Autologous Bone Marrow Transplantation - Blog Science Connections

480 Phase I and II Studies of Alkylating Agents in Breast Cancer
to normal after 1 month of dialysis. The etiology was not documented but the
problem may have been caused by dimethyl sulfoxide toxicity.
DISCUSSION
In this phase 1 and 11 study we showed, as others have done (6,7), that high
doses of alkylating agents followed by ABMT were able to induce a high
response rate with acceptable toxic effects, in patients with advanced breast
cancer.
Transplantation-related deaths were observed in the first two patients
whose performance status was extremely poor at that time and who had a
long history of multiresistant disease. Despite intensification of the conditioning
regimen by the addition of other alkylating agents to melphalan, the next
patients' tolerance of the procedure was quite acceptable; these patients were
treated sooner after the diagnosis, and they had a good performance status.
Although the response rate was exceptionally high for these patients (five
objective responses among six patients), the short duration of these
responses was generally disappointing. Local recurrences were a major
cause of failure in the patients treated early in the evolution of inflammatory
breast cancer, which suggests that these patients may need adjuvant
extensive local-regional radiotherapy.
Our current data invite us to use high doses of a combination of
alkylating agents and ABMT early in the disease course of selected patients
with inflammatory breast cancer, in association with extensive radiotherapy.
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