High-dose therapy with peripheral blood stem cell (PBSC) support using an innovative mobilization regimen in patients with high-risk primary or chemoresponsive metastatic breast cancers
Journal
Breast Cancer Research and Treatment
Journal Volume
49
Journal Issue
3
Pages
237-244
Date Issued
1998
Author(s)
Lin M.-T.
Lin D.-T.
Lui L.-T.
Lin J.-F.
Chang Y.-S.
Yu S.-C.
Abstract
High-dose therapy followed by peripheral blood stem cell (PBSC) support was performed in 29 patients with primary high-risk (Group I) or chemoresponsive metastatic (Group II) breast cancer patients. Group I patients had received PBSC mobilization within 4 weeks of modified radical mastectomy. Group II patients had to achieve minimal residual disease (MRD) by induction chemotherapy before being considered eligible for PBSC mobilization and high-dose therapy. An innovative FE120C regimen (5-FU 600 mg/m2, i.v., day 1; epirubicin 120 mg/m2, i.v., day 1; cyclophosphamide 600 mg/m2, i.v., day 1) plus G-CSF (300 μg/day, subcutaneous injection for 9 days, from day 4 post-FE120 C) was used to mobilize PBSCs. After high-dose CTCb (cyclophosphamide 6000 mg/m2, thiothepa 500 mg/m2, carboplatin 800 mg/m2, in 4 days), patients received PBSC infusion and daily C-CSF 300 μg subcutaneous injection. There were 19 and 16 patients enrolled into Group I and Group II, respectively. Ten of the Group II patients had achieved minimal residual disease (MRD) after induction chemotherapy. The median numbers of mobilized total CD34+ cells for Group I and Group II patients were 27.3 (9.2 to 114.1) x 106/kg and 17.1 (5.9 to 69.1) x 106/kg respectively. The median time to neutrophil recovery (ANC ? 500/μL) was 8 and 9 days in Group I and II, respectively. The median time to platelet recovery (? 50,000/μL) was 10 and 15 days in Group I and II, respectively. No major treatment-related toxicities were noted. In Group I, 13 out of 19 patients (68.4%; 43-87%, 95% C.I.) remained recurrence-free with a median follow-up of 31 months (6+ to 55+ months). In Group II, 3 out of 10 patients (30%; 7-65%, 95% C.I.) remained progression-free at 33+, 35+, 39+ months from induction therapy. We suggest that the FE120C plus G-CSF is an effective and innovative regimen for PBSC mobilization in breast cancer patients, and high-dose CTCb therapy with PBSC support is a safe and well-tolerated treatment modality.
SDGs
Other Subjects
carboplatin; cd34 antigen; cyclophosphamide; epirubicin; fluorouracil; recombinant granulocyte colony stimulating factor; thiotepa; adult; article; breast cancer; cancer recurrence; clinical article; clinical trial; diarrhea; drug infusion; drug safety; drug tolerability; female; fever; follow up; hematopoietic stem cell transplantation; human; human cell; infection; intravenous drug administration; leukocyte count; mastectomy; metastasis; minimal residual disease; mucosa inflammation; nausea; neutropenia; neutrophil; priority journal; subcutaneous drug administration; thrombocyte count; vomiting; Adult; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Clinical Protocols; Cyclophosphamide; Epirubicin; Female; Fluorouracil; Follow-Up Studies; Granulocyte Colony-Stimulating Factor; Humans; Mastectomy, Modified Radical; Middle Aged; Radiotherapy, Adjuvant; Recurrence; Survival Rate
Type
journal article