2000
DOI: 10.1038/sj.bmt.1702449
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The feasibility of high-dose chemotherapy in breast cancer patients with impaired left ventricular function

Abstract: Summary:Breast cancer patients with cardiac disease are usually excluded from clinical trials of high-dose chemotherapy. We treated 52 patients with inflammatory and/or metastatic disease with sequential high-dose melphalan and stem cell rescue followed by high-dose thiotepa and stem cell rescue. Stem cells were mobilized with cyclophosphamide and/or paclitaxel and filgrastim. Left ventricular ejection fraction (LVEF) was measured by equilibrium radionuclide angiocardiography (ERNA) at baseline, after each cou… Show more

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Cited by 8 publications
(8 citation statements)
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“…Three women with an LVEF o50% (4772%) underwent a sequence of HD cyclophosphamide (5 g/m 2 ), HD melphalan (140 mg/m 2 ) and HD thiotepa (900 mg/m 2 ) without any clinical cardiotoxicity. 102 In this series of patients, however, the patient with the lowest baseline LVEF (33%) had CHF, although easily managed. 102 Another report showed that patients undergoing HD chemotherapy with LVEF o50% (range 49-39%) do not necessarily experience more pronounced cardiac deterioration than patients starting from LVEF 450% when treated with different HD chemotherapy regimens, including HD cyclophosphamide.…”
Section: Hd Chemotherapy In Patients With Subclinical Cardiac Dysfuncmentioning
confidence: 99%
See 1 more Smart Citation
“…Three women with an LVEF o50% (4772%) underwent a sequence of HD cyclophosphamide (5 g/m 2 ), HD melphalan (140 mg/m 2 ) and HD thiotepa (900 mg/m 2 ) without any clinical cardiotoxicity. 102 In this series of patients, however, the patient with the lowest baseline LVEF (33%) had CHF, although easily managed. 102 Another report showed that patients undergoing HD chemotherapy with LVEF o50% (range 49-39%) do not necessarily experience more pronounced cardiac deterioration than patients starting from LVEF 450% when treated with different HD chemotherapy regimens, including HD cyclophosphamide.…”
Section: Hd Chemotherapy In Patients With Subclinical Cardiac Dysfuncmentioning
confidence: 99%
“…102 In this series of patients, however, the patient with the lowest baseline LVEF (33%) had CHF, although easily managed. 102 Another report showed that patients undergoing HD chemotherapy with LVEF o50% (range 49-39%) do not necessarily experience more pronounced cardiac deterioration than patients starting from LVEF 450% when treated with different HD chemotherapy regimens, including HD cyclophosphamide. 90 Six patients with initial LVEF o50% (4277%) were given enalapril and they underwent conditioning regimens containing HD cyclophosphamide X120 mg/kg even twice with no cardiac function deterioration at a median follow-up of 18 Table 2 Risk factors for HD chemotherapy-associated cardiac toxicity…”
Section: Hd Chemotherapy In Patients With Subclinical Cardiac Dysfuncmentioning
confidence: 99%
“…The author found that none of these patients had any clinical worsening of cardiac function following PTX treatment. Rose et al [12] studied 52 patients with metastatic breast cancer who were treated with high-dose chemotherapy. Patients who received PTX had a slight decrease in left ventricular ejection fraction (LVEF) following therapy; they remained completely asymptomatic.…”
Section: Introductionmentioning
confidence: 99%
“…Rose and coworkers reported an unexpected, significant decrease in L-VEF after a double course of HDC. 23 However, our data show that diastolic abnormalities expressed as balance or inversion of E/A wave ratio pattern are present without systolic dysfunction and this may be an initial expression of cardiotoxicity and a sign of myocardial disorder. Moreover, our data suggest that idarubicin was not crossresistant with epirubicin: 3/5 patients with stable disease and 1/9 in partial response after six courses of GET experienced a further cell killing and were converted to a better response category (conversion rate 28.6%).…”
Section: Discussionmentioning
confidence: 62%