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High-dose chemotherapy and autologous stem-cell transplantation for ovarian cancer: an autologous blood and marrow transplant registry report. Ann Intern Med 2000 Oct 03;133(7):504-15 PMID: 11015163

Pubmed ID

11015163

Abstract

BACKGROUND: Autologous transplantation is increasingly used to treat epithelial ovarian cancer. However, it is not clear which patients may benefit.

OBJECTIVE: To determine overall and progression-free survival and factors associated with favorable outcome after autotransplantation for ovarian cancer.

DESIGN: Observational cohort study.

SETTING: 57 centers reporting to the Autologous Blood and Marrow Transplant Registry (ABMTR).

PATIENTS: 421 women who received transplants between 1989 and 1996.

INTERVENTIONS: High-dose chemotherapy using diverse regimens with hematopoietic stem-cell rescue.

MEASUREMENTS: Primary outcomes were progression-free survival and overall survival. Multivariate analyses using Cox proportional hazards regression considered the following factors: age, Karnofsky performance score, initial stage, histologic characteristics, previous therapy, remission status, extent of disease, graft source, transplant regimen, and year of transplantation.

RESULTS: Most patients had extensive previous chemotherapy. Forty-one percent had platinum-resistant tumors, and 38% had tumors at least 1 cm in diameter. Only 34 patients (8%) received transplants as part of initial therapy. The probability of death within 100 days was 11% (95% CI, 8% to 14%). Two-year progression-free survival was 12% (CI, 9% to 16%), and 2-year overall survival was 35% (CI, 30% to 41%). Younger age, Karnofsky performance score of at least 90%, non-clear-cell disease, remission at transplantation, and platinum sensitivity were associated with better outcomes. Progression-free and overall survival were 22% (CI, 12% to 33%) and 55% (CI, 42% to 66%), respectively, for women with a high Karnofsky performance score and non-clear-cell, platinum-sensitive tumors.

CONCLUSIONS: Some subgroups of patients with ovarian cancer seem to have good outcomes after autotransplantation, although several biases may have affected these observations. Phase III trials are needed to compare such outcomes with outcomes of conventional chemotherapy.

Author List

Stiff PJ, Veum-Stone J, Lazarus HM, Ayash L, Edwards JR, Keating A, Klein JP, Oblon DJ, Shea TC, Thomé S, Horowitz MM

Author

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




Scopus

2-s2.0-0034601768   44 Citations

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

Age Factors
Antineoplastic Agents
Antineoplastic Combined Chemotherapy Protocols
Carcinoma
Cohort Studies
Combined Modality Therapy
Data Interpretation, Statistical
Disease Progression
Drug Resistance, Neoplasm
Female
Hematopoietic Stem Cell Transplantation
Humans
Neoplasm Staging
Ovarian Neoplasms
Remission Induction
Survival Rate
Transplantation, Autologous
jenkins-FCD Prod-331 a335b1a6d1e9c32173c9534e6f6ff51494143916