Autologous Bone Marrow Transplantation - Blog Science Connections

490 ABMTfor Breast Cancer
initial six patients were treated with high-dose cyclophosphamide alone and
the next four with the combination of cyclophosphamide and BCNU
(carmustine). Both groups of patients received cryopreserved nonpurged
autologous marrow cells following completion of drug therapy.
PATIENTS AND METHODS
All patients gave written informed consent to participate in the study after
it had been approved by the Institutional Review Board. Since the inception of
the trial, 30 premenopausal women who either had metastatic breast
carcinoma or were at high risk for relapse of stage II or III tumors have
undergone bone marrow procurement. Two patients were excluded because
of tumor contamination of the harvested marrow despite normal preharvest
marrow biopsies. Two others died of metastatic disease before marrow could
be transplanted. Of 26 patients eligible for the trial, 10 have received
transplantations thus far. The clinical characteristics of these patients are
shown in Table 1. Ages ranged from 37 to 53 years (median, 40 years). All
tumors were estrogen receptor (ER)- and progesterone receptor (PgR)-
negative, except for one in a woman with an ER-, PgR+ carcinoma that had
failed to respond to hormonal manipulation. All had measurable metastases,
and all but one had visceral disease. Patient number 4 with only skin and soft
tissue metastases had extensive chest wall inflammatory carcinoma that had
progressed despite local radiotherapy and combination chemotherapy.
Three of the patients had a poor performance status (3-4 on the Zubrod
scale). Seven had had prior radiotherapy. All 10 had received chemotherapy
prior to bone marrow harvesting, and only one had not been previously
treated with standard doses of cyclophosphamide. Five of the 10 had had
Table 1. Pretransplant Clinical Characteristics
Patient Age PS Prior Therapy Disease Sites
1 41 1 Ft", Mp 8 Pleura, lung, nodes
2 47 2 R a , CMF S Pleura
3 37 0 R a , CMF 8 , CAF Lung
4 53 1 R, CMF, Pt, A Chest wall
5 39 4 R a , CMF", CAPt, Vb Liver
6 53 1 T, Ma, CMF, A Lung,bone
7 39 3 CAF 8 , C, R, Vb Lung, liver, brain
8 37 2 CMF 8 , CAF a , R Lung, bone, brain
9 40 0 CMFPr 8 Lung,nodes
10 39 3 CAF 8 Lung, bone, nodes
"Adjuvant
therapy.
Abbreviations: PS, performance status (Zubrod); R, radiotherapy; Mp, melphalan;
C, cyclophosphamide; M, methotrexate; F, 5-fluorouracil; A, Adriamycin; Pt, cisplatin;
Vb, vinblastine; Pr, prednisone; T, tamoxifen; Ma, megestrol acetate.