High-dose chemotherapy and autologous stem cell support followed by posttransplantation doxorubicin as initial therapy for metastatic breast cancer

Margarida DeMagalhaes-Silverman, Elana Bloom, Barry Lembersky, John Lister, Steven Pincus, Witold Rybka, Michael Voloshin, John Wilson, Edward Ball

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

High-dose chemotherapy is associated with a high complete response rate and possibly some survival advantage in patients with metastatic breast cancer. We designed a clinical trial consisting of a two-step high-dose chemotherapy regimen followed by posttransplantation doxorubicin as the first chemotherapy treatment for metastatic disease. Twenty-one patients with metastatic breast cancer and no previous chemotherapy for metastatic disease were treated with high-dose cyclophosphamide (Cy; 5000 mg/m2), followed by granulocyte colony-stimulating factor. Peripheral blood stem cells were collected. Subsequently, patients received Cy (6000 mg/m2), thiotepa (500 mg/m2), and carboplatin (800 mg/m2) (CTCb) with hematopoietic rescue. Upon recovery of hematopoietic and gastrointestinal toxicity, three cycles of doxorubicin (Dox; 60 mg/m2) were delivered. After Cy, nine patients (45%) developed neutropenic fevers. There were no episodes of bacteremia. Patients received CTCb 37 days after starting Cy and had a hospital stay of 19 days. After CTCb, the median number of days to an absolute neutrophil count > 5 x 109/liter was 8, and the median number of days to a platelet count > 20 x 109/liter was 9. Neutropenic fevers occurred in 12 patients. There were no hemorrhagic complications. Fifty-five of the 63 planned courses of Dox were delivered. The median time from peripheral blood stem cell infusion to the first Dox cycle was 38 days. The median time to the second Dox cycle was 28 days, and to the last cycle was 30 days. Three episodes of neutropenic fevers were observed. Two patients developed herpes zoster. This regimen is feasible, with acceptable toxicity.

Original languageEnglish (US)
Pages (from-to)193-197
Number of pages5
JournalClinical Cancer Research
Volume3
Issue number2
StatePublished - Mar 18 1997

Fingerprint

Doxorubicin
Stem Cells
Breast Neoplasms
Drug Therapy
Fever
Therapeutics
Thiotepa
Carboplatin
Herpes Zoster
Granulocyte Colony-Stimulating Factor
Bacteremia
Platelet Count
Cyclophosphamide
Length of Stay
Neutrophils
Clinical Trials
Survival

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

DeMagalhaes-Silverman, Margarida ; Bloom, Elana ; Lembersky, Barry ; Lister, John ; Pincus, Steven ; Rybka, Witold ; Voloshin, Michael ; Wilson, John ; Ball, Edward. / High-dose chemotherapy and autologous stem cell support followed by posttransplantation doxorubicin as initial therapy for metastatic breast cancer. In: Clinical Cancer Research. 1997 ; Vol. 3, No. 2. pp. 193-197.
@article{4d23243df39b414fbcf80e50cdeec5f1,
title = "High-dose chemotherapy and autologous stem cell support followed by posttransplantation doxorubicin as initial therapy for metastatic breast cancer",
abstract = "High-dose chemotherapy is associated with a high complete response rate and possibly some survival advantage in patients with metastatic breast cancer. We designed a clinical trial consisting of a two-step high-dose chemotherapy regimen followed by posttransplantation doxorubicin as the first chemotherapy treatment for metastatic disease. Twenty-one patients with metastatic breast cancer and no previous chemotherapy for metastatic disease were treated with high-dose cyclophosphamide (Cy; 5000 mg/m2), followed by granulocyte colony-stimulating factor. Peripheral blood stem cells were collected. Subsequently, patients received Cy (6000 mg/m2), thiotepa (500 mg/m2), and carboplatin (800 mg/m2) (CTCb) with hematopoietic rescue. Upon recovery of hematopoietic and gastrointestinal toxicity, three cycles of doxorubicin (Dox; 60 mg/m2) were delivered. After Cy, nine patients (45{\%}) developed neutropenic fevers. There were no episodes of bacteremia. Patients received CTCb 37 days after starting Cy and had a hospital stay of 19 days. After CTCb, the median number of days to an absolute neutrophil count > 5 x 109/liter was 8, and the median number of days to a platelet count > 20 x 109/liter was 9. Neutropenic fevers occurred in 12 patients. There were no hemorrhagic complications. Fifty-five of the 63 planned courses of Dox were delivered. The median time from peripheral blood stem cell infusion to the first Dox cycle was 38 days. The median time to the second Dox cycle was 28 days, and to the last cycle was 30 days. Three episodes of neutropenic fevers were observed. Two patients developed herpes zoster. This regimen is feasible, with acceptable toxicity.",
author = "Margarida DeMagalhaes-Silverman and Elana Bloom and Barry Lembersky and John Lister and Steven Pincus and Witold Rybka and Michael Voloshin and John Wilson and Edward Ball",
year = "1997",
month = "3",
day = "18",
language = "English (US)",
volume = "3",
pages = "193--197",
journal = "Clinical Cancer Research",
issn = "1078-0432",
publisher = "American Association for Cancer Research Inc.",
number = "2",

}

DeMagalhaes-Silverman, M, Bloom, E, Lembersky, B, Lister, J, Pincus, S, Rybka, W, Voloshin, M, Wilson, J & Ball, E 1997, 'High-dose chemotherapy and autologous stem cell support followed by posttransplantation doxorubicin as initial therapy for metastatic breast cancer', Clinical Cancer Research, vol. 3, no. 2, pp. 193-197.

