High-Dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation as Adjuvant Treatment in High-Risk Breast Cancer: Data from the European Group for Blood and Marrow Transplantation Registry

M. Martino, F. Lanza, L. Pavesi, M. Öztürk, D. Blaise, R. Leno Núñez, H. C. Schouten, A. Bosi, U. De Giorgi, D. Generali, G. Rosti, A. Necchi, A. Ravelli, C. Bengala, Manuela Badoglio, P. Pedrazzoli, Marco Bregni

Research output: Contribution to journalArticle

Abstract

The aim of this retrospective study was to assess toxicity and efficacy of adjuvant high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation (AHSCT) in 583 high-risk breast cancer (BC) patients (>3 positive nodes) who were transplanted between 1995 and 2005 in Europe. All patients received surgery before transplant, and 55 patients (9.5%) received neoadjuvant treatment before surgery. Median age was 47.1 years, 57.3% of patients were premenopausal at treatment, 56.5% had endocrine-responsive tumors, 19.5% had a human epidermal growth factor receptor 2 (HER2)-negative tumor, and 72.4% had ≥10 positive lymph nodes at surgery. Seventy-nine percent received a single HDC procedure. Overall transplant-related mortality was 1.9%, at.9% between 2001 and 2005, whereas secondary tumor-related mortality was.9%. With a median follow-up of 120 months, overall survival and disease-free survival rates at 5 and 10 years in the whole population were 75% and 64% and 58% and 44%, respectively. Subgroup analysis demonstrated that rates of overall survival were significantly better in patients with endocrine-responsive tumors,
Original languageEnglish
Pages (from-to)475-481
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume22
Issue number3
DOIs
Publication statusPublished - 2016

Fingerprint

Hematopoietic Stem Cell Transplantation
Registries
Transplantation
Bone Marrow
Drug Therapy
Neoplasms
Survival Rate
Transplants
Therapeutics
Neoadjuvant Therapy
Mortality
Disease-Free Survival
Retrospective Studies
Lymph Nodes
Breast Neoplasms
Survival
Population

Keywords

  • Autologous hematopoietic stem cell transplantation
  • High-dose chemotherapy
  • High-risk breast cancer

Cite this

High-Dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation as Adjuvant Treatment in High-Risk Breast Cancer: Data from the European Group for Blood and Marrow Transplantation Registry. / Martino, M.; Lanza, F.; Pavesi, L.; Öztürk, M.; Blaise, D.; Leno Núñez, R.; Schouten, H. C.; Bosi, A.; De Giorgi, U.; Generali, D.; Rosti, G.; Necchi, A.; Ravelli, A.; Bengala, C.; Badoglio, Manuela; Pedrazzoli, P.; Bregni, Marco.

In: Biology of Blood and Marrow Transplantation, Vol. 22, No. 3, 2016, p. 475-481.

