[High-dose chemotherapy with hematopoietic salvage in patients with breast cancer]

During the last years, high-dose chemotherapy with autologous hematological rescue has been increasingly used not only in the treatment of patients with relapsing lymphoma but also in ovarian and breast carcinoma. In this manuscript we present results in patients with high-risk primary breast cancer, and in those with metastatic tumors. When high-dose chemotherapy is given in the adjuvant setting for women presenting with > or = 10 metastatic axillary nodes, results are very promising since 72% of the patients are alive without evidence of disease more than 3 years after operation. In patients with inflammatory breast carcinoma, high-dose chemotherapy induces 80% of complete remissions. Considering patients with metastatic disease, high-dose, chemotherapy increases the complete remission rate and duration of response. In several studies, survival exceeding 5 years without relapse is seen in 10 to 15% of the patients. Toxic death rate globally is 10% and is decreasing progressively since the first studies. However, in order to really determine the value of high-dose chemotherapy with autologous hematological support, randomized trials will be needed, comparing this new approach to conventional treatment. Such studies are already going on in the USA and in Europe and results are awaited with great interest.