Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Breast Cancer

High-dose chemotherapy (CTM) for breast cancer

Bone Marrow Transplantation volume 26, pages 257–268 (2000)Cite this article

Abstract

We designed and implemented a new mitoxantrone-based high-dose chemotherapy regimen to minimize pulmonary injury (seen in carmustine-based regimens) in patients with breast cancer. One hundred and ninety-one breast cancer patients (99 stage II/IIIA; 27 stage IIIB; 65 stage IV responsive to conventional-dose chemotherapy) were treated with high-dose chemotherapy (CTM) delivered over 4 days (cyclophosphamide (6 g/m2), thiotepa (600 mg/m2), and mitoxantrone (24–60 mg/m2)) followed by autologous hematopoietic stem cell rescue. Stage II/III patients received chest wall radiation and tamoxifen (if hormone-receptor positive) after CTM. The 5-year event-free survival (EFS) for stage II/IIIA patients with 10 or more involved axillary lymph nodes (n = 80) was 62 ± 12%. Hormone receptor-positive patients with 10 or more nodes did significantly better than negative patients. The EFS for stage IIIB patients at 5 years was 44 ± 19%; for stage IV patients at 5 years was 17 ± 10%. Stage IV patients achieving complete response in viscera and/or soft tissue prior to CTM did significantly better than those achieving a partial response. There were six (3%) treatment-related deaths including two due to diffuse alveolar hemorrhage. There were no episodes of delayed interstitial pneumonitis. There were six severe cardiac events in 91 patients (6.6%) but none after instituting mitoxantrone dose-adjustment in the final 100 patients. We conclude that CTM is associated with a low treatment-related mortality and little pulmonary toxicity. CTM produces excellent outcomes in stage II/IIIA patients with 10 or more involved axillary lymph nodes. Bone Marrow Transplantation (2000) 26, 257–268.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Peters WP . The rationale for high-dose chemotherapy with autologous bone marrow support in treating breast cancer. In: Dicke K, Spitzer G, Zander A (eds) Autologous Bone marrow transplantation. Proceedings of the First International Symposium MD Anderson Cancer Center Press: Houston, TX 1985 pp 189–196

    Google Scholar 

  2. Frei E III, Antman K, Teicher B et al. Bone marrow autotransplantation for solid tumors – Prospects J Clin Oncol 1989 7: 515–526

    Article  PubMed  Google Scholar 

  3. Antman K, Bearman SI, Davidson N et al. Dose intensive strategy in breast cancer: current status. In: Champlin RE, Gale RP (eds) New Strategies in Bone Marrow Transplantation Allen R. Liss: New York 1991 pp 423–436

    Google Scholar 

  4. Hryniuk W, Levine MN . Analysis of dose intensity for adjuvant chemotherapy trials in stage II breast cancer J Clin Oncol 1986 4: 1162–1170

    Article  CAS  PubMed  Google Scholar 

  5. Hryniuk WM, Bush H . The importance of dose intensity in chemotherapy of metastatic breast cancer J Clin Oncol 1986 2: 1281–1288

    Article  Google Scholar 

  6. Peters WP, Ross M, Vredenburgh JJ et al. High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primarybreast cancer J Clin Oncol 1993 11: 1132–1143

    Article  CAS  PubMed  Google Scholar 

  7. Peters WP, Berry D, Vredenburgh JJ et al. Five year followup of high-dose combination alkylating agents with ABMT as consolidation after standard-dose CAF for primary breast cancer involving ⩾10 axillary lymph nodes (Duke/CALGB 8782) Proc Am Soc Clin Oncol 1995 14: 317 (Abstr. 933)

    Google Scholar 

  8. Gianni AM, Siena S, Bregni M et al. Efficacy, toxicity, and applicability of high-dose sequential chemotherapy as adjuvant treatment in operable breast cancer with 10 or more involved axillary lymph nodes: five-year results J Clin Oncol 1997 15: 2312–2321

    Article  CAS  PubMed  Google Scholar 

  9. Eddy D . High-dose chemotherapy with autologous bonemarrow transplantation for the treatment of metastatic breastcancer J Clin Oncol 1992 10: 657–670

    Article  CAS  PubMed  Google Scholar 

  10. Peters WP . Autologous bone marrow transplantation for breast cancer. In: Forman SJ, Blume KG, Thomas ED (eds) Bone Marrow Transplantation Blackwell Scientific Publications: Boston 1994 789–801

