. Stem cells were collected from the bone marrow and periphery after mobilization with growth factors. Patients received thiotepa 250 mg/m2 once daily i.v. for 3 days, mitoxantrone 40 mg/m2 for 1 day and carboplatin 333 mg/m2 once daily i.v. for 3 days as the conditioning regimen for the HDCT. Radiation therapy and tamoxifen was offered to patients post HDCT if appropriate. Progression-free survival and overall survival was assessed over a 15-year period.


RESULTS
At the time of last follow-up in May, 2007, sixteen patients had relapsed. The median overall survival was 49.5 months. The median progression free survival was 40 months. There were no transplant-related deaths. Mucositis and infections were the major side-effects. These results show that HDCT with the TMJ regimen is safe and effective in patients with stage IIIB IBC.
Yalamanchili
Kiran
K
Division of Oncology and Hematology, New York Medical College and Zalmen A. Arlin Cancer Institute, Westchester Medical Center, Valhalla, NY, USA.
Lalmuanpuii
Judy
J
Waheed
Faisal
F
Farjami
Sassan
S
Kancherla
Ram
R
Qureshi
Zeeshan
Z
Hoang
Albert
A
Khaled
Yusuf
Y
Lake
Diana
D
Puccio
Carmello
C
Chun
Hoo G
HG
Seiter
Karen
K
Ahmed
Tauseef
T
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D033581:Stem Cell Transplantation / Q000379:methods*; D013852:Thiotepa / Q000008:administration & dosage / Q000009:adverse effects
D013852:Thiotepa; D016190:Carboplatin; D008942:Mitoxantrone