Effective treatment of a patient with a high-grade endometrial stromal sarcoma with an accelerated regimen of carboplatin and paclitaxel

The rarity of endometrial stromal sarcoma (ESS) and its poor response to tr eatment provides fertile ground for investigational therapies. An accelerat ed regimen of carboplatin and paclitaxel is investigated. A patient with a recent history of treated tuberculosis of the lung represented with inferti lity and acute abdominal pain from suspected fibroids, and underwent a lapa rotomy with a diagnosis of a high-grade ESS. A novel therapeutic approach u sing a regimen of carboplatin and paclitaxel with the reinfusion of filgras tim-mobilized peripheral blood progenitor cells is described. A partial res ponse was observed following six cycles of chemotherapy. Grade IV thrombocy topenia occurred after the last cycle, with recovery prior to pelvic radiot herapy. The patient remained well 1 year post-diagnosis. High-grade ESS is responsive to combination chemotherapy with paclitaxel and carboplatin, and requires further evaluation. The use of an accelerated regimen may also ha ve contributed to the response and this question awaits randomized trials. [(C) 2000 Lippincott Williams & Wilkins.].