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Solid Tumours

High-dose busulfan, melphalan and thiotepa as consolidation for non-inflammatory high-risk breast cancer

Bone Marrow Transplantation volume 26, pages 51–59 (2000)Cite this article

Abstract

The purpose of this study was to evaluate the toxicity and efficacy of high-dose busulfan, melphalan and thiotepa (Bu/Mel/TT) in patients with high-risk non-inflammatory breast cancer defined as stage II disease ⩾10 lymph nodes (n = 52) or stage III (n = 69), and prognostic factors for treatment outcome. One hundred and twenty-one patients (median age, 46 years) were treated with high-dose Bu (12 mg/kg), Mel (100 mg/m2) and TT (500 mg/m2) (HDC) followed by autologous stem cell infusion (ASCI). One hundred patients were initially treated with surgery followed by standard adjuvant chemotherapy prior to HDC/ASCI. Twenty-one patients with stage III disease had inoperable tumors at diagnosis and were treated with neoadjuvant chemotherapy and surgery before HDC/ASCI. Transplant-related mortality was 6%. The probabilities of event-free survival (EFS) at 3 and 5 years (median follow-up of 36 months) from transplant were, for all patients: 0.62–0.60; stage II: 0.71–0.67: stage III: 0.55–0.55 (for stage III adjuvant and neoadjuvant groups: 0.60–0.60 and 0.42–0.42, respectively). Multivariate analysis did not identify variables associated with poor outcome. The efficacy of Bu/Mel/TT is similar to other HDC regimens reported for patients with high-risk non-inflammatory breast cancer. Bu/Mel/TT has high activity in stage II disease and a moderate benefit in stage III operable tumors. Bone Marrow Transplantation (2000) 26, 51–59.

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Acknowledgements

This study was supported by grants from the National Institutes of Health CA 47748, CA 18221, CA 15704, CA 09515 and the Jose Carreras International Leukemia Foundation. FG-D is supported by a grant from Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.

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  1. Fred Hutchinson Cancer Research, University of Washington and Puget Sound Oncology Consortium, Seattle, WA, USA

    F Gutierrez-Delgado, LA Holmberg, H Hooper, FR Appelbaum, RB Livingston, RT Maziarz, P Weiden, S Rivkin, P Montgomery, K Kawahara & W Bensinger

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  1. F Gutierrez-Delgado
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Gutierrez-Delgado, F., Holmberg, L., Hooper, H. et al. High-dose busulfan, melphalan and thiotepa as consolidation for non-inflammatory high-risk breast cancer. Bone Marrow Transplant 26, 51–59 (2000). https://doi.org/10.1038/sj.bmt.1702461

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