High-dose chemotherapy and autologous stem-cell transplantation in breast cancer

42 breast cancer patients were treated by high-dose chemotherapy (HDC) and autologous peripheral stem-cell transplantation (ASTx) in the Donauspital b etween 1992 and 1999. 24 patients had stage II/III breast cancer with high risk for relapse. The other 18 patients underwent HDC and ASTx in chemosens itive stage IV. After previous conventional chemotherapy peripheral stem-ce lls were harvested by one cycle of mobilisation chemotherapy (epirubicin/ta xol, FEC 120 or cyclophosphamide) followed by cytokine stimulation. 16 pati ents were treated by a tandem transplantation (conditioning protocol for 1( st) ASTx was melphalan 200 mg/m(2) and for 2(nd) transplant it was CTC: cyc lophosphamide 6 g/m(2). thiotepa 500 mg/m(2); carboplatin 800 mg/m(2)). The other m 26 patients received one HDC with CTC as conditioning protocol. Th e HDC was well tolerated by all patients, there was no transplant-related m ortality. The median survival and the progression-free survival (PFS) after HDC and ASTx in stage IV breast cancer patients were 28 and 11 months, res pectively. The median survival and PFS were not yet reached in stage II/III patients after 55 months. The actuarial survival and PFS in that patient g roup were 70 % after 55 months. Our data confirm the low risk and good effi cacy of HDC and ASTx in breast cancer patients. Nevertheless randomised stu dies are necessary to evaluate the importance of HDC compared to intensifie d conventional protocols without ASTx.