Occult tumor cell contamination in patients with stage II III breast cancer receiving sequential high-dose chemotherapy

• Published in: Bone marrow transplantation (Basingstoke) Vol. 32; no. 11; pp. 1059 - 1064
• Main Authors: VIRET, F, CHABANNON, C, BARDOU, V. J, LADAIQUE, P, BRAUD, A. C, MARANINCHI, D, VIENS, P, SAINTY, D, GENRE, D, GONCALVES, A, ARNOULET, C, GRAVIS, G, BERTUCCI, F, HOUVENAEGHEL, G, JACQUEMIER, J
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.12.2003
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - toxicity; Apheresis; Biological and medical sciences; Blood Component Removal - adverse effects; Blood Component Removal - standards; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Breast cancer; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Cancer; Care and treatment; Cell Count; Chemotherapy; Complications and side effects; Contamination; Cyclophosphamide; Cyclophosphamide - administration & dosage; Cytokeratin; Dose-Response Relationship, Drug; Doxorubicin - administration & dosage; Epithelial cells; Epithelium; Evaluation; Female; Health risks; Hematopoietic Stem Cell Mobilization; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - standards; Histology; Humans; Medical sciences; Metastases; Middle Aged; Monoclonal antibodies; Neoplasm Metastasis - pathology; Neoplastic Cells, Circulating - pathology; Patient outcomes; Patients; Pharmacology. Drug treatments; Prospective Studies; Stem cell transplantation; Stem cells; Survival Analysis; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Treatment Outcome; Tumor cells; Tumors; France; Antineoplastic agent; Human; Prognosis; Apheresis; tumor cell contamination; Stem cell; Hematopoietic cell; breast cancer; Malignant tumor; Contamination; Autograft; Treatment; apheresis products; Graft; Mammary gland; sequential high-dose chemotherapy; High dose; Tumor cell
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1704283

The purpose of this study was to evaluate the presence of micrometastatic cells in the apheresis products from patients with breast cancer, and also to determine if repeated infusion of contaminated products had any clinical impact. A total of 94 patients with high-risk breast cancer were enrolled in a prospective single center study to evaluate the use of dose-intensified chemotherapy (doxorubicine 75 mg/m(2) and cyclophosphamide 3000 or 6000 mg/m(2) for four cycles) with repeated (x 2) stem cell reinfusion. All women were monitored for the presence of metastatic cells in aphereses, collected after first course of intensive chemotherapy, and following additional mobilization with rhG-CSF. Epithelial cells were screened with monoclonal antibodies directed to cytokeratin. Eight of the 94 patients had detectable tumor cells in one or several aphereses collected after intensive chemotherapy; this was unrelated to other tumor characteristics, including size, histology, Scarff Bloom and Richardson (SBR) grading (presence or absence of hormone receptors). Hemato-poietic reconstitution was similar in the cells from these eight patients, and in the total patient population. Three of these eight patients relapsed. This study has confirmed that contamination of apheresis products remains a rare event, which does not seem to affect clinical evolution, even when reinfused into the patient.