High-dose carboplatin, thiotepa and cyclophosphamide (CTC) with peripheral blood stem cell support in the adjuvant therapy of high-risk breast cancer: A practical approach

E. Van der Wall, W. J. Nooijen, J. W. Baars, M. J. Holtkamp, J. H. Schornagel, D. J. Richel, E. J T Rutgers, I. C M Slaper-Cortenbach, C. E. Van der Schoot, S. Rodenhuis

Research output: Contribution to journalArticle

Abstract

In 29 chemotherapy-naive patients with stage II-III breast cancer, peripheral blood stem cells (PBSCs) were mobilised following fluorouracil 500 mg m-2, epirubicin 90-120 mg m-2 and cyclophosphamide 500 mg m-2 (FEC) and granulocyte colony-stimulating factor (G-CSF; Filgrastim) 300 μg s.c. daily. In all but one patient, mobilisation was successful, requiring three or fewer leucocytopheresis sessions in 26 patients; 28 patients subsequently underwent high-dose chemotherapy consisting of carboplatin 1600 mg m-2, thiotepa 480 mg m-2 and cyclophosphamide 6 g m-2 (CTC) followed by PBSC transplantation. Haemopoietic engraftment was rapid with a median time to neutrophils of 500 x 106 l-1 of 9 days (range 8-10) in patients who received G-CSF after PBSC-transplantation; platelet transfusion independence was reached within a median of 10 days (range 7-16). Neutropenic fever occurred in 96% of patients. Gastrointestinal toxicity was substantial but reversible. Renal, neural or ototoxicity was not observed. Complications related to the central venous catheter were encountered in 64% of patients, with major vein thrombosis occurring in 18%. High-dose CTC-chemotherapy with PBSC-transplantation, harvested after mobilisation with FEC and G-CSF, is reasonably well tolerated without life-threatening toxicity and is a suitable high-dose strategy for the adjuvant treatment of breast cancer.

Original languageEnglish (US)
Pages (from-to)857-862
Number of pages6
JournalBritish Journal of Cancer
Volume71
Issue number4
StatePublished - 1995
Externally publishedYes

Fingerprint

Thiotepa
Carboplatin
Cyclophosphamide
Breast Neoplasms
Granulocyte Colony-Stimulating Factor
Peripheral Blood Stem Cell Transplantation
Drug Therapy
Therapeutics
Platelet Transfusion
Epirubicin
Central Venous Catheters
Peripheral Blood Stem Cells
Fluorouracil
Veins
Neutrophils
Thrombosis
Fever
Kidney

Keywords

  • Adjuvant high-dose chemotherapy
  • Morbidity
  • Peripheral blood progenitor cell support

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Van der Wall, E., Nooijen, W. J., Baars, J. W., Holtkamp, M. J., Schornagel, J. H., Richel, D. J., ... Rodenhuis, S. (1995). High-dose carboplatin, thiotepa and cyclophosphamide (CTC) with peripheral blood stem cell support in the adjuvant therapy of high-risk breast cancer: A practical approach. British Journal of Cancer, 71(4), 857-862.

High-dose carboplatin, thiotepa and cyclophosphamide (CTC) with peripheral blood stem cell support in the adjuvant therapy of high-risk breast cancer : A practical approach. / Van der Wall, E.; Nooijen, W. J.; Baars, J. W.; Holtkamp, M. J.; Schornagel, J. H.; Richel, D. J.; Rutgers, E. J T; Slaper-Cortenbach, I. C M; Van der Schoot, C. E.; Rodenhuis, S.

In: British Journal of Cancer, Vol. 71, No. 4, 1995, p. 857-862.

