Klin Onkol 1999; 12(4): 128-132.
Summary: The survival of patients with advanced breast cancer remains poor in spite of the progress achieved by conventional chemotherapy. One of the possible ways to improve the therapeutic effectiveness is intensive cyclic chemotherapy. The toxicity of this treatment modality needs further investigation for optimal hematopoietic support. In our study, we evaluated the effectiveness of administration of whole blood rich in peripheral blood progenitor cells (PBPC) and cryopreserved PBPC harvested by leucapheresis. 29 women with advanced breast cancer were treated, average age 46 years (range 26-58). Six cycles of chemotherapy (epirubicin 150 mg/m2 and cyclophosphamide 1250 mg/m2 administered in 14 days intervals) were given. G-CSF for the attenuation of neutropenia and mobilisation of PBPC was used. Leucaphereses were practiced on days 11, 12 and 13. Harvested cells were divided after cryoconservation into three parts and were administered after 48 hours, 24 hours after application of cytostatics. Grade IV leukopenia was found in 72% of the whole blood support group and in 49% in the group in which PBPC was obtained by leucapheresis. Grade IV thrombocytopenia was found in 29% of cycles, in the whole blood support group and 12% with the support of PBPC obtained by leucapheresis. The disease free interval in two years is 70%. There was a statistically significant decrease of the ejection fraction of the left ventricle after treatment. This finding persisted in control examination three months after therapy. There was an average value of 56% (SD 5,2) before treatment and 52,1% (SD 5,1) after treatment. We observed no clinical symptoms of heart failure. Good tolerance of the treatment was confirmed. However, there is a need to attain the same effectiveness by the administration of whole blood as the administration of PBPC obtained by leucapheresis. Therefore, we are looking for better methods of mobilization and harvest.
