HIGH-DOSE CHEMOTHERAPY WITH AUTOLOGOUS STEM-CELL SUPPORT IN PATIENTS WITH RESPONDING STAGE-IV BREAST-CANCER

Ninety-four patients underwent high-dose chemotherapy with stem cell s upport for stage IV breast cancer. The high-dose chemotherapy consiste d of the Stamp V regimen in all patients comprising cyclophosphamide, thiotepa and carboplatin (CTCb), Twenty-three patients received sequen tial high-dose therapies with the first consisting of high-dose melpha lan and the second of Stamp V. Two patients died from chemotherapy-rel ated complications resulting in a transplant-related mortality at 100 days of 2.2%, The progression-free survival at 3 years was 36% in pati ents with no evidence of disease at the first course of high-dose ther apy compared with 17% in patients with remaining disease at time of th e high-dose therapy (P = 0.03), There was no difference in overall sur vival between patients with no evidence of disease and other patients. The source of stem cells, single or double courses of high-dose thera py, positive selection of CD34(+) cells, or number of involved sites h ad no influence on either progression-free survival or overall surviva l. Further studies of more intensive induction chemotherapy followed b y high-dose therapy with stem cell support are indicated.