Research output: Contribution to journalArticle

Martino, M. ; Lanza, F. ; Pavesi, L. ; Öztürk, M. ; Blaise, D. ; Leno Núñez, R. ; Schouten, H. C. ; Bosi, A. ; De Giorgi, U. ; Generali, D. ; Rosti, G. ; Necchi, A. ; Ravelli, A. ; Bengala, C. ; Badoglio, Manuela ; Pedrazzoli, P. ; Bregni, Marco. / High-Dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation as Adjuvant Treatment in High-Risk Breast Cancer: Data from the European Group for Blood and Marrow Transplantation Registry. In: Biology of Blood and Marrow Transplantation. 2016 ; Vol. 22, No. 3. pp. 475-481.
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abstract = "The aim of this retrospective study was to assess toxicity and efficacy of adjuvant high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation (AHSCT) in 583 high-risk breast cancer (BC) patients (>3 positive nodes) who were transplanted between 1995 and 2005 in Europe. All patients received surgery before transplant, and 55 patients (9.5{\%}) received neoadjuvant treatment before surgery. Median age was 47.1 years, 57.3{\%} of patients were premenopausal at treatment, 56.5{\%} had endocrine-responsive tumors, 19.5{\%} had a human epidermal growth factor receptor 2 (HER2)-negative tumor, and 72.4{\%} had ≥10 positive lymph nodes at surgery. Seventy-nine percent received a single HDC procedure. Overall transplant-related mortality was 1.9{\%}, at.9{\%} between 2001 and 2005, whereas secondary tumor-related mortality was.9{\%}. With a median follow-up of 120 months, overall survival and disease-free survival rates at 5 and 10 years in the whole population were 75{\%} and 64{\%} and 58{\%} and 44{\%}, respectively. Subgroup analysis demonstrated that rates of overall survival were significantly better in patients with endocrine-responsive tumors,",
keywords = "Autologous hematopoietic stem cell transplantation, High-dose chemotherapy, High-risk breast cancer",
author = "M. Martino and F. Lanza and L. Pavesi and M. {\"O}zt{\"u}rk and D. Blaise and {Leno N{\'u}{\~n}ez}, R. and Schouten, {H. C.} and A. Bosi and {De Giorgi}, U. and D. Generali and G. Rosti and A. Necchi and A. Ravelli and C. Bengala and Manuela Badoglio and P. Pedrazzoli and Marco Bregni",
note = "Export Date: 14 March 2017 CODEN: BBMTF Correspondence Address: Martino, M.; Hematology and Stem Cell Transplant Unit, Azienda Ospedaliera BMMItaly; email: maxmartino@live.com References: Pedrazzoli, P., Martino, M., Delfanti, S., High-dose chemotherapy with autologous hematopoietic stem cell transplantation for high-risk primary breast cancer (2015) J Natl Cancer Inst Monogr, 51, pp. 70-75; Hortobagyi, G.N., What is the role of high-dose chemotherapy in the era of targeted therapies? (2004) J Clin Oncol, 22, pp. 2263-2266; Castagna, L., Martino, M., Are there still reasons to believe that high-dose chemotherapy has a role in breast cancer management? (2013) Bone Marrow Transplant, 48, p. 305; Peters, W.P., Ross, M., Vredenburgh, J.J., High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer (1993) J Clin Oncol, 11, pp. 1132-1143; Gianni, A.M., Siena, S., Bregni, M., Efficacy, toxicity, and applicability of high-dose sequential chemotherapy as adjuvant treatment in operable breast cancer with 10 or more involved axillary nodes: five-year results (1997) J Clin Oncol, 15, pp. 2312-2321; Pedrazzoli, P., Ferrante, P., Kulekci, A., Autologous hematopoietic stem cell transplantation for breast cancer in Europe: critical evaluation of data from the European Group for Blood and Marrow Transplantation (EBMT) Registry 1990-1999 (2003) Bone Marrow Transplant, 32, pp. 489-494; Weiss, R.B., Rifkin, R.M., Stewart, F.M., High-dose chemotherapy for high-risk primary breast cancer: an on-site review of the Bezwoda study (2000) Lancet, 355, pp. 999-1003; Passweg, J.R., Baldomero, H., Bader, P., Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants (2015) Bone Marrow Transplant, 50, pp. 476-482; Nitz, U.A., Mohrmann, S., Fischer, J., Comparison of rapidly cycled tandem high-dose chemotherapy plus peripheral-blood stem-cell support versus dose-dense conventional chemotherapy for adjuvant treatment of high-risk breast cancer: results of a multicentre phase III trial (2005) Lancet, 366, pp. 1935-1944; Rodenhuis, S., Bontenbal, M., van Hoesel, Q.G., Efficacy of high-dose alkylating chemotherapy in HER2/neu-negative breast cancer (2006) Ann Oncol, 17, pp. 588-596; Berry, D.A., Ueno, N.T., Johnson, M.M., High-dose chemotherapy with autologous stem-cell support as adjuvant therapy in breast cancer: overview of 15 randomized trials (2011) J Clin Oncol, 