We found that patients with squamous cell carcinoma and absence of thrombocytopenia and obstruction had a better overall survival. However, this is a limited retrospective analysis; we therefore recommend that these prognostic factors be evaluated in larger studies.

Thiotepa (TT) has not been reported to cause cardiomyopathy, whereas cyclophosphamide (Cy)-related cardiomyopathy is well characterized. To search for cases of acute onset cardiomyopathy associated with TT, we retrospectively reviewed 171 patients who received TT-containing conditioning regimens for blood or marrow transplantation (BMT). Nine of 171 patients (5.3%) developed clinical congestive heart failure in the post-BMT period. The median time to onset of heart failure was 15 days after BMT (range 5-30). The median pre-BMT left ventricular ejection fraction (LVEF) was 50% (range 42-65%) as determined by two-dimensional echocardiogram, or gated blood pool scan. At the time of cardiomyopathy onset, LVEF was 30%. Six patients died of causes unrelated to heart failure. All affected patients who developed congestive heart failure following administration of TT had some evidence of cardiac dysfunction prior to transplantation. Significant risk factors for the development of cardiomyopathy included low pre-BMT-LVEF and female sex--particularly in females receiving allogeneic transplantation. The incidence of congestive heart failure with TT-containing regimens was similar to the incidence using other regimens with and without Cy. The mean time to clinical evidence of TT-associated cardiomyopathy was longer than the mean time reported with Cy. We recommend caution in using high-dose TT-containing regimens for patients with histories of cardiac dysfunction.

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Summary: Isolated nondominant right coronary artery stenosis causing significant angina and right ventricular infarction has been reported previously, but the importance of monitoring right-sided precordial leads during chest pain in patients with obstructive lung disease has not been documented.

10628 Background: Locally advanced breast cancer accounts for 28% (n 350) of all breast cancer cases (1370 patients) treated at our Aga Khan University Hospital over the last 15 years. This is sharp comparison to the US data (only 3–6% of all cases). Methods: Patients with LABC who received surgery upfront were excluded. One hundred and seventy cases receiving PC were evaluated. Patients receiving TAC (taxotere, Adriamycin and cyclophosphamide)chemotherapy (n 60) were evaluated in a prospective Phase II study (2003- ongoing). These were then compared with FAC/AC or CMF regimens given from1998–2005, the data of which were extracted for Breast Cancer Tumor registry. Women were eligible if they were; histological confirmed invasive infiltrating carcinoma, clinical TNM: T3, T4, N2, N3, M0, as per AJCC (6th edition), PS 0–1, with adequate renal, liver and hematological functions. Patients were treated with regimens TAC containing T (75 mg/m2), A (50 mg/m2) and C (500 mg/m2) or FAC: F (500 mg/m2), A (50 mg/m2) and C (500 mg/m2) or A (60 mg/m2) C (600 mg/m2) and CMF: C (600 mg/m2), M (40 mg/m2) and F (600 mg/m2) q3wk 2 to 4 cycles. Type of surgery depended upon the response rates and the patients’ desire. Balance to complete a total of 4–6 cycles of chemotherapy was given in the adjuvant setting. Adjuvant hormone therapy was given for receptor positive cases. Results: Demographics, response rates, BCS and toxicities are reported in table. Conclusions: Locally advanced breast cancer is common in this region, owing to lack of screening. Preoperative TAC chemotherapy leads to impressively higher response rates, pathological complete response rates and probability of BCS, than when compared with FAC/AC chemotherapy or CMF chemotherapy, given in the same setting. Where as survival data of patients with TAC is not available, we feel that this will be superior to AC/FAC or CMF, given higher pathological complete response rates. [Table: see text] No significant financial relationships to disclose.