    Google Scholar 

  11. Rahman ZU, Frye DK, Buzdar AU et al. Impact of selection process on response rate and long-term survival of potential high-dose chemotherapy candidates treated with standard-dose doxorubicin containing chemotherapy in patients with metastatic breast cancer J Clin Oncol 1997 15: 3171–3177

    Article  CAS  PubMed  Google Scholar 

  12. Gradishar WJ, Tallman MS, Abrams JS . High-dose chemotherapy for breast cancer Ann Intern Med 1996 125: 599–604

    Article  CAS  PubMed  Google Scholar 

  13. Bezwoda WR, Seymor L, Dansey RD . High-dose chemotherapy with hematopoietic rescue as primary treatment for metastatic breast cancer: a randomized trial J Clin Oncol 1995 13: 2483–2489

    Article  CAS  PubMed  Google Scholar 

  14. Peters WP, Schpall EJ, Jones RB et al. High-dose combination alkylating agents with bone marrow support as initial treatment for metastatic breast cancer J Clin Oncol 1988 6: 1368–1376

    Article  CAS  PubMed  Google Scholar 

  15. Todd NW, Peters, Ost AH et al. Pulmonary drug toxicity in patients with primary breast cancer treated with high-dose combination chemotherapy and autologous bone marrow transplantation Am Rev Respir Dis 1993 147: 1264–1270

    Article  CAS  PubMed  Google Scholar 

  16. Jones RB, Matthes S, Shpall EJ et al. Acute lung injury following treatment with high-dose cyclophosphamide, cisplatin, and carmustine: pharmacodynamic evaluation of carmustine J Natl Cancer Inst 1993 85: 640–647

    Article  CAS  PubMed  Google Scholar 

  17. Beahrs OH, Henson DE, Hutter RVP, Myers MH (eds) . In: Manual for Staging of Cancer JB Lippincott Company: Philadelphia 1988 pp 145–150

  18. Oken MM, Creech RH, Tormey DC et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group Am J Clin Oncol 1982 5: 649–655

    Article  CAS  PubMed  Google Scholar 

  19. Linker CA, Ries CA, Damon LE et al. Autologous bone marrow transplantation for acute myeloid leukemia using busulfan plus etoposide as a preparative regimen Blood 1993 81: 311–318

    CAS  PubMed  Google Scholar 

  20. Rugo H, Damon L, Ries C, Linker C . Single day large volume leukopheresis following standard dose chemotherapy forbreast cancer is adequate for transplantation Blood 1995 86: (Suppl. 1) 408a (Abstr. 1618)

    Google Scholar 

  21. Antman K, Ayash L, Elias A et al. A phase II study of high-dose cyclophosphamide, thiotepa and, carboplatin with autologous marrow support in women with measurable advanced breast cancer responding to standard-dose therapy J Clin Oncol 1992 10: 102–110

    Article  CAS  PubMed  Google Scholar 

  22. Alexander J, Dainiak N, Berger HJ et al. Serial assessment of doxorubicin cardiac toxicity with quantitative radionuclide angiocardiography New Engl J Med 1979 300: 278–283

    Article  CAS  PubMed  Google Scholar 

  23. Henderson IC, Allegra JC, Woodcock T et al. Randomized clinical trial comparing mitoxantrone with doxorubicin in previously treated patients with metastatic breast cancer J Clin Oncol 1989 7: 560–571

    Article  CAS  PubMed  Google Scholar 

  24. Robbins RA, Linder J, Stahl MG et al. Diffuse alveolar hemorrhage in autologous bone marrow transplant recipients Am J Med 1989 87: 511–518

    Article  CAS  PubMed  Google Scholar 

  25. Chao NJ, Duncan SR, Long GD et al. Corticosteroid therapy for diffuse alveolar hemorrhage in autologous bone marrow transplant recipients Ann Int Med 1991 114: 145–146

    Article  CAS  PubMed  Google Scholar 

  26. Jones SE, Moon TE, Bonadonna G et al. Comparison of different trials of adjuvant chemotherapy in stage II breast cancer using a natural history data base Am J Clin Oncol 1987 10: 387–395

    Article  CAS  PubMed  Google Scholar 

  27. Moon TE, Jones SE, Bonadonna G et al. Development and use of a natural history data base of breast cancer studies Am J Clin Oncol 1987 10: 396–403

    Article  CAS  PubMed  Google Scholar 

  28. Abeloff MD, Beveridge RA, Donehower RC et al. Sixteen-week dose-intense chemotherapy in the adjuvant treatment of breast cancer J Natl Cancer Inst 1990 82: 570–574