20, pp. 3214-3223; De Giorgi, U., Amadori, D., Dose intensification in hormone receptor-negative and/or human epidermal growth factor receptor 2-negative high-risk primary breast cancer (2012) J Clin Oncol, 30, p. 758; Moroni, M., High-dose chemotherapy as adjuvant therapy in breast cancer: could there be a survival benefit? (2012) J Clin Oncol, 30, p. 759; Wang, J., Zhang, Q., Zhou, R., High-dose chemotherapy followed by autologous stem cell transplantation as a first-line therapy for high-risk primary breast cancer: a meta-analysis (2012) PLoS One, 7, p. e33388; Peccatori, J., Barkholt, L., Demirer, T., Prognostic factors for survival in patients with advanced renal cell carcinoma undergoing nonmyeloablative allogeneic stem cell transplantation (2005) Cancer, 104, pp. 2099-2103; Ueno, N.T., Rizzo, J.D., Demirer, T., Allogeneic hematopoietic cell transplantation for metastatic breast cancer (2008) Bone Marrow Transplant, 41, pp. 537-545; Harrington, D., Linear rank tests in survival analysis (2005) Encyclopedia of biostatistics, , Wiley Interscience Hoboken, NJ; McCullagh, P., Nelder, J.A., Generalized linear models (Chapman & Hall/CRC monographs on statistics & applied probability) (1989), 2nd ed. Chapman & Hall London, UKPedrazzoli, P., Martinelli, G., Gianni, A.M., Adjuvant high-dose chemotherapy with autologous hematopoietic stem cell support for high-risk primary breast cancer: results from the Italian national registry (2014) Biol Blood Marrow Transplant, 20, pp. 501-506; Martino, M., Ballestrero, A., Zambelli, A., Long-term survival in patients with metastatic breast cancer receiving intensified chemotherapy and stem cell rescue: data from the Italian registry (2013) Bone Marrow Transplant, 48, pp. 414-418; Tallman, M.S., Gray, R., Robert, N.J., Conventional adjuvant chemotherapy with or without high-dose chemotherapy and autologous stem-cell transplantation in high-risk breast cancer (2003) N Engl J Med, 349, pp. 17-26; Peters, W.P., Rosner, G.L., Vredenburgh, J.J., Prospective, randomized comparison of high-dose chemotherapy with stem-cell support versus intermediate-dose chemotherapy after surgery and adjuvant chemotherapy in women with high-risk primary breast cancer: a report of CALGB 9082, SWOG 9114, and NCIC MA-13 (2005) J Clin Oncol, 23, pp. 2191-2200; Kr{\"o}ger, N., Damon, L., Zander, A.R., Secondary acute leukemia following mitoxantrone-based high-dose chemotherapy for primary breast cancer patients (2003) Bone Marrow Transplant, 32, pp. 1153-1157; Berry, D.A., Ueno, N.T., Johnson, M.M., High-dose chemotherapy with autologous hematopoietic stem-cell transplantation in metastatic breast cancer: overview of six randomized trials (2011) J Clin Oncol, 29, pp. 3224-3231; Basser, R.L., O'Neill, A., Martinelli, G., Multicycle dose-intensive chemotherapy for women with high-risk primary breast cancer: results of International Breast Cancer Study Group Trial 15-95 (2006) J Clin Oncol, 24, pp. 370-378; Szekely, B., Iwamoto, T., Szasz, A.M., A 3-gene proliferation score (TOP-FOX-67) can re-classify histological grade-2, ER-positive breast cancers into low- and high-risk prognostic categories (2013) Breast Cancer Res Treat, 138, pp. 691-698; Markiewicz, A., Wełnicka-Jaśkiewicz, M., Skokowski, J., Prognostic significance of ESR1 amplification and ESR1 PvuII, CYP2C19*2, UGT2B15*2 polymorphisms in breast cancer patients (2013) PLoS One, 8, p. e72219; Gluz, O., Nitz, U.A., Harbeck, N., Triple-negative high-risk breast cancer derives particular benefit from dose intensification of adjuvant chemotherapy: results of WSG AM-01 trial (2008) Ann Oncol, 19, pp. 861-870; Marino, P., Roch{\'e}, H., Moatti, J.P., High-dose chemotherapy for patients with high-risk breast cancer: a clinical and economic assessment using a quality-adjusted survival analysis (2008) Am J Clin Oncol, 31, pp. 117-124; Siena, S., Bregni, M., Di Nicola, M., Durability of hematopoiesis following autografting with peripheral blood hematopoietic progenitors (1994) Ann Oncol, 5, pp. 935-941; K{\"o}rbling, M., Fliedner, T.M., The evolution of clinical peripheral blood stem cell transplantation (1996) Bone Marrow Transplant, 17, pp. 675-678; Antman, K.H., Rowlings, P.A., Vaughan, W.P., High-dose chemotherapy with autologous hematopoietic stem-cell support for breast cancer in North America (1997) J Clin Oncol, 15, pp. 1870-1879",
year = "2016",
doi = "10.1016/j.bbmt.2015.12.011",
language = "English",
volume = "22",
pages = "475--481",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
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TY - JOUR

