High-dose chemotherapy with autologous peripheral stem cell support in advanced ovarian cancer

Pierluigi Benedetti-Panici, Stefano Greggi, Giovanni Scambia, M. Giovanna Salerno, Giacomo Menichella, Luca Pierelli, M. Laura Foddai, Bruno Bizzi, Salvatore Mancuso

Research output: Contribution to journalArticle

Abstract

Twenty patients with advanced (stage III-IV), previously untreated ovarian carcinoma were treated by: (a) induction chemotherapy (40 mg/m2 cisplatin, days 1-4; 1.5 g/m2 cyclophosphamide, day 4; every 4 weeks for two cycles) followed by (b) intensification chemotherapy (100 mg/m2 cisplatin, day 1; 650 mg/m2 etoposide, day 2; 1.8 g/m2 carbo-platin, day 3). Eligibility criteria further included: age less than 55 years, moderately good to poor tumour grade, macroscopic (>0.5 cm) residual tumour. Autologous peripheral stem cells were recruited after the induction cycles and, to ensure haemato-logical support, autologous bone marrow harvesting was routinely performed in the first 14 cases. Haematological support consisted of autologous peripheral stem cells and autologous bone marrow transplant in 16 and four patients, respectively. All patients are evaluable for toxicity and 19 for pathological response, one being dead of systemic mycosis 35 days after the autologous bone marrow transplant. Severe extra-haematoiogical toxicities were the following: gastrointestinal (100% neurological (10% hepatic (10% Pathological response was detected in 84% of cases (CR 37% microscopic PR 26% macroscopic PR 21% Median follow-up times of 48 and 41 months have been reached respectively from enrolment and second-look. Four-year 62% overall and 57% progression-free survivals have been reached. Ten patients are still alive with NED (six of seven with CR, three of five with microscopic PR, and one of four with macroscopic PR). Autologous peripheral stem cell transplant significantly reduced the duration of aplasia compared with autologous bone marrow transplant, and toxicity was proved to be manageable in those patients undergoing autologous peripheral stem cell transplant. The prolonged disease-free survival in patients showing CR and microscopic PR suggests that further investigation on this new approach is worthwhile.

Original languageEnglish
Pages (from-to)133-138
Number of pages6
JournalAnnals of Medicine
Volume27
Issue number1
DOIs
Publication statusPublished - 1995

Keywords

  • Chemotherapy
  • Ovarian carcinoma
  • Stem cell support

ASJC Scopus subject areas

  • Medicine(all)

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    Benedetti-Panici, P., Greggi, S., Scambia, G., Salerno, M. G., Menichella, G., Pierelli, L., Foddai, M. L., Bizzi, B., & Mancuso, S. (1995). High-dose chemotherapy with autologous peripheral stem cell support in advanced ovarian cancer. Annals of Medicine, 27(1), 133-138. https://doi.org/10.3109/07853899509031949