    Article  CAS  PubMed  Google Scholar 

  29. Davidson NE, Abeloff MD . Adjuvant systemic therapy in women with early-stage breast cancer at high risk for relapse J Natl Cancer Inst 1992 84: 301–305

    Article  CAS  PubMed  Google Scholar 

  30. Kaufman M, Jonat W, Caffier H et al. Adjuvant systemic risk adapted cytotoxic ± tamoxifen therapy in women with node positive breast cancer. In: Salmon S (ed) Adjuvant Therapy of Cancer V Grune & Stratton: Orlando 1987 337–346

    Google Scholar 

  31. Clark GM, McGuire WL . New biologic prognostic factors in breast cancer Oncol 1989 3: 49–54

    CAS  Google Scholar 

  32. Buzzoni R, Bonadonna G, Valagussa P et al. Adjuvantchemotherapy with doxorubicin plus cyclophosphamide, methotrexate, and fluorouracil in the treatment of resectable breastcancer with more than three positive axillary nodes J Clin Oncol 1991 9: 2134–2140

    Article  CAS  PubMed  Google Scholar 

  33. Bonadonna G, Zambetti M, Valagussa P . Sequential or alternating doxorubicin and CMF regimens in breast cancer with more than three positive nodes. Ten year results JAMA 1995 273: 542–547

    Article  CAS  PubMed  Google Scholar 

  34. Buzdar AV, Kau S-W, Hortobagyi GN et al. Clinical course of patients with breast cancer with ten or more positive nodes who were treated with doxorubicin-containing adjuvant therapy Cancer 1992 69: 448–452

    Article  CAS  PubMed  Google Scholar 

  35. Gilchrist KW, Gray R, Fowble B et al. Tumor necrosis factor is a prognostic predictor for early recurrance and death in lymph-node positive breast cancer: a 10-year follow-up study of 728 Eastern Cooperative Oncology Group patients J Clin Oncol 1993 10: 1919–1935

    Google Scholar 

  36. Spaeth D, Luprosi E, Weber B et al. High-risk primary breast cancer (PBC) with 10 or more positive axillary lymph nodes (PALN). A 163 patients (pts) series Proc Am Soc Clin Oncol 1994 13: 106 (Abstr. 226)

    Google Scholar 

  37. Ung O, Langlands AO, Barraclough B et al. Combined chemotherapy and radiotherapy for patients with breast cancer and extensive nodal involvement J Clin Oncol 1995 13: 435–443

    Article  CAS  PubMed  Google Scholar 

  38. Garcia-Carbenero R, Hidalgo M, Paz-Ares L et al. Patient selection in high-dose chemotherapy trials: relevance in high-risk breast cancer J Clin Oncol 1997 15: 3178–3184

    Article  Google Scholar 

  39. Tajita T, Tokuda J, Ohta M et al. Role of autologous bone marrow transplantation in cancer chemotherapy Low Temp Med 1989 15: 44–50

    Google Scholar 

  40. Somlo G, Doroshow JH, Forman S et al. High-dose chemotherapy and stem-cell rescue in the treatment of high-riskbreast cancer: prognostic indicators of progression-free andoverall survival J Clin Oncol 1997 15: 2882–2893

    Article  CAS  PubMed  Google Scholar 

  41. Crump M, Goss PE, Prince M, Girouard C . Outcome of extensive evaluation before adjuvant therapy in women with breast cancer and 10 or more positive axillary lymph nodes J Clin Oncol 1996 14: 66–69

    Article  CAS  PubMed  Google Scholar 

  42. Diab SG, deMoor CA, Clark GM et al. Radiation therapy improves survival by decreasing local failure in breast cancer patients with 10 or more positive axillary lymph nodes (ALN) treated with mastectomy Proc Am Soc Clin Oncol 1997 16: 130a (Abstr. 458)

    Google Scholar 

  43. Peters W, Rosner G, Vredenburgh J et al. A prospective, randomized comparison of two of combination alkylating agents (AA) as consolidation after CAF in high-risk primary breast cancer involving ten or more axillary lymph nodes (LN): preliminary results of CALGB 9082/SWOG 9114/NCICMA-13 Proc Am Soc Clin Oncol 1999 18: 1a (Abstr. 2)

