Administration of G-CSF in the posttransplant period accelerates the rate of neutrophil engraftment, shortens the duration of hospitalization, and reduces the number of days on nonprophylactic antibiotics in patients who receive autologous PBSC with or without autologous bone marrow following high-dose therapy.

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Summary:Seventy women with high-risk stage II (n = 10), IIIA Breast cancer remains an important source of morbidity and mortality among women, with an estimated 46 000 deaths annually in the United States alone. 1 Despite extensive (n = 12), IIIB (n = 11), or IV (n = 37) breast cancer research, recently published studies continue to report zero received cyclophosphamide 6000 mg/m 2 , etoposide or near-zero long-term progression-free survival rates 2400 mg/m 2 , and carboplatin 1200 mg/m 2 followed by among women with metastatic disease 2-7 and less than 50% infusion of autologous hematopoietic stem cells (AHSC).long-term survival among women with locoregional disWomen with high-risk stage II disease had eight or ease. 8,9 For example, a recently published 20-year followmore involved axillary lymph nodes (n = 9) or axillary up analysis 8 of a major adjuvant chemotherapy trial and breast relapse following lumpectomy, chemoreported 37% long-term progression-free survival among therapy, and radiation therapy (n = 1). Women with women with one to three involved axillary lymph nodes, measurable stage III or stage IV disease were required 26% progression-free survival among women with four to to demonstrate complete or partial response to conven-10 axillary nodes involved, and no long-term progressiontional-dose chemotherapy prior to transplant. The overfree survivors among women with more than 10 involved all (complete plus partial) response rate for the 31 nodes. Similarly, a recently reported large chemotherapy patients not in complete remission at the time of transtrial in women with previously untreated metastatic disease plant was 55%. With a median follow-up of 545 days, reported a 0% survival rate at less than 5 years. 7 the 2-year actuarial progression-free survival rates forDisappointing long-term results with conventional-dose patients with stage II, IIIA, IIIB and IV are 86, 75, 42 therapy, as well as both controlled and uncontrolled studies and 13%, respectively. Factors independently predictive suggesting a chemotherapeutic dose-response relationship of longer progression-free survival by multivariate for breast cancer within conventional dose ranges 7-9 have analysis included lower stage disease, status of disease led to the introduction of high-dose therapy (HDC) folat transplant (in CR vs not in CR), and positive estrogen lowed by rescue with autologous blood or marrow-derived receptor status. Factors predictive of more rapid neuhematopoietic stem cells (AHSC) in women with metastatic trophil engraftment by multivariate analysis included or high-risk non-metastatic breast cancer. 10-33 post-transplant administration of hematopoietic growthWe elected to study the combination of high-dose cyclofactors, greater number of infused CFU-GM, mobilizphosphamide, etoposide, and carboplatin (CEC) for a phase ation with G-CSF or cyclophosphamide/G-CSF (vs II study in this patient population for several reasons: (1) mobilization with GM-CSF or no mobilization), andThe efficacy of high-dose alkylating agent-based c...

Summary:We report two cases of severe leg ulcerations in patients being treated with thalidomide for graft-versus-host disease following bone marrow transplantation. Local wound care and debridement were attempted, but one patient required skin grafting to ensure healing. We propose that this complication may be due to the antiangiogenic properties of thalidomide and urge careful attention to skin breakdown in patients being treated with this compound. Bone Marrow Transplantation (2001) 27, 229-230. Keywords: thalidomide; skin; ulceration; transplant; GVHD Case reports Patient 1A 47-year-old man with progressive B cell chronic lymphocytic leukemia (CLL) originally treated with fludarabine, prednisone, danozol, leukeran, cytoxan, vincristine and dexamethasone underwent an allogeneic bone marrow transplant with busulfan/cytoxan conditioning in February 1996. On day 28 he developed total body erythema with some skin desquamation which resolved following treatment with methylprednisolone and cyclosporine. On day 73 staphylococcal A immunopheresis was utilized to treat severe immune thrombocytopenic purpura due to an auto-antibody. By day 98 this had resolved following six aphereses. His skin was still dry at this time, but no longer flaking. By day 400 his CLL was in full remission. His skin was lichenified in areas of his torso but no sclerodermatous changes were noted. His immunosuppressives were stopped on day 500. On day 510 he was doing well with some thickened skin and scaling over his hands and knuckles. Two weeks after stopping the immunosuppressives, his skin