HIGH-DOSE THERAPY WITH AUTOLOGOUS BONE-MARROW TRANSPLANTATION AS A SALVAGE REGIMEN FOR OVARIAN-CANCER

Between 1983 and 1988, eight patients with refractory epithelial ovari an cancer were treated with marrow ablative chemoradiotherapy followed by autologous bone marrow transplantation. By using a high dose regim en it was proposed that improved tumor response would be achieved, lea ding to increased patient salvage. The regimen consisted of cyclophosp hamide 60 mg per kilogram per day intravenously (IV) for two consecuti ve days in seven patients and one patient received melphalan 180 mg/m( 2)IV. In conjunction with the chemotherapy the patients received 12.5 Gray of radiation in 2.5 Gray fractions, to the total body in five pat ients and to the trunk in three patients. All patients had Stage III o r IV disease and had previously been treated with cisplatin. All had s urgically documented minimal (less than 5 millimeters) disease prior t o high dose therapy (HDT). There were three treatment related deaths. The remaining patients had disease recurrence noted from 7 to 13 month s after HDT. This study suggests that a different therapeutic regimen should be considered in future studies utilizing HDT with autologous b one marrow transplantation for refractory ovarian cancer.