High-dose chemotherapy and hematopoietic support for patients with high-risk primary breast cancer and involvement of 4 to 9 lymph nodes.

Journal Article (Clinical Trial;Journal Article)

Despite modern chemotherapy, advanced breast cancer remains a significant cause of cancer morbidity and mortality in women. Patients with disease involvement of multiple lymph nodes represent a subgroup with a high risk of relapse. In particular, 50% of patients with 4 to 9 axillary lymph nodes involved will relapse after standard chemotherapy. In an effort to improve the survival of patients with 4 to 9 involved nodes, we performed a phase II study in which 61 patients with surgically diagnosed stage II or III breast cancer and 4 to 9 positive lymph nodes received 3 cycles of doxorubicin and 5-fluorouracil followed by high-dose chemotherapy consisting of cisplatin, cyclophosphamide, and carmustine and infusion of autologous hematopoietic progenitor cells. All patients received posttransplantation localized radiotherapy unless contraindicated, and all patients with hormone receptor-positive disease received tamoxifen. After a median patient follow-up of 6.7 years (range, 4.6-8.6 years), the 5-year overall survival rate was 79% (95% CI, 69%-90%), with relapse-free survival of 73% (95% CI, 62%-85%). Treatment-related mortality was 3%. Interstitial pneumonitis occurred in 69% of patients but did not contribute to mortality. Our study presents long-term favorable results regarding the use of consolidative HDC with autologous hematopoietic support in previously untreated patients with high-risk primary breast cancer.

Full Text

Duke Authors

Cited Authors

  • Stuart, MJ; Peters, WP; Broadwater, G; Hussein, A; Ross, M; Marks, LB; Folz, RJ; Long, GD; Rizzieri, D; Chao, NJ; Vredenburgh, JJ

Published Date

  • 2002

Published In

Volume / Issue

  • 8 / 12

Start / End Page

  • 666 - 673

PubMed ID

  • 12523579

International Standard Serial Number (ISSN)

  • 1083-8791

Digital Object Identifier (DOI)

  • 10.1053/bbmt.2002.v8.abbmt080666


  • eng

Conference Location

  • United States