High-dose busulfan, melphalan and thiotepa as consolidation for noninflammatory high-risk breast cancer

F. Gutierrez-Delgado, L. A. Holmberg, H. Hooper, F. R. Appelbaum, R. B. Livingston, R. T. Maziarz, P. Weiden, S. Rivkin, P. Montgomery, K. Kawahara, W. Bensinger

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6 Scopus citations


The purpose of this study was to evaluate the toxicity and efficacy of high-dose busulfan, melphalan and thiotepa (Bu/Mel/TT) in patients with high-risk non-inflammatory breast cancer defined as stage II disease ≥ 10 lymph nodes (n = 52) or stage III (n = 69), and prognostic factors for treatment outcome. One hundred and twenty-one patients (median age, 46 years) were treated with high-dose Bu (12 mg/kg), Mel (100 mg/m2) and TT (500 mg/m2) (HDC) followed by autologous stem cell infusion (ASCI). One hundred patients were initially treated with surgery followed by standard adjuvant chemotherapy prior to HDC/ASCI. Twenty-one patients with stage III disease had inoperable tumors at diagnosis and were treated with neoadjuvant chemotherapy and surgery before HDC/ASCI. Transplant-related mortality was 6%. The probabilities of event-free survival (EFS) at 3 and 5 years (median follow-up of 36 months) from transplant were, for all patients: 0.62-0.60; stage II: 0.71-0.67: stage III: 0.55-0.55 (for stage III adjuvant and neoadjuvant groups: 0.60-0.60 and 0.42-0.42, respectively). Multivariate analysis did not identify variables associated with poor outcome. The efficacy of Bu/Mel/TT is similar to other HDC regimens reported for patients with high-risk non-inflammatory breast cancer. Bu/Mel/TT has high activity in stage II disease and a moderate benefit in stage III operable tumors.

Original languageEnglish (US)
Pages (from-to)51-59
Number of pages9
JournalBone Marrow Transplantation
Issue number1
StatePublished - 2000


  • Breast cancer
  • Busulfan
  • High-dose chemotherapy
  • Melphalan
  • PBSC
  • Thiotepa

ASJC Scopus subject areas

  • Hematology
  • Transplantation


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