Faculty Collaboration Database

High-dose chemotherapy with autologous hematopoietic stem-cell support for breast cancer in North America. J Clin Oncol 1997 May;15(5):1870-9

Date

05/01/1997

Pubmed ID

9164197

DOI

10.1200/JCO.1997.15.5.1870

Scopus ID

2-s2.0-0030979431 (requires institutional sign-in at Scopus site)   309 Citations

Abstract

PURPOSE: To identify trends in high-dose therapy with autologous hematopoietic stem-cell support (autotransplants) for breast cancer (1989 to 1995).

PATIENTS AND METHODS: Analysis of patients who received autotransplants and were reported to the Autologous Blood and Marrow Transplant Registry. Between January 1, 1989 and June 30, 1995, 19,291 autotransplants were reviewed; 5,886 were for breast cancer. Main outcomes were progression-free survival (PFS) and survival.

RESULTS: Between 1989 and 1995, autotransplants for breast cancer increased sixfold. After 1992, breast cancer was the most common indication for autotransplant. Significant trends included increasing use for locally advanced rather than metastatic disease (P < .00001) and use of blood-derived rather than marrow-derived stem cells (P < .00001). One-hundred-day mortality decreased from 22% to 5% (P < .0001). Three-year PFS probabilities were 65% (95% confidence intervals [Cls], 59 to 71) for stage 2 disease, and 60% (95% Cl, 53 to 67) for stage 3 disease. In metastatic breast cancer, 3-year probabilities of PFS were 7% (95% Cl, 4 to 10) for women with no response to conventional dose chemotherapy; 13% (95% Cl, 9 to 17) for those with partial response; and 32% (95% Cl, 27 to 37) for those with complete response. Eleven percent of women with stage 2/3 disease and less than 1% of those with stage 4 disease participated in national cooperative group randomized trials.

CONCLUSION: Autotransplants increasingly are used to treat breast cancer. One-hundred-day mortality has decreased substantially. Three-year survival is better in women with earlier stage disease and in those who respond to pretransplant chemotherapy.

Author List

Antman KH, Rowlings PA, Vaughan WP, Pelz CJ, Fay JW, Fields KK, Freytes CO, Gale RP, Hillner BE, Holland HK, Kennedy MJ, Klein JP, Lazarus HM, McCarthy PL Jr, Saez R, Spitzer G, Stadtmauer EA, Williams SF, Wolff S, Sobocinski KA, Armitage JO, Horowitz MM

Author

Mary M. Horowitz MD, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Antineoplastic Agents
Breast Neoplasms
Combined Modality Therapy
Female
Hematopoietic Stem Cell Transplantation
Humans
Middle Aged
Neoplasms, Second Primary
Randomized Controlled Trials as Topic
Registries
Transplantation, Autologous