    Google Scholar 

  44. Antman K, Rowlings PA, Vaughan WP et al. High-dose chemotherapy with autologous hematopoietic stem-cell support for breast cancer in North America J Clin Oncol 1997 15: 1870–1879

    Article  CAS  PubMed  Google Scholar 

  45. Overgaard M, Hansen PS, Overgaard J et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy New Engl J Med 1997 337: 949–955

    Article  CAS  PubMed  Google Scholar 

  46. Ragaz J, Jackson SM, Le N et al. Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer New Engl J Med 1997 337: 956–962

    Article  CAS  PubMed  Google Scholar 

  47. Rodenhuis S, Richel DJ, van der Wall E et al. Randomised trial of high-dose chemotherapy and haemopoietic progenitor-cell support in operable breast cancer with extensive axillary lymph-node involvement Lancet 1998 352: 515–521

    Article  CAS  PubMed  Google Scholar 

  48. Hortobagyi GN, Buzdar AU, Champlin R et al. Lack of efficacy of adjuvant high-dose (HD) tandem combination chemotherapy (CT) for high-risk primary breast cancer (HRPBC) – a randomized trial Proc Am Soc Clin Oncol; 1998 17: 123a (Abstr. 471)

    Google Scholar 

  49. Bezwoda WR . Randomised, controlled trial of high dose chemotherapy for high risk, surgically treated, primary breast cancer Proc Am Soc Clin Oncol 1999 18: 2a (Abstr. 4)

    Google Scholar 

  50. Vahdat L, Antman K . Dose-intensive chemotherapy in breast cancer. In: Armitage J, Antman K (eds) High-Dose Cancer Therapy: Pharmacology, Hematopoietins, Stem Cells, 2nd edition Williams and Wilkins: Philadelphia 1995 802–823

    Google Scholar 

  51. Jaiyesimi JA, Buzdar AV, Hortobagyi G . Inflammatory breast cancer: a review J Clin Oncol 1992 10: 1014–1024

    Article  CAS  PubMed  Google Scholar 

  52. Broun ER, Sledge GW, Einhorn LH et al. High-dose carboplatin and mitoxantrone with autologous bone marrow support in the treatment of advanced breast cancer Am J Clin Oncol 1993 16: 9–13

    CAS  PubMed  Google Scholar 

  53. Fields KK, Elfenbein GJ, Perkins JD et al. Two novel high-dose treatment regimens for metastatic breast cancer –ifosfamide, carboplatin, plus etoposide and mitoxantrone plusthiotepa: outcomes and toxicities Semin Oncol 1993 20: (Suppl. 6) 59–66

    CAS  PubMed  Google Scholar 

  54. Williams SF, Mick R, Desser R et al. High-dose consolidation therapy with autologous stem cell rescue in stage IV breast cancer J Clin Oncol 1989 7: 1824–1830

    Article  CAS  PubMed  Google Scholar 

  55. Kennedy MJ, Beveridge RA, Rowley SD et al. High-dose chemotherapy with reinfusion of purged autologous bone marrow following dose-intense induction as initial therapy for metastatic breast cancer J Natl Cancer Inst 1991 83: 920–926

    Article  CAS  PubMed  Google Scholar 

  56. Ayash LJ, Elias A, Wheeler C et al. Double dose-intensive chemotherapy with autologous marrow and peripheral blood progenitor-cell support for metastatic breast cancer: a feasibility study J Clin Oncol 1994 12: 37–44

    Article  CAS  PubMed  Google Scholar 

  57. Ghalie R, Richman CM, Adler SS et al. Treatment of metastatic breast cancer with a split course high-dosechemotherapy regimen and autologous bone marrow transplantation J Clin Oncol 1994 12: 342–346

    Article  CAS  PubMed  Google Scholar 

  58. Crown J, Kritz A, Vahdat L et al. Rapid administration of multiple cycles of high-dose myelosuppressive chemotherapy in patients with metastatic breast cancer J Clin Oncol 1993 11: 1144–1149

    Article  CAS  PubMed  Google Scholar 

  59. Klumpp TR, Mangan KF, Glenn LD et al. Phase II pilot study of high-dose busulfan and cyclophosphamide followed by autologous bone marrow or peripheral stem cell transplantation in patients with advanced chemosensitive breast cancer Bone Marrow Transplant 1993 11: 337–339

    CAS  PubMed  Google Scholar 

  60. Ayash LJ, Wheeler C, Fairclough D et al. Prognostic factors for prolonged progression-free survival with high-dose chemotherapy with autologous stem cell support for advanced breast cancer J Clin Oncol 1995 13: 2043–2049