T1 - High-Dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation as Adjuvant Treatment in High-Risk Breast Cancer: Data from the European Group for Blood and Marrow Transplantation Registry

AU - Martino, M.

AU - Lanza, F.

AU - Pavesi, L.

AU - Öztürk, M.

AU - Blaise, D.

AU - Leno Núñez, R.

AU - Schouten, H. C.

AU - Bosi, A.

AU - De Giorgi, U.

AU - Generali, D.

AU - Rosti, G.

AU - Necchi, A.

AU - Ravelli, A.

AU - Bengala, C.

AU - Badoglio, Manuela

AU - Pedrazzoli, P.

AU - Bregni, Marco

N1 - Export Date: 14 March 2017 CODEN: BBMTF Correspondence Address: Martino, M.; Hematology and Stem Cell Transplant Unit, Azienda Ospedaliera BMMItaly; email: maxmartino@live.com References: Pedrazzoli, P., Martino, M., Delfanti, S., High-dose chemotherapy with autologous hematopoietic stem cell transplantation for high-risk primary breast cancer (2015) J Natl Cancer Inst Monogr, 51, pp. 70-75; Hortobagyi, G.N., What is the role of high-dose chemotherapy in the era of targeted therapies? (2004) J Clin Oncol, 22, pp. 2263-2266; Castagna, L., Martino, M., Are there still reasons to believe that high-dose chemotherapy has a role in breast cancer management? (2013) Bone Marrow Transplant, 48, p. 305; Peters, W.P., Ross, M., Vredenburgh, J.J., High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer (1993) J Clin Oncol, 11, pp. 1132-1143; Gianni, A.M., Siena, S., Bregni, M., Efficacy, toxicity, and applicability of high-dose sequential chemotherapy as adjuvant treatment in operable breast cancer with 10 or more involved axillary nodes: five-year results (1997) J Clin Oncol, 15, pp. 2312-2321; Pedrazzoli, P., Ferrante, P., Kulekci, A., Autologous hematopoietic stem cell transplantation for breast cancer in Europe: critical evaluation of data from the European Group for Blood and Marrow Transplantation (EBMT) Registry 1990-1999 (2003) Bone Marrow Transplant, 32, pp. 489-494; Weiss, R.B., Rifkin, R.M., Stewart, F.M., High-dose chemotherapy for high-risk primary breast cancer: an on-site review of the Bezwoda study (2000) Lancet, 355, pp. 999-1003; Passweg, J.R., Baldomero, H., Bader, P., Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants (2015) Bone Marrow Transplant, 50, pp. 476-482; Nitz, U.A., Mohrmann, S., Fischer, J., Comparison of rapidly cycled tandem high-dose chemotherapy plus peripheral-blood stem-cell support versus dose-dense conventional chemotherapy for adjuvant treatment of high-risk breast cancer: results of a multicentre phase III trial (2005) Lancet, 366, pp. 1935-1944; Rodenhuis, S., Bontenbal, M., van Hoesel, Q.G., Efficacy of high-dose alkylating chemotherapy in HER2/neu-negative breast cancer (2006) Ann Oncol, 17, pp. 588-596; Berry, D.A., Ueno, N.T., Johnson, M.M., High-dose chemotherapy with autologous stem-cell support as adjuvant therapy in breast cancer: overview of 15 randomized trials (2011) J Clin Oncol, 20, pp. 3214-3223; De Giorgi, U., Amadori, D., Dose intensification in hormone receptor-negative and/or human epidermal growth factor receptor 2-negative high-risk primary breast cancer (2012) J Clin Oncol, 30, p. 758; Moroni, M., High-dose chemotherapy as adjuvant therapy in breast cancer: could there be a survival benefit? (2012) J Clin Oncol, 30, p. 759; Wang, J., Zhang, Q., Zhou, R., High-dose chemotherapy followed by autologous stem cell transplantation as a first-line therapy for high-risk primary breast cancer: a meta-analysis (2012) PLoS One, 7, p. e33388; Peccatori, J., Barkholt, L., Demirer, T., Prognostic factors for survival in patients with advanced renal cell carcinoma undergoing nonmyeloablative allogeneic stem