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High-dose chemotherapy and autologous stem cell transplantation as treatment for high-risk breast cancer

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Abstract

High-dose chemotherapy with autologous stem cell transplantation has emerged as a common treatment for patients with breast cancer who have a poor prognosis. The success of this approach appears to depend on the tumor burden and the sensitivity of the disease to chemotherapy because treatment techniques have been refined and treatment-related mortality has declined. Phase II studies in patients with stage II and III disease are encouraging and suggest that treatment with high-dose chemotherapy before the development of metastatic disease may provide an advantage in terms of relapse-free and overall survival. However, tumor cells may contaminate stem cell collections and contribute to relapse after transplantation. Therefore it may be important to separate and select purified CD34+ cells which are not contaminated. It has been suggested that selection bias contributes to the favorable preliminary results observed in phase II studies of high-risk patients. Such issues, together with patient and physician bias regarding the benefits of this strategy, emphasize the need to complete the prospective randomized trials now underway.

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  1. Division of Hematology-Oncology, Department of Medicine, Northwestern University Medical School, Robert H. Lurie Cancer Center, Chicago, IL, USA

    Martin S. Tallman & William J. Gradishar

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  1. Martin S. Tallman
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Correspondence to Martin S. Tallman.

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Tallman, M.S., Gradishar, W.J. High-dose chemotherapy and autologous stem cell transplantation as treatment for high-risk breast cancer. Cancer Chemother Pharmacol 42 (Suppl 1), S60–S67 (1998). https://doi.org/10.1007/s002800051081

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