It was ultimately determined to be no more effective than normal treatment, and to have significantly higher side effects, including treatment-related death. It also gave rise to one of the most serious cases of research misconduct of the 20th century. Donnall Thomas had shown that bone marrow could be harvested from a person and transplanted into the same or another person. Chronic consequences of the treatment included development of leukemias and lymphomas and heightened vulnerability to infections soon after the transplant. In HDC, the bone marrow transplantation was used to maximise chemotherapeutic dosage. By harvesting and freezing bone marrow, then implanting the marrow after HDC, doctors were theoretically able to break through the frontier of toxicity; the so-called "red ceiling".
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High-Dose Chemotherapy & Stem Cell Transplant For Breast Cancer
High-dose chemotherapy and bone marrow transplant - Wikipedia
High-dose chemotherapy in breast cancer is a subject of considerable controversy. Preliminary results from several randomized trials have shown that it is certainly not the breakthrough hoped for in the early s. The available data are, however, compatible with a modest but potentially important effect on relapse-free survival in the adjuvant treatment of high-risk breast cancer. To prove such an effect, several more years of maturation are required for a number of randomized studies. At this point in time, there is no justification for the use of high-dose chemotherapy in breast cancer outside clinical studies. High-dose chemotherapy in breast cancer continues to be a controversial subject. Following an era in which this treatment modality was considered by many to represent a standard of care for patients with high-risk primary breast cancer, many physicians and most of the public now believe that high-dose chemotherapy is both excessively toxic and ineffective.
High-dose chemotherapy (bone marrow transplant)
The role of high-dose chemotherapy in the adjuvant treatment of breast cancer will eventually be defined by a range of randomized trials that still require years for maturation. Two underpowered single-institution studies from the MD Anderson Cancer Center and from the Netherlands Cancer Institute failed to show an advantage for high-dose therapy. A randomized Scandinavian study compared prolonged and intensive chemotherapy without stem-cell support with brief chemotherapy followed by the STAMP-V regimen. The intensive conventional treatment arm was shown to be superior in terms of relapse-free survival.
High-dose chemotherapy is based on the scientific hypothesis that escalating the dose of drug will overcome drug resistance and improve outcome. Autologous bone marrow transplantation and, more recently, peripheral stem cell transplantation used as a means to restore marrow, made this a viable treatment for patients with selected tumours such as haematological malignancies. The role in breast cancer is less certain.