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. Schornagell, D. J. Richell, E. J.T. Rutgers, I. C.M. Slaper-Cortenbach, C. E. van der Schoot, S. Rodenhuis

Research output: Contribution to journalArticlepeer-review

Abstract

In 29 chemotherapy-naive patients with stage II-III breast cancer, peripheral blood stem cells (PBSCs) were mobilised following fluorouracil 500mg m-2, epirubicin 90-120mg 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 1061-1 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
DOIs
StatePublished - Apr 1995

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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