HIGH-DOSE SEQUENTIAL CHEMOTHERAPY WITH STEM-CELL SUPPORT FOR NONMETASTATIC BREAST-CANCER

The importance of dose-intensity has been suggested in breast cancer, The aim of this study was to evaluate the feasability of a high-dose i ntensity doxorubicin-cyclophosphamide regimen with supporting G-CSF an d blood stem cells, Twenty-five patients with non-metastatic breast ca ncer received four cycles of doxorubicin (75 mg/m(2)) and cyclophospha mide (3000 mg/m(2)) at 3 week intervals, Apheresis was performed after the first cycle and if necessary after the second cycle, Stem cells w ere reinfused after the third and fourth cycles, G-CSF was started on day 3 of each cycle (5 mu g/kg/day) and was stopped the day before the last apheresis or when absolute neutrophil count was above 0.5 x 10(9 )/l. Median received dose-intensity was respectively 25 mg/m(2)/week ( range 22-26) and 1000 mg/m(2)/week (range 904-1065) for doxorubicin an d cyclophosphamide, Grade IV thrombocytopenia occurred in 8% of cycles , Two patients needed platelets and 12 red cell transfusion, Fifteen p atients were readmitted for a median duration of 4 days (range 1-7), W e have established a safe, outpatient, high-dose intensity doxorubicin -cyclophosphamide regimen with supporting G-CSF and blood stem cells w hich can be submitted for comparison with the current standards.