Autologous Hematopoietic Cell Transplantation for Breast Cancer and Germ-cell Tumors

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Autologous hematopoietic progenitor-cell support (AHPCS), derived from bone marrow or from peripheral blood progenitor cells (PBPCs), allows for the dose escalation of chemotherapy up to 10-fold, exploiting the dose-response effect of alkylators and other drugs. While AHPCS circumvents myelosuppression, extramedullary organ toxicities become dose limiting. These substantial dose increments clearly increase the antitumor activity of high-dose chemotherapy (HDC) compared with standard dose chemotherapy (SDC), with the goal of improving patient outcome. Widespread substitution of PBPCs for bone marrow support and other improvements in patient care have increased the safety of HDC to current treatment-related mortality (TRM) rates below 5%. Since the advent of modern cisplatin-based chemotherapy, cure rates for metastatic germ-cell tumors have reached 70-80%. The standard first-line regimen of bleomycin/etoposide/cisplatin yields long-term event-free survival rates of 90% in advanced-disease good-risk patients.

Original languageEnglish (US)
Title of host publicationThomas' Hematopoietic Cell Transplantation
Subtitle of host publicationFifth Edition
PublisherWiley-Blackwell
Pages739-750
Number of pages12
Volume2-2
ISBN (Electronic)9781118416426
ISBN (Print)9781118416006
DOIs
StatePublished - Jan 1 2016

Keywords

  • Autologous stem-cell transplantation
  • Breast cancer
  • Germ-cell tumor
  • High-dose chemotherapy
  • Testicular cancer

ASJC Scopus subject areas

  • General Medicine

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