title: The clinical significance of tumor cells in bone marrow or apheresis product and the efficacy of CD34+ selection and high-dose chemotherapy in patients with Stage III breast cancer.
abstract: The purpose of this study is to determine the presence of disseminated tumor cells in bone marrow or apheresis product, and also to evaluate the clinical significance of contaminated products and the efficacy of CD34(+) selection and high-dose chemotherapy in patients with Stage III breast cancer. Fifty-five patients were enrolled in this prospective cohort study. Whereas CD34(+) positive selection was not carried out in the first group (unselected group, n:31), CD34(+) positive selection was performed in the second group (CD34 selected group, n:24). Tumor cells were detected with anticytokeratin monoclonal antibody in the bone marrow, apheresis product and positive fraction. Tumor cells were found in six (19.3%) patients in unselected group and four patients (16.6%) in CD34 selected group (P = 0.76). The percentages of distant metastases were found higher in unselected group (51.6% vs. 25%, P < 0.01). Although there were no differences between the two groups for disease free survival (DFS; 44% vs. 74%, P = 0.24) or overall survival (54% vs. 68%, P = 0.84), DFS was significantly lower in patients with tumor cells than in patients without tumor cells (21% vs. 62%, P = 0.02). In conclusion, the presence of tumor cells in bone marrow or apheresis product decreases DFS in patients with Stage III breast cancer who underwent high-dose chemotherapy. CD34(+) selection does not change survivals, but it may decrease the distant metastases.
authors.affiliation: Department of Medical Oncology, Gulhane Military Medical Academy, 06018 Etlik, Ankara, Turkey. farpaci@gata.edu.tr
authors.forename: Fikret
authors.initials: F
authors.lastname: Arpaci
authors.forename: Mukerrem
authors.initials: M
authors.lastname: Safali
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozet
authors.forename: Ali U
authors.initials: AU
authors.lastname: Ural
authors.forename: Turker
authors.initials: T
authors.lastname: Cetin
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozturk
authors.forename: Selmin
authors.initials: S
authors.lastname: Ataergin
authors.forename: Okan
authors.initials: O
authors.lastname: Kuzhan
authors.forename: Seref
authors.initials: S
authors.lastname: Komurcu
authors.forename: Bekir
authors.initials: B
authors.lastname: Ozturk
authors.forename: Cengizhan
authors.initials: C
authors.lastname: Acikel
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001781:Blood Component Removal; D001854:Bone Marrow Cells / Q000473:pathology*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D015996:Survival Rate