Late intensification with high-dose melphalan and autologous bone marrow support in breast cancer patients responding to conventional chemotherapy

Fifteen patients with advanced breast cancer who had achieved either a good partial or a complete response to conventional chemotherapy were selected to receive intensification treatment with high-dose melphalan 140-200 mg/m2 (HDM). All patients received autologous bone marrow rescue. All patients e...

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Bibliographic Details
Published in:Cancer chemotherapy and pharmacology 1988-01, Vol.21 (3), p.255-260
Main Authors: VINCENT, M. D, POWLES, T. J, COOMBES, R. C, MCELWAIN, T. J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antineoplastic agents
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Bone Marrow Transplantation
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Breast Neoplasms - therapy
Chemotherapy
Combined Modality Therapy
Evaluation Studies as Topic
Female
Humans
Medical sciences
Melphalan - adverse effects
Melphalan - therapeutic use
Middle Aged
Neoplasm Recurrence, Local
Neutropenia - chemically induced
Neutropenia - therapy
Pharmacology. Drug treatments
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Summary:Fifteen patients with advanced breast cancer who had achieved either a good partial or a complete response to conventional chemotherapy were selected to receive intensification treatment with high-dose melphalan 140-200 mg/m2 (HDM). All patients received autologous bone marrow rescue. All patients experienced marked haematological toxicity, and most experienced moderate or mild gastrointestinal side effects. There were three treatment-related deaths. Of twelve assessable patients eleven have relapsed; median time to relapse after HDM is 7 months. Nine of these eleven have died from recurrent breast cancer. Of the three patients remaining alive, only one is disease-free, at 18 months after HDM. Analysis of the pattern of metastatic relapse suggests that recurrence was due to failure of HDM to eradicate residual disease in the patient, rather than reinfusion of viable tumour cells. Treatment intensification with HDM has not succeeded in prolonging survival in patients already in good remission.
ISSN:0344-5704
1432-0843
DOI:10.1007/BF00262781