Survival after autologous hematopoietic stem cell transplantation for patients with inflammatory breast carcinoma.

BACKGROUND. The authors retrospectively determined the clinical outcome of patients with inflammatory breast carcinoma (IBC) treated with high dose chemotherapy (HDC) and autologous bone marrow (ABM) or peripheral blood stem cell (PBSC) support. METHODS. Twenty-four consecutive patients with IBC received HDC, including escalating doses of carboplatin (range, 1.2-1.8 g/m(2)) and cyclophosphamide (range, 4.8-6.0 g/m(2)) over 3 days followed by ABM (n = 5) or PBSC infusion (n = 19). Restaging evaluation was performed 100 days after transplant, every 6 months for 2 years, and then yearly thereafter. After transplantation, fifteen patients received immunotherapy with interleukin-2 (IL-2) or IL-2 and interferon-alpha. RESULTS. The 2-year estimated disease free survival (DFS) and overall survival (OS) for these patients were 71% (90% confidence interval [CI], 55-87%) and 73% (90% CI, 53-93%), respectively. The median follow-up of surviving patients was 19 months (range, 8-68 months). Six patients developed disease recurrence at a median of 10 months (range, 4-16 months) after transplantation. Four of these 6 patients died from metastatic disease at a median of 18 months (range, 14-21 months). Using the generalized Wilcoxon test and the Cox proportional hazards regression model, patients with tumors that demonstrated estrogen receptors had an improved DFS (P = 0.03). CONCLUSIONS. Combining HDC and ABM or PBSC for patients with IBC may yield an improved OS and DFS. Cancer 1999;85:93-9. (C) 1999 American Cancer Society.