Summary:
The purpose of this study was to identify characteristics significant to survival and progression-free survival in patients with advanced ovarian cancer receiving high-dose chemotherapy. In all, 96 patients received autologous stem cell transplantation. Regimens included paclitaxel with carboplatin (PC), topotecan, melphalan, cyclophosphamide (TMC) and cyclophosphamide, BCNU, thiotepa (CBT). At the time of transplantation, 43% of patients were in clinical CR, 34% were in clinical PR, 18% had progressive disease and 5% had stable disease. There were no treatment-related deaths. The 6-year survival by Kaplan–Meier was 38%. For patients who received transplantation for remission consolidation, the 6-year survival was 53% with a PFS of 29%. On univariate analysis, the CBT regimen, clear cell histology and disease status other than CR prior to treatment were statistically significant adverse prognostic factors. This analysis has demonstrated that patients in clinical remission are most likely to benefit from autologous transplantation, with the exception of patients with clear cell histology. The TMC combination appeared to be superior to the PC and CBT combinations. Comparative studies of different consolidation approaches will be necessary to determine if autologous transplantation is the preferred treatment for this patient population.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Oriel KA, Hartenbach EM, Remington PL . Trends in United States ovarian cancer mortality, 1979–1995. Obstet Gynecol 1999; 93: 30–33.
Hanai A . Trends and differentials in ovarian cancer: incidence, mortality and survival experience. APMIS 1990; 98 (Suppl. 12): 1–20.
Yancik R . Ovarian cancer: age contrasts in incidence, histology, disease stage at diagnosis, and mortality. Cancer 1993; 71 (Suppl. 2): 517–523.
Gore M, Mainwaring P, A'Hern R et al. Randomized trial of dose-intensity with single-agent carboplatin in patients with epithelial ovarian cancer. London Gynaecological Oncology Group. J Clin Oncol 1998; 16: 2426–2434.
Donato ML, Gershenson D, Ippoliti C et al. High-dose ifosfamide and etoposide with filgrastim for stem cell mobilization in patients with advanced ovarian cancer. Bone Marrow Transplant 2000; 25: 1137–1140.
Calvert AH, Newell DR, Gumbrell LA et al. Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol 1989; 7: 1748–1756.
Donato ML, Gershenson DM, Wharton JT et al. High-dose topotecan, melphalan and cyclophosphamide (TMC) with stem cell support: a new regimen for the treatment of advanced ovarian cancer. Gynecol Oncol 2001; 82: 420–426.
Rustin GJ, Nelstrop AE, McClean P et al. Defining response of ovarian carcinoma to initial chemotherapy according to serum CA 125. J Clin Oncol 1996; 14: 1545–1551.
Clark TG, Stewart ME, Altman DG, Gabra H, Smyth JF . A prognostic model for ovarian cancer. Br J Cancer 2001; 85: 944–952.
Sugiyama T, Kamura T, Kigawa J et al. Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy. Cancer 2000; 88: 2584–2589.
Tammela J, Geisler JP, Eskew Jr PN, Geisler HE . Clear cell carcinoma of the ovary: poor prognosis compared to serous carcinoma. Eur J Gynaecol Oncol 1998; 19: 438–440.
Eren M, Rakar S, Klanar B, Syrjänen K . Endometriosis-associated ovarian carcinoma (EAOC): an entity district from other ovarian carcinomas as suggested by a nested case–control study. Gynecol Oncol 2001; 83: 100–108.
Stiff PJ, Veum-Stone J, Lazarus HM et al. High-dose chemotherapy and autologous stem-cell transplantation for ovarian cancer: an Autologous Blood and Marrow Transplant Registry Report. Ann Intern Med 2000; 133: 504–515.
Barakat RR, Sabbatini P, Bhaskaran D et al. Intraperitoneal chemotherapy for ovarian carcinoma: results of long-term follow-up. J Clin Oncol 2002; 20: 694–698.
Tournigand C, Louvet C, Molitor JL et al. Intravenous chemotherapy, early debulking surgery, and consolidation intraperitoneal chemotherapy in advanced ovarian carcinoma. Gynecol Oncol 2001; 83: 198–204.
MacGibbon A, Bucci J, MacLeod C et al. Whole abdominal radiotherapy following second-look laparotomy for ovarian cancer. Gynecol Oncol 1999; 75: 62–67.
Pickel H, Lahousen M, Petru E et al. Consolidation radiotherapy after carboplatin-based chemotherapy in radically operated advanced ovarian cancer. Gynecol Oncol 1999; 72: 215–219.
Cmelak AJ, Kapp DS . Long-term survival with whole abdominopelvic irradiation in platinum-refractory persistent or recurrent ovarian cancer. Gynecol Oncol 1997; 65: 453–460.
Lambert ME, Rustin GJ, Gregory WM, Nelstrop AE . A randomized trial of five versus eight courses of cisplatin or carboplatin in advanced epithelial ovarian carcinoma. A North Thames Ovary Group Study. Ann Oncol 1997; 8: 327–333.
Hakes TB, Chalas E, Hoskins WJ et al. Randomized prospective trial of 5 versus 10 cycles of cyclophosphamide, doxorubicin, and cisplatin in advanced ovarian carcinoma. Gynecol Oncol 1992; 45: 284–289.
Berek JS, Markman M, Stonebraker B et al. Intraperitoneal interferon-alpha in residual ovarian carcinoma: a phase II gynecologic oncology group. Gynecol Oncol 1999; 75: 10–14.
Hortobagyi GN, Ueno NT, Xia W et al. Cationic liposome-mediated E1A gene transfer to human breast and ovarian cancer cells and its biologic effects: a phase I trial. J Clin Oncol 2001; 19: 3422–3433.
Ledermann JA . High-dose chemotherapy with peripheral blood stem cell transplantation (PBSCT) in ovarian cancer. Int J Gynecol Cancer 2000; 10 (Suppl. 1): 53–56.
Legros M, Dauplat S, Fleury J et al. High-dose chemotherapy with hematopoietic rescue in patients with stage III to IV ovarian cancer: long-term results. J Clin Oncol 1997; 15: 1302–1308.
Stiff PJ, Bayer R, Kerger C et al. High-dose chemotherapy with autologous transplantation for persistent/relapsed ovarian cancer: a multivariate analysis of survival for 100 consecutively treated patients. J Clin Oncol 1997; 15: 1309–1317.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Donato, M., Aleman, A., Champlin, R. et al. Analysis of 96 patients with advanced ovarian carcinoma treated with high-dose chemotherapy and autologous stem cell transplantation. Bone Marrow Transplant 33, 1219–1224 (2004). https://doi.org/10.1038/sj.bmt.1704473
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1704473
Keywords
This article is cited by
-
Thymoquinone attenuates cyclophosphamide-induced pulmonary injury in rats
Inflammopharmacology (2013)
-
A phase I/II study of CY and topotecan in patients with high-risk malignancies undergoing autologous hematopoietic cell transplantation: the St Jude long-term follow-up
Bone Marrow Transplantation (2012)
-
Phase II study evaluating consolidation whole abdominal intensity-modulated radiotherapy (IMRT) in patients with advanced ovarian cancer stage FIGO III - The OVAR-IMRT-02 Study
BMC Cancer (2011)
-
Phase I trial of autologous hematopoietic SCT with escalating doses of topotecan combined with CY and carboplatin in patients with relapsed or persistent ovarian or primary peritoneal carcinoma
Bone Marrow Transplantation (2010)
-
Phase I/II trial of multicycle high-dose chemotherapy with peripheral blood stem cell support for treatment of advanced ovarian cancer
Bone Marrow Transplantation (2006)