Bowers C, Adkins D, Dunphy F, Harrison B, LeMaistre C F, Spitzer G
Saint Louis University Medical Center, MO 63110-0250.
Bone Marrow Transplant. 1993 Nov;12(5):525-30.
High-dose chemotherapy given with autologous bone marrow support has resulted in significant tumor responses in the majority of patients with metastatic breast cancer, a minority of which are durable. To improve on these results, we are developing high-dose preparative regimens which may be given in successive cycles, each with autologous bone marrow transplantation (ABMT), over a short duration. In this report, 44 patients with metastatic breast cancer were treated with thiotepa (total dose: 900 mg/m2) and mitoxantrone (MT), administered in a dose-escalation fashion, with ABMT. The dose-limiting non-hematologic toxicity of mitoxantrone was cardiotoxicity, with the maximum tolerated dose being 50 mg/m2 Mucositis and pneumonia were also frequent treatment-related side-effects. The overall tumor response rate was 49% in this heavily pre-treated group of patients. We are currently evaluating the toxicity and efficacy of tandem non-cross-resistant transplant regimens, using the MT combination for the second cycle of therapy, in patients with metastatic breast cancer sensitive to standard dose chemotherapy.
在大多数转移性乳腺癌患者中，给予自体骨髓支持的大剂量化疗已产生显著的肿瘤反应，其中少数反应是持久的。为了改善这些结果，我们正在开发高剂量预处理方案，该方案可在短时间内连续多个周期给药，每个周期都进行自体骨髓移植（ABMT）。在本报告中，44例转移性乳腺癌患者接受了硫替派（总剂量：900mg/m²）和米托蒽醌（MT）治疗，采用剂量递增方式给药，并进行ABMT。米托蒽醌的剂量限制性非血液学毒性是心脏毒性，最大耐受剂量为50mg/m²。粘膜炎和肺炎也是常见的与治疗相关的副作用。在这个经过大量预处理的患者组中，总体肿瘤反应率为49%。我们目前正在评估串联非交叉耐药移植方案的毒性和疗效，在对标准剂量化疗敏感的转移性乳腺癌患者中，将MT联合方案用于第二个治疗周期。
