© 2004 European Society for Medical Oncology
Original Article |
Micrometastatic bone marrow cells at diagnosis have no impact on survival of primary breast cancer patients with extensive axillary lymph node involvement treated with stem cell-supported high-dose chemotherapy
1 University of Heidelberg, Department of Gynecology and Obstetrics, Heidelberg; 2 Institute for Gynecological Oncology, Mannheim; 3 University of Heidelberg, Department of Internal Medicine V, Heidelberg; 4 University of Heidelberg, Department of Pathology, Heidelberg; 5 University of Heidelberg, Coordination Center for Clinical Trials, Heidelberg; 6 University of Düsseldorf, Department of Hematology and Oncology, Düsseldorf, Germany
* Correspondence to: Dr A. Schneeweiss, University of Heidelberg, Department of Gynecology and Obstetrics, Vossstrasse 9, D-69115 Heidelberg, Germany. Tel: +49-6221-567856; Fax: +49-6221-567920; Email: andreas_schneeweiss{at}med.uni-heidelberg.de
Backround: To determine the impact of micrometastatic bone marrow cells (MMC) on survival in high-risk primary breast cancer (HRPBC) patients treated with high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT).
Patients and methods: Ninety-one HRPBC patients (73 patients with 
10 involved axillary lymph nodes (ALN), 18 premenopausal women with 4 involved ALN) received one cycle (eight patients) or two cycles of HDCT and ASCT. Bone marrow aspiration was performed before systemic treatment to search for MMC using a cocktail of four monoclonal epithelial-specific antibodies (5D3, HEA125, BM7 and BM8). The influence of MMC and other prognostic factors on disease-free survival (DFS), distant DFS (DDFS), and overall survival (OS) was analysed.
Results: In 23 of 91 patients (25%) we detected a median of three MMC (range, 1–43) among 106 mononuclear cells. With a median follow-up of 62 months (range, 10–117), the detection of MMC was not associated with DFS (P=0.929), DDFS (P=0.664) or OS (P=0.642). In multivariate analysis the strongest predictor was nodal ratio for DFS (P=0.012) and expression of p53 for OS (P <0.001).
Conclusion: The detection of MMC at diagnosis has no impact on survival in HRPBC patients treated with HDCT and ASCT.
Key words: high-dose chemotherapy, micrometastatic bone marrow cells, primary breast cancer, prognostic impact, survival
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