    Article  CAS  PubMed  Google Scholar 

  61. Dunphy FR, Spitzer G, Rossiter-Fornoff JE et al. Factors predicting long-term survival for metastatic breast cancer patients treated with high-dose chemotherapy and bone marrow support Cancer 1994 73: 2157–2167

    Article  CAS  PubMed  Google Scholar 

  62. Falkson G, Gelman R, Falkson CI et al. Factors predicting for response, time to treatment failure, and survival in women with metastatic breast cancer treated with DAVTH: a prospective Eastern Cooperative Oncology Group study J Clin Oncol 1991 9: 2153–2161

    Article  CAS  PubMed  Google Scholar 

  63. Peters WP, Jones RB, Vredenburgh J et al. A large, prospective, randomized trial of high-dose combination alkylating agents (CPB) with autologous cellular support (ABMS) as consolidation for patients with metastatic breast cancer achieving complete remission after intensive doxorubicin-based induction chemotherapy (AFM) Proc Am Soc Clin Oncol 1996 15: 121 (Abstr. 149)

    Google Scholar 

  64. Doroshow J, Somlo G, Ahn C et al. Prognostic factors predicting progression-free (PFS) and overall survival (OS) in patients (PTS) with responsive metastatic breast cancer (MBC) treated with high-dose chemotherapy (HDCT) and bone marrow stem cell reinfusion Proc Am Soc Clin Oncol 1995 14: 319 (Abstr. 942)

    Google Scholar 

  65. Stuart-Harris R, Bozek T, Pavlidis AN et al. An active new agent in the treatment of advanced breast cancer Cancer Chemother Pharmacol 1982 12: 1–4

    Google Scholar 

  66. Yap HY, Blumenschein G, Schell F et al. Dihydroxyanthracenedione: a promising new drug in the treatment of metastatic breast cancer Ann Intern Med 1981 95: 694–697

    Article  CAS  PubMed  Google Scholar 

  67. Levin M, Pandya KJ, Khandekar JD et al. Phase II study of mitoxantrone in advanced breast cancer: An Eastern Cooperative Oncology Group pilot study Cancer Treat Rep 1984 68: 1511–1512

    CAS  PubMed  Google Scholar 

  68. Smalley R, Gams R . Phase II study of mitoxantrone in patients with metastatic breast carcinoma: a Southeastern Cancer Study Group project Cancer Treat Rep 1983 67: 1039–1040

    CAS  PubMed  Google Scholar 

  69. Shenkenberg TD, Van Hoff DD . Mitoxantrone a new anticancer drug with significant clinical activity Ann Int Med 1986 105: 67–81

    Article  CAS  PubMed  Google Scholar 

  70. Neidhart JA, Gochonur D, Roch R et al. A comparison of mitoxantrone and doxorubicin in breast cancer J Clin Oncol 1986 4: 672–677

    Article  CAS  PubMed  Google Scholar 

  71. Coleman RE, Maisey MN, Knight RK et al. Mitoxantrone in advanced breast cancer – a phase II study with special attention to cardiac toxicity Eur J Cancer Clin Oncol 1984 20: 771–776

    Article  CAS  PubMed  Google Scholar 

  72. Baum JG, McCarthy A, LeRoy DK et al. Proceedings of the workshop on mitoxantrone cardiac toxicity and the workshop on clinical evaluation of anthracycline cardiac toxicity. Cancer Treat Symposia, vol. 3 National Institutes of Health: Bethesda, Maryland 1984

    Google Scholar 

  73. Wallerstein R Jr, Spitzer G, Dunphy F et al. A phase II study of mitoxantrone, etoposide, and thiotepa with autologous bone marrow support for patients with relapsed breast cancer J Clin Oncol 1990 8: 1782–1788

    Article  PubMed  Google Scholar 

  74. Bowers C, Adkins D, Dunphy F et al. Dose escalation of mitoxantrone given with thiotepa and autologous bone marrow transplantation for metastatic breast cancer Bone Marrow Transplant 1993 12: 525–530

    CAS  PubMed  Google Scholar 

  75. Gisselbrecht C, Extra JM, Lotz JP et al. Cyclophos-phamide/mitoxantrone/melphalan (CMA) regimen prior to autologous bone marrow transplantation (ABMT) in metastatic breast cancer Bone Marrow Transplant 1996 18: 857–863

