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Titolo:
Tandem-cycle high-dose melphalan and cisplatin with peripheral blood progenitor cell support in patients with breast cancer and other malignancies
Autore:
Somlo, G; Chow, W; Hamasaki, V; Leong, L; Margolin, K; Morgan, R; Sniecinski, I; Frankel, P; Reardon, D; Longmate, J; Raschko, J; Shibata, S; ODonnell, M; Smith, E; Tetef, M; Forman, S; Yen, Y; Molina, A; Doroshow, JH;
Indirizzi:
City Hope Natl Med Ctr, Dept Med Oncol, Duarte, CA 91010 USA City Hope Natl Med Ctr Duarte CA USA 91010 ed Oncol, Duarte, CA 91010 USA City Hope Natl Med Ctr, Dept Therapeut Res, Duarte, CA 91010 USA City HopeNatl Med Ctr Duarte CA USA 91010 peut Res, Duarte, CA 91010 USA City Hope Natl Med Ctr, Dept Transfus Med, Duarte, CA 91010 USA City Hope Natl Med Ctr Duarte CA USA 91010 sfus Med, Duarte, CA 91010 USA City Hope Natl Med Ctr, Dept Biostat, Duarte, CA 91010 USA City Hope Natl Med Ctr Duarte CA USA 91010 Biostat, Duarte, CA 91010 USA City Hope Natl Med Ctr, Dept Hematol & Bone Marrow Transplantat, Duarte, CA 91010 USA City Hope Natl Med Ctr Duarte CA USA 91010 splantat, Duarte, CA 91010 USA
Titolo Testata:
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
fascicolo: 5, volume: 7, anno: 2001,
pagine: 284 - 293
SICI:
1083-8791(2001)7:5<284:THMACW>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
COLONY-STIMULATING FACTOR; BONE-MARROW SUPPORT; PHASE-I TRIAL; HEMATOPOIETIC RECOVERY; AUTOLOGOUS MARROW; PROGRESSION-FREE; CHEMOTHERAPY; STEM; CYCLOPHOSPHAMIDE; THERAPY;
Keywords:
melphalan; cisplatin; breast cancer; high-dose chemotherapy; stem cell transplantation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
42
Recensione:
Indirizzi per estratti:
Indirizzo: Somlo, G City Hope Natl Med Ctr, Dept Med Oncol, 1500 E Duarte Rd, Duarte,CA 91010USA City Hope Natl Med Ctr 1500 E Duarte Rd Duarte CA USA 91010 10USA
Citazione:
G. Somlo et al., "Tandem-cycle high-dose melphalan and cisplatin with peripheral blood progenitor cell support in patients with breast cancer and other malignancies", BIOL BLOOD, 7(5), 2001, pp. 284-293

Abstract

We evaluated the feasibility of tandem-cycle high-dose chemotherapy (HDCT)with cisplatin, melphalan, and peripheral blood progenitor cells (PBPCs). Fifty patients with high-risk primary (n = 17) or stage TV breast cancer (n= 29) or other malignancies (n = 4) received 2 cycles of intravenous melphalan, 20 to 151.8 mg/m(2), and cisplatin, 200 mg/m(2), followed by granulocyte-macrophage colony-stimulating factor (GM-CSF) or G-CSE Starting at 40 mg/m(2) of melphalan, patients also received PBPCs. Delayed platelet recovery defined the maximum tolerated dose (MTD) for melphalan at 101.2 mg/m(2) per cycle. There were no treatment-related deaths. Cycle 2 was delivered at a median of 1.7 months after cycle 1; 72% of patients treated at the MTD received both cycles. Cycle 2 was omitted when patients refused it or had disease progression or toxicities, primarily prolonged thrombocytopenia. Complete response rates in stage TV breast cancer patients increased from 28% pre-HDCT to 55% after cycle 2. At a median follow-up of 4.6 years (range, 1.5-8.1 years), 11 of 29 patients with stage IV breast carcinoma were alive with 5-year projected progression-free and overall survival rates of 19% (95%confidence interval [CI], 7%-41%) and 39% (95% CI, 20%-62%), respectively. Five-year projected progression-free and overall survival rates for patients with stage TV breast cancer in complete response following HDCT versus all others were 35% (95% CI, 15%-70%) versus 0% (P = .01) and 61% (95% CI, 35%-91%) versus 10% (95% CI, 2%-60%) (P = .003; log-rank test), respectively. Estrogen-receptor positivity was predictive of reduced risk of progression (relative risk [RR], 0.25; 95% CI, 0.10-0.65; P = .003) and death (RR, 0.27; 95% CI, 0.10-0.72; P = .009) after adjusting for response status. Five-year projected relapse-free and overall survival rates were 71% (95% CI, 43%-96%) and 82% (95% CI, 56%-100%), respectively, for the 17 patients with high-risk primary breast cancer. Tandem-cycle high-dose melphalan and cisplatin with PBPCs is feasible. Preliminary data suggest significant activity in selected patients with stage IV responding breast carcinoma.

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Documento generato il 11/07/20 alle ore 09:17:51