cell transplantation (2005) Cancer, 104, pp. 2099-2103; Ueno, N.T., Rizzo, J.D., Demirer, T., Allogeneic hematopoietic cell transplantation for metastatic breast cancer (2008) Bone Marrow Transplant, 41, pp. 537-545; Harrington, D., Linear rank tests in survival analysis (2005) Encyclopedia of biostatistics, , Wiley Interscience Hoboken, NJ; McCullagh, P., Nelder, J.A., Generalized linear models (Chapman & Hall/CRC monographs on statistics & applied probability) (1989), 2nd ed. Chapman & Hall London, UKPedrazzoli, P., Martinelli, G., Gianni, A.M., Adjuvant high-dose chemotherapy with autologous hematopoietic stem cell support for high-risk primary breast cancer: results from the Italian national registry (2014) Biol Blood Marrow Transplant, 20, pp. 501-506; Martino, M., Ballestrero, A., Zambelli, A., Long-term survival in patients with metastatic breast cancer receiving intensified chemotherapy and stem cell rescue: data from the Italian registry (2013) Bone Marrow Transplant, 48, pp. 414-418; Tallman, M.S., Gray, R., Robert, N.J., Conventional adjuvant chemotherapy with or without high-dose chemotherapy and autologous stem-cell transplantation in high-risk breast cancer (2003) N Engl J Med, 349, pp. 17-26; Peters, W.P., Rosner, G.L., Vredenburgh, J.J., Prospective, randomized comparison of high-dose chemotherapy with stem-cell support versus intermediate-dose chemotherapy after surgery and adjuvant chemotherapy in women with high-risk primary breast cancer: a report of CALGB 9082, SWOG 9114, and NCIC MA-13 (2005) J Clin Oncol, 23, pp. 2191-2200; Kröger, N., Damon, L., Zander, A.R., Secondary acute leukemia following mitoxantrone-based high-dose chemotherapy for primary breast cancer patients (2003) Bone Marrow Transplant, 32, pp. 1153-1157; Berry, D.A., Ueno, N.T., Johnson, M.M., High-dose chemotherapy with autologous hematopoietic stem-cell transplantation in metastatic breast cancer: overview of six randomized trials (2011) J Clin Oncol, 29, pp. 3224-3231; Basser, R.L., O'Neill, A., Martinelli, G., Multicycle dose-intensive chemotherapy for women with high-risk primary breast cancer: results of International Breast Cancer Study Group Trial 15-95 (2006) J Clin Oncol, 24, pp. 370-378; Szekely, B., Iwamoto, T., Szasz, A.M., A 3-gene proliferation score (TOP-FOX-67) can re-classify histological grade-2, ER-positive breast cancers into low- and high-risk prognostic categories (2013) Breast Cancer Res Treat, 138, pp. 691-698; Markiewicz, A., Wełnicka-Jaśkiewicz, M., Skokowski, J., Prognostic significance of ESR1 amplification and ESR1 PvuII, CYP2C19*2, UGT2B15*2 polymorphisms in breast cancer patients (2013) PLoS One, 8, p. e72219; Gluz, O., Nitz, U.A., Harbeck, N., Triple-negative high-risk breast cancer derives particular benefit from dose intensification of adjuvant chemotherapy: results of WSG AM-01 trial (2008) Ann Oncol, 19, pp. 861-870; Marino, P., Roché, H., Moatti, J.P., High-dose chemotherapy for patients with high-risk breast cancer: a clinical and economic assessment using a quality-adjusted survival analysis (2008) Am J Clin Oncol, 31, pp. 117-124; Siena, S., Bregni, M., Di Nicola, M., Durability of hematopoiesis following autografting with peripheral blood hematopoietic progenitors (1994) Ann Oncol, 5, pp. 935-941; Körbling, M., Fliedner, T.M., The evolution of clinical peripheral blood stem cell transplantation (1996) Bone Marrow Transplant, 17, pp. 675-678; Antman, K.H., Rowlings, P.A., Vaughan, W.P., High-dose chemotherapy with autologous hematopoietic stem-cell support for breast cancer in North America (1997) J Clin Oncol, 15, pp. 1870-1879

