Autologous Bone Marrow Transplantation - Blog Science Connections

Treatment Strategies in Breast Cancer 469
infusion over 1 hour, cisplatin as a continuous infusion over 3 days, and
carmustine intravenously at 5 mg/m 2 /minute. Thio-TEPA and melphalan
were given as intravenous infusions over 2 hours. The pharmacokinetics of
these agents were measured and reported elsewhere (15-17).
Supportive Care
Patients were treated in simple reverse isolation using a low-bacterial,
low-fungal-content diet. Their hematocrit was maintained at more than 42%,
and platelets were transfused to maintain a platelet count higher than
20,000/mm3.
RESULTS
High-dose combination alkylating-agent therapy with ABMS resulted in
frequent and rapid regressions of measurable breast cancer lesions in the
treated patients. Despite the similar frequency of objective tumor regression
in patients who had or had not received previous chemotherapy for
metastatic breast cancer, the two groups differed in the frequency of
complete response and in the time to treatment failure. Table 3 shows the
objective response rates in treated patients. The overall response rate was
similar among patients who received high-dose combination alkylating
agents as initial therapy or after previous treatment with standard chemotherapy.
The frequency of complete response was substantially higher,
however, among patients who were treated with the combination of cyclophosphamide,
cisplatin, and carmustine as their initial treatment for metastatic
disease.
Figures 1 and 2 show the time to treatment failure for all responding
Table 3. Treatment Results of High-Dose Chemotherapy and Autologous Bone
Marrow Support
Disease Status
Response
No. Treated/
No. Evaluable
Treatment Program 3 for Response % CR + PR % CR
No previous chemotherapy 21/16 14 50
(88 days)
CPA, cisplatin, and carmustine
Previous chemotherapy 12/9 7 33
CPA, cisplatin, and phenylalanine
mustard
(78 days)
CPA, cisplatin, and thio-TEPA
Abbreviations: CR, complete response; PR, partial response; CPA,
cyclophosphamide.
"Treatment programs described in Table 2.