High-dose therapy with peripheral blood stem cell (PBSC) support using an innovative mobilization regimen in patients with high-risk primary or chemoresponsive metastatic breast cancers

Kun Huei Yeh, Ming Tseh Lin, Dong Tsamn Lin, Jih Luh Tang, Louis Tak Lui, Jing Fang Lin, Yu Shiahn Chang, Ann Lii Cheng, Sen Chang Yu, King Jen Chang, Yao Chang Chen

Research output: Contribution to journalArticlepeer-review

Abstract

High-dose therapy followed by peripheral blood stem cell (PBSC) support was performed in 29 patients with primary high-risk (Group I) or chemoresponsive metastatic (Group II) breast cancer patients. Group I patients had received PBSC mobilization within 4 weeks of modified radical mastectomy. Group II patients had to achieve minimal residual disease (MRD) by induction chemotherapy before being considered eligible for PBSC mobilization and high-dose therapy. An innovative FE120C regimen (5-FU 600 mg/m2, i.v., day 1; epirubicin 120 mg/m2, i.v., day 1; cyclophosphamide 600 mg/m2, i.v., day 1) plus G-CSF (300 μg/day, subcutaneous injection for 9 days, from day 4 post-FE120 C) was used to mobilize PBSCs. After high-dose CTCb (cyclophosphamide 6000 mg/m2, thiothepa 500 mg/m2, carboplatin 800 mg/m2, in 4 days), patients received PBSC infusion and daily C-CSF 300 μg subcutaneous injection. There were 19 and 16 patients enrolled into Group I and Group II, respectively. Ten of the Group II patients had achieved minimal residual disease (MRD) after induction chemotherapy. The median numbers of mobilized total CD34+ cells for Group I and Group II patients were 27.3 (9.2 to 114.1) x 106/kg and 17.1 (5.9 to 69.1) x 106/kg respectively. The median time to neutrophil recovery (ANC ≤ 500/μL) was 8 and 9 days in Group I and II, respectively. The median time to platelet recovery (≤ 50,000/μL) was 10 and 15 days in Group I and II, respectively. No major treatment-related toxicities were noted. In Group I, 13 out of 19 patients (68.4%; 43-87%, 95% C.I.) remained recurrence-free with a median follow-up of 31 months (6+ to 55+ months). In Group II, 3 out of 10 patients (30%; 7-65%, 95% C.I.) remained progression-free at 33+, 35+, 39+ months from induction therapy. We suggest that the FE120C plus G-CSF is an effective and innovative regimen for PBSC mobilization in breast cancer patients, and high-dose CTCb therapy with PBSC support is a safe and well-tolerated treatment modality.

Original languageEnglish (US)
Pages (from-to)237-244
Number of pages8
JournalBreast Cancer Research and Treatment
Volume49
Issue number3
DOIs
StatePublished - 1998
Externally publishedYes

Keywords

  • Breast cancer
  • High-dose therapy
  • Mobilization regimen
  • PBSC support

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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