Summary:term follow-up of a larger cohort of patients will be needed to ascertain the overall efficacy of this type of therapy. In this phase II trial, we used a double dose-intensive chemotherapy and stem cell rescue protocol to treat Keywords: lymphoma; breast cancer; dose-intensive chemotherapy; ABMT; double transplant breast cancer (BCA) patients or non-Hodgkin's lymphoma patients (NHL). The first cycle consisted of highdose melphalan followed by ABMT. The second cycle used a novel chemotherapy combination; thiotepa, etoHigh-dose chemotherapy (HDC) with autologous hematoposide, carboplatin and cyclophosphamide (TECC) folpoietic stem cell rescue is being increasingly used for the lowed by ABMT. We treated 12 patients in total, nine treatment of solid tumors or hematopoietic malignancies with BCA, three with NHL. All nine BCA patients were that do not respond to, or relapse after conventional chemotreated with the two cycle protocol. The three NHL therapy. 1,2 High-dose combination chemotherapy with autopatients were treated with the second cycle only. Bone logous bone marrow transplant (ABMT) has become marrow (BM, 1 patient), peripheral blood stem cells increasingly popular as an effective treatment of breast (PBSC, 10 patients) or both (1 patient) were reinfused cancer (BCA) and non-Hodgkin's lymphoma (NHL).
60-72 h after completion of each cycle of chemotherapy.In the treatment of advanced BCA the most promising Recovery was rapid; the ANC rose to greater than conditioning regimens have been a combination of alkylat-500/l on day +11 (+8 to + 20) and the platelet count ing agents followed by stem cell rescue. [1][2][3][4] Because of their to greater than 20 000/l on day +12 (+6 to +20). The steep dose-response curves, and their main dose-limiting toxicities included the expected neutropenic fevers, sevtoxicity being myelosuppression, the alkylating agents are ere mucositis, diarrhea, and a low incidence of mild excellent candidates for dose escalation with stem cell resrenal insufficiency. No patients developed veno-occluscue. To circumvent tumor resistance many investigators ive disease, hemorrhagic cystitis or overt bleeding. With devised multi-cycle multi-agent dose-escalated strategies. a mean follow-up of 37 months, 83.3% of the patients Several institutions now use a multi-cycle regimen based are alive. Six patients are in complete remission; one on one single agent cycle, and one multi-agent cycle. For patient with BCA relapsed and expired; one patient instance, the Dana Farber Cancer Institute (Boston, MA, with NHL is in CR now over 18 months after relapse USA) used melphalan in their first cycle, and a combination and subsequent treatment with interferon; one patient of cyclophosphamide, thiotepa, and carboplatin in their is too early to evaluate. Progression-free survival overall second cycle. They achieved a progression-free rate of 53% is 75%, which is at least equivalent to many other recent at 15 months with their regimen. 5 The University of studies using similar regimens. In addition, we ha...