    CAS  PubMed  Google Scholar 

  76. de Graaf H, Willemse PHB, de Vries EGE et al. Intensive chemotherapy with autologous bone marrow transfusion as primary treatment in women with breast cancer and more than five involved axillary lymph nodes Eur J Cancer 1994 30A: 150–153

    Article  CAS  PubMed  Google Scholar 

  77. Herzig RH, Fay JW, Herzig GP et al. Phase I–II studies with high-dose thiotepa and autologous bone marrow transplantation in patients with refractory malignancies. In: Herzig GP (ed) High-dose Thiotepa and Autologous Marrow Transplantation John Wiley & Sons Medical Group: Dallas 1987 17–23

    Google Scholar 

  78. Wolff SN, Herzig RH, Herzig GP et al. High-dose thiotepa with autologous bone marrow transplantation for metastatic malignant melanoma. In: Herzig GP (ed) High-dose Thiotepa and Autologous Marrow Transplantation John Wiley & Sons Medical Group: Dallas 1987 25–30

    Google Scholar 

  79. Gurtoo HL, Hipkens JH, Sharma SD . Role of glutathione in the metabolism-dependent toxicity in chemotherapy of cyclophosphamide Cancer Res 1981 41: 3584–3591

    CAS  PubMed  Google Scholar 

  80. Kaminer LS, Williams SF, Beschorner J et al. High-dose chemotherapy with autologous hematopoietic stem cell support in the refractory stage IV breast carcinoma Bone Marrow Transplant 1989 4: 359–362

    CAS  PubMed  Google Scholar 

  81. Jules-Elyse K, Gulati S, Stover DE et al. Pulmonary complications in autologous bone marrow transplantation Am Rev Respir Dis 1990 141: A604 (Abstr.)

    Google Scholar 

  82. Zander AR, Kruger W, Kroger N et al. High dose mitoxantrone with thiotepa, cyclophosphamide and autologous stem cell rescue for high risk stage II and stage III breast cancer Bone Marrow Transplant 1996 18: (Suppl. 1) S24–S25

    PubMed  Google Scholar 

Download references

Acknowledgements

We wish to thank the bone marrow transplant coordinators and nurses Bridget Mazzini, Sharon Coleman, Flo Agudelo, Lisa Bare, Mary Salom, Thea Fand, Catherine Doherty, Suzanne Gooding, and Cindy Ruttan, and Cheryl Breed RNP, for their efforts in the care of these patients, as well as Joy Cruz, Marian Costillo, Deane Hanes and Janet Seim for their expert processing of hematopoietic stem cells. We also wish to thank Jazmine Bergeron and Kevin Cheli-Colando for their assistance with manuscript preparation.

Author information

Authors and Affiliations

  1. Division of Hematology/Oncology, The University of California, San Francisco, CA, USA

    LE Damon, HS Rugo, CA Ries & CA Linker

  2. Alta Bates Comprehensive Cancer Center, Berkeley, CA, USA

    JL Wolf, E Gold, M Cassidy, G Cecchi, N Cohen, D Irwin & M Tracy

  3. Division of Bone Marrow Transplantation, University of Hamburg, Hamburg, Germany

    AR Zander

Authors
  1. LE Damon
    View author publications

    Search author on:PubMed Google Scholar

  2. JL Wolf
    View author publications

    Search author on:PubMed Google Scholar

  3. HS Rugo
    View author publications

    Search author on:PubMed Google Scholar

  4. E Gold
    View author publications

    Search author on:PubMed Google Scholar

  5. AR Zander
    View author publications

    Search author on:PubMed Google Scholar

  6. M Cassidy
    View author publications

    Search author on:PubMed Google Scholar

  7. G Cecchi
    View author publications

    Search author on:PubMed Google Scholar

  8. N Cohen
    View author publications

    Search author on:PubMed Google Scholar

  9. D Irwin
    View author publications

    Search author on:PubMed Google Scholar

  10. M Tracy
    View author publications

    Search author on:PubMed Google Scholar

  11. CA Ries
    View author publications

    Search author on:PubMed Google Scholar

  12. CA Linker
    View author publications

    Search author on:PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Damon, L., Wolf, J., Rugo, H. et al. High-dose chemotherapy (CTM) for breast cancer. Bone Marrow Transplant 26, 257–268 (2000). https://doi.org/10.1038/sj.bmt.1702481

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/sj.bmt.1702481

Keywords

This article is cited by

Search

Advanced search

Quick links