Research output: Contribution to journalArticle

Van der Wall, E, Nooijen, WJ, Baars, JW, Holtkamp, MJ, Schornagel, JH, Richel, DJ, Rutgers, EJT, Slaper-Cortenbach, ICM, Van der Schoot, CE & Rodenhuis, S 1995, 'High-dose carboplatin, thiotepa and cyclophosphamide (CTC) with peripheral blood stem cell support in the adjuvant therapy of high-risk breast cancer: A practical approach', British Journal of Cancer, vol. 71, no. 4, pp. 857-862.
Van der Wall, E. ; Nooijen, W. J. ; Baars, J. W. ; Holtkamp, M. J. ; Schornagel, J. H. ; Richel, D. J. ; Rutgers, E. J T ; Slaper-Cortenbach, I. C M ; Van der Schoot, C. E. ; Rodenhuis, S. / High-dose carboplatin, thiotepa and cyclophosphamide (CTC) with peripheral blood stem cell support in the adjuvant therapy of high-risk breast cancer : A practical approach. In: British Journal of Cancer. 1995 ; Vol. 71, No. 4. pp. 857-862.
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abstract = "In 29 chemotherapy-naive patients with stage II-III breast cancer, peripheral blood stem cells (PBSCs) were mobilised following fluorouracil 500 mg m-2, epirubicin 90-120 mg m-2 and cyclophosphamide 500 mg m-2 (FEC) and granulocyte colony-stimulating factor (G-CSF; Filgrastim) 300 μg s.c. daily. In all but one patient, mobilisation was successful, requiring three or fewer leucocytopheresis sessions in 26 patients; 28 patients subsequently underwent high-dose chemotherapy consisting of carboplatin 1600 mg m-2, thiotepa 480 mg m-2 and cyclophosphamide 6 g m-2 (CTC) followed by PBSC transplantation. Haemopoietic engraftment was rapid with a median time to neutrophils of 500 x 106 l-1 of 9 days (range 8-10) in patients who received G-CSF after PBSC-transplantation; platelet transfusion independence was reached within a median of 10 days (range 7-16). Neutropenic fever occurred in 96{\%} of patients. Gastrointestinal toxicity was substantial but reversible. Renal, neural or ototoxicity was not observed. Complications related to the central venous catheter were encountered in 64{\%} of patients, with major vein thrombosis occurring in 18{\%}. High-dose CTC-chemotherapy with PBSC-transplantation, harvested after mobilisation with FEC and G-CSF, is reasonably well tolerated without life-threatening toxicity and is a suitable high-dose strategy for the adjuvant treatment of breast cancer.",
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AU - Van der Wall, E.

AU - Nooijen, W. J.

AU - Baars, J. W.

AU - Holtkamp, M. J.

AU - Schornagel, J. H.

AU - Richel, D. J.

AU - Rutgers, E. J T

AU - Slaper-Cortenbach, I. C M

AU - Van der Schoot, C. E.

AU - Rodenhuis, S.

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AB - In 29 chemotherapy-naive patients with stage II-III breast cancer, peripheral blood stem cells (PBSCs) were mobilised following fluorouracil 500 mg m-2, epirubicin 90-120 mg m-2 and cyclophosphamide 500 mg m-2 (FEC) and granulocyte colony-stimulating factor (G-CSF; Filgrastim) 300 μg s.c. daily. In all but one patient, mobilisation was successful, requiring three or fewer leucocytopheresis sessions in 26 patients; 28 patients subsequently underwent high-dose chemotherapy consisting of carboplatin 1600 mg m-2, thiotepa 480 mg m-2 and cyclophosphamide 6 g m-2 (CTC) followed by PBSC transplantation. Haemopoietic engraftment was rapid with a median time to neutrophils of 500 x 106 l-1 of 9 days (range 8-10) in patients who received G-CSF after PBSC-transplantation; platelet transfusion independence was reached within a median of 10 days (range 7-16). Neutropenic fever occurred in 96% of patients. Gastrointestinal toxicity was substantial but reversible. Renal, neural or ototoxicity was not observed. Complications related to the central venous catheter were encountered in 64% of patients, with major vein thrombosis occurring in 18%. High-dose CTC-chemotherapy with PBSC-transplantation, harvested after mobilisation with FEC and G-CSF, is reasonably well tolerated without life-threatening toxicity and is a suitable high-dose strategy for the adjuvant treatment of breast cancer.

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