VI Autologous Bone Marrow Transplantation.pdf - Blog Science ...

tors both for progression-free survival and for overall survival. Probability values
for these five variables are respectively: (1) soft-tissue site (P=.047 and .013);
(2) liver site (P=.007 and .007); (3) prior chemotherapy (P=.004 and .008); (4) disease-free
interval from mastectomy to metastasis < 1 year (P=.027 and .047); (5)
non-caucasian race (P=.0001 and .0002).
DISCUSSION
The observed overall complete remission rate of 55% is twice the (1%-21%)
range observed using conventional chemotherapy for this unfavorable subgroup
of patients. 0,2
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This report identifies a subset of patients who benefit the most as having 1-2
sites of disease primarily distributed to parenchymal lung or regional draining
lymph nodes. Prognostic Factors predicting for poor survival by this analysis
include liver site, soft-tissue site, >1 disease site, prior chemotherapy exposure,
short DFI, and non-caucasian race.
In this report progression-free survival and overall survival curves reveal a
plateau that persists at 5 year follow-up. The encouraging observed "overall
complete response" rate in this report (55%) is equivalent to most other reported
high-dose protocols (range 20-64%). wwo,n,i2,i3,i4,i5> other high-dose protocols
exclude patients over age 55, patients with stable disease, and report an early
toxic death rate of range 3%-40%. (8
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> Our low mortality of 8% while including
patients up to age 62 (in the pre-growth factor era), supports a double
high-dose approach.
REFERENCES
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Cancer. Cancer 70:129-135,1992.
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hormonally refractory breast cancer with double high-dose chemotherapy intensification
and bone marrow support. J Clin Oncol 8:1207-1216,1990.
8. Peters W, Shpall E: High-dose combination alkylating agents with bone marrow
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1988.
9. Antman K, Ayash L, Elias A, et al: A phase II study of high-dose cyclophosphamide,
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SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION