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

Massimo Martino, Francesco Lanza, Lorenzo Pavesi, Mustafa Öztürk, Didier Blaise, Rubén Leno Núñez, Harry C. Schouten, Alberto Bosi, Ugo De Giorgi, Daniele Generali, Giovanni Rosti, Andrea Necchi, Andrea Ravelli, Carmelo Bengala, Manuela Badoglio, Paolo Pedrazzoli, Marco Bregni, European Group for Blood and Marrow Transplantation Solid Tumor Working Party

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, <10 positive lymph nodes, and smaller tumor size. HER2 status did not affect survival probability. Adjuvant HDC with AHSCT has a low mortality rate and provides impressive long-term survival rates in patients with high-risk BC. Our results suggest that this treatment modality should be considered in selected high-risk BC patients and further investigated in clinical trials.

Original languageEnglish
Pages (from-to)475-81
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume22
Issue number3
DOIs
Publication statusPublished - Mar 2016

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Keywords

  • Adult
  • Aged
  • Autografts
  • Breast Neoplasms
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Europe
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Middle Aged
  • Registries
  • Survival Rate
  • Journal Article
  • Multicenter Study

Cite this

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, M., Pedrazzoli, P., Bregni, M., & European Group for Blood and Marrow Transplantation Solid Tumor Working Party (2016). 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. Biology of Blood and Marrow Transplantation, 22(3), 475-81. https://doi.org/10.1016/j.bbmt.2015.12.011