High-dose chemotherapy and autologous stem cell support followed by posttransplantation doxorubicin as initial therapy for metastatic breast cancer. / DeMagalhaes-Silverman, Margarida; Bloom, Elana; Lembersky, Barry; Lister, John; Pincus, Steven; Rybka, Witold; Voloshin, Michael; Wilson, John; Ball, Edward.

In: Clinical Cancer Research, Vol. 3, No. 2, 18.03.1997, p. 193-197.

Research output: Contribution to journalArticle

TY - JOUR

T1 - High-dose chemotherapy and autologous stem cell support followed by posttransplantation doxorubicin as initial therapy for metastatic breast cancer

AU - DeMagalhaes-Silverman, Margarida

AU - Bloom, Elana

AU - Lembersky, Barry

AU - Lister, John

AU - Pincus, Steven

AU - Rybka, Witold

AU - Voloshin, Michael

AU - Wilson, John

AU - Ball, Edward

PY - 1997/3/18

Y1 - 1997/3/18

N2 - High-dose chemotherapy is associated with a high complete response rate and possibly some survival advantage in patients with metastatic breast cancer. We designed a clinical trial consisting of a two-step high-dose chemotherapy regimen followed by posttransplantation doxorubicin as the first chemotherapy treatment for metastatic disease. Twenty-one patients with metastatic breast cancer and no previous chemotherapy for metastatic disease were treated with high-dose cyclophosphamide (Cy; 5000 mg/m2), followed by granulocyte colony-stimulating factor. Peripheral blood stem cells were collected. Subsequently, patients received Cy (6000 mg/m2), thiotepa (500 mg/m2), and carboplatin (800 mg/m2) (CTCb) with hematopoietic rescue. Upon recovery of hematopoietic and gastrointestinal toxicity, three cycles of doxorubicin (Dox; 60 mg/m2) were delivered. After Cy, nine patients (45%) developed neutropenic fevers. There were no episodes of bacteremia. Patients received CTCb 37 days after starting Cy and had a hospital stay of 19 days. After CTCb, the median number of days to an absolute neutrophil count > 5 x 109/liter was 8, and the median number of days to a platelet count > 20 x 109/liter was 9. Neutropenic fevers occurred in 12 patients. There were no hemorrhagic complications. Fifty-five of the 63 planned courses of Dox were delivered. The median time from peripheral blood stem cell infusion to the first Dox cycle was 38 days. The median time to the second Dox cycle was 28 days, and to the last cycle was 30 days. Three episodes of neutropenic fevers were observed. Two patients developed herpes zoster. This regimen is feasible, with acceptable toxicity.

AB - High-dose chemotherapy is associated with a high complete response rate and possibly some survival advantage in patients with metastatic breast cancer. We designed a clinical trial consisting of a two-step high-dose chemotherapy regimen followed by posttransplantation doxorubicin as the first chemotherapy treatment for metastatic disease. Twenty-one patients with metastatic breast cancer and no previous chemotherapy for metastatic disease were treated with high-dose cyclophosphamide (Cy; 5000 mg/m2), followed by granulocyte colony-stimulating factor. Peripheral blood stem cells were collected. Subsequently, patients received Cy (6000 mg/m2), thiotepa (500 mg/m2), and carboplatin (800 mg/m2) (CTCb) with hematopoietic rescue. Upon recovery of hematopoietic and gastrointestinal toxicity, three cycles of doxorubicin (Dox; 60 mg/m2) were delivered. After Cy, nine patients (45%) developed neutropenic fevers. There were no episodes of bacteremia. Patients received CTCb 37 days after starting Cy and had a hospital stay of 19 days. After CTCb, the median number of days to an absolute neutrophil count > 5 x 109/liter was 8, and the median number of days to a platelet count > 20 x 109/liter was 9. Neutropenic fevers occurred in 12 patients. There were no hemorrhagic complications. Fifty-five of the 63 planned courses of Dox were delivered. The median time from peripheral blood stem cell infusion to the first Dox cycle was 38 days. The median time to the second Dox cycle was 28 days, and to the last cycle was 30 days. Three episodes of neutropenic fevers were observed. Two patients developed herpes zoster. This regimen is feasible, with acceptable toxicity.

UR - http://www.scopus.com/inward/record.url?scp=0031029404&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031029404&partnerID=8YFLogxK

M3 - Article

C2 - 9815672

AN - SCOPUS:0031029404

VL - 3

SP - 193

EP - 197

JO - Clinical Cancer Research

JF - Clinical Cancer Research

SN - 1078-0432

IS - 2

ER -