PY - 2016

Y1 - 2016

N2 - The aim of this retrospective study was to assess toxicity and efficacy of adjuvant high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation (AHSCT) in 583 high-risk breast cancer (BC) patients (>3 positive nodes) who were transplanted between 1995 and 2005 in Europe. All patients received surgery before transplant, and 55 patients (9.5%) received neoadjuvant treatment before surgery. Median age was 47.1 years, 57.3% of patients were premenopausal at treatment, 56.5% had endocrine-responsive tumors, 19.5% had a human epidermal growth factor receptor 2 (HER2)-negative tumor, and 72.4% had ≥10 positive lymph nodes at surgery. Seventy-nine percent received a single HDC procedure. Overall transplant-related mortality was 1.9%, at.9% between 2001 and 2005, whereas secondary tumor-related mortality was.9%. With a median follow-up of 120 months, overall survival and disease-free survival rates at 5 and 10 years in the whole population were 75% and 64% and 58% and 44%, respectively. Subgroup analysis demonstrated that rates of overall survival were significantly better in patients with endocrine-responsive tumors,

AB - The aim of this retrospective study was to assess toxicity and efficacy of adjuvant high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation (AHSCT) in 583 high-risk breast cancer (BC) patients (>3 positive nodes) who were transplanted between 1995 and 2005 in Europe. All patients received surgery before transplant, and 55 patients (9.5%) received neoadjuvant treatment before surgery. Median age was 47.1 years, 57.3% of patients were premenopausal at treatment, 56.5% had endocrine-responsive tumors, 19.5% had a human epidermal growth factor receptor 2 (HER2)-negative tumor, and 72.4% had ≥10 positive lymph nodes at surgery. Seventy-nine percent received a single HDC procedure. Overall transplant-related mortality was 1.9%, at.9% between 2001 and 2005, whereas secondary tumor-related mortality was.9%. With a median follow-up of 120 months, overall survival and disease-free survival rates at 5 and 10 years in the whole population were 75% and 64% and 58% and 44%, respectively. Subgroup analysis demonstrated that rates of overall survival were significantly better in patients with endocrine-responsive tumors,

KW - Autologous hematopoietic stem cell transplantation

KW - High-dose chemotherapy

KW - High-risk breast cancer

U2 - 10.1016/j.bbmt.2015.12.011

DO - 10.1016/j.bbmt.2015.12.011

M3 - Article

VL - 22

SP - 475

EP - 481

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

IS - 3

ER -