New strategies in marrow purging for breast cancer patients receiving high-dose chemotherapy with autologous bone marrow transplantation

Breast Cancer Res Treat. 1993:26 Suppl:S19-23. doi: 10.1007/BF00668356.

Abstract

High-dose chemotherapy and autologous bone marrow transplantation (ABMT) are commonly used to treat selected patients with high-risk breast cancer. A limitation of ABMT is that clonogenic cancer cells could be collected with the bone marrow and produce a relapse of diseases when reinfused into patients. Purging the marrow ex vivo may eliminate the tumor cells, but it can also delay engraftment. We employed two different purging methods whereby breast cancer cells were depleted without delaying engraftment. The addition of WR-2721 (amifostine) to 4-hydroperoxycyclophosphamide (4-HC) reduced the time to engraftment by 10 days compared with marrow purged with 4-HC alone (26 versus 37 days, respectively). The positive selection of CD34+ hematopoietic progenitors produced engraftment within 21 days. The use of granulocyte colony-stimulating factor (G-CSF) accelerated the engraftment time of CD34+ hematopoietic progenitors to 11 days.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Amifostine*
  • Antigens, CD / immunology
  • Antigens, CD34
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bone Marrow Purging*
  • Bone Marrow Transplantation*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / therapy*
  • Combined Modality Therapy
  • Cyclophosphamide / analogs & derivatives*
  • Dose-Response Relationship, Drug
  • Doxorubicin / administration & dosage
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Methotrexate / administration & dosage
  • Stem Cells / drug effects
  • Stem Cells / immunology

Substances

  • Antigens, CD
  • Antigens, CD34
  • Doxorubicin
  • Cyclophosphamide
  • Amifostine
  • Fluorouracil
  • perfosfamide
  • Methotrexate

Supplementary concepts

  • AMF protocol