autologous blood and marrow transplantation - Blog Science ...

The Presence of Micrometastases in Bone Marrow and
Blood in High-Risk Stage II Breast Cancer Patients
Before and After High-Dose Therapy
Gunnar Kvalheim, Bjern Erikstein, Ester Gilen, Iris Her
Wide Sommer, Gunn Anker, Ragnar Tellhaug,
Arne Kolstad, John M. Nesland.
Clinical Stem Cell Laboratory (G.K., E.G., I.H.), Department of Medical
Oncology and Radiotherapy (B.E.), Department of Pathology (J.M.N.),
The Norwegian Radium Hospital, University of Oslo; Department of
Medical Oncology and Radiotherapy (H.S.), Ullevdl Hospital, Oslo;
Department of Medical Oncology and Radiotherapy (G.A.),
Haukeland Hospital; Department of Medical Oncology and
Radiotherapy (R.T.), University Hospital, Trondheim;
Department of Medical Oncology and Radiotherapy (A.K.),
University Hospital, Troms0, Norway.
INTRODUCTION
The majority of breast carcinoma patients are not in advanced stages when first
diagnosed and are considered potentially curable. However, about 50% of these
patients will subsequently develop recurrent disease. Even in patients without
tumor involvement in axillary lymph nodes (LNs) at surgery, there is a death rate
of 25% over a decade. Previous reports have demonstrated that adjuvant
chemotherapy improves the outcome of both lymph node positive (LN +
) and
negative (LN~) breast cancer patients. 1
Prognostic factors such as tumor size and
histological grade have been reported to be of clinical value in selecting
unfavorable prognostic LN~ and LN +
patients. 2
Despite these factors, however, a
high proportion of patients in the low-risk group will experience recurrences of the
disease. This underscores the need for more basic knowledge about individual
breast cancer patients.
New treatment modalities for breast cancer patients are under development.
High-dose chemotherapy with autologous hematopoietic progenitor cell support is
being used with increasing frequency to treat breast cancer patients with poor
prognosis. 3-5
The most common cause for the ultimate failure of an autologous
transplant is not lack of engraftment, toxicity of therapy, or infection, but rather
relapse of disease. There is evidence that reinfusion of autografts containing tumor
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