Summary
Background: Patients with breast cancer stage II and more than 10 positive lymph nodes have a poor prognosis. With the development of peripheral blood stem cell transplantation and the resulting possibility of dose-intensification, treatment results have considerably improved. This study was performed to evaluate the safety of stem cell transplantation of selected CD34-positive cells.
Methods: 17 high-risk patients received high-dose chemotherapy followed by peripheral stem cell transplantation. The peripheral stem cells were collected, the CD34-positive cells were isolated and cryopreserved. Following high-dose chemotherapy, the stem cells were re-infused and stimulated with the cytokine G-CSF (10 µg/kg).
Results: All engrafted patients achieved normal blood counts. The leukocyte count increased to >1500/µl by day 10, the median platelet count reached >20,000/µl after 10 days, too. In addition, supportive therapeutic measures were reduced without increasing the risks of infections or mortality. No patient showed life-threatening infection, no death occurred. After a median follow-up period of 14 months 70% of patients are in complete remission.
Conclusions: High-dose chemotherapy with peripheral stem cell transplantation is a toxic but safe treatment option for high-risk patients with breast cancer. The treatment results show an increase in disease-free survival of 57 to 88% after five years. Randomized studies are needed to confirm these data.