Monitoring of minimal residual cancer in bone marrow in high-risk breast cancer patients treated with high-dose chemotherapy
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KeywordsBreast Cancer Patient Epirubicin Independent Predictive Factor Stem Cell Support Bone Marrow Change
The present study aimed to investigate the clinical relevance of minimal residual cancer in breast cancer patients before and after high-dose adjuvant chemotherapy with or without progenitor stem cell support.
One hundred and eighteen high-risk stage II breast cancer patients entering the Scandinavian Study Group multicentre trial  were randomised to nine cycles of dose-escalated FEC (5-flurouracil, epirubicin, cyclophosphamide) or three cycles of standard FEC followed by high-dose chemotherapy. Bone marrow (BM) samples at diagnosis and 6 months after completion of chemotherapy were assessed for the presence of cytokeratin-positive (CK+) cells. CK+ cells in BM were evaluated as a prognostic and predictive marker and were compared with other defined prognostic factors of the primary tumour.
Monitoring BM changes at time of diagnosis and at 6 months post-treatment is an independent predictive factor for breast cancer-specific survival (P = 0.001, univariate analysis). Those who have consistent CK-negative BM findings constitute a group of patients with good prognosis.
Monitoring of CK+ cells in BM before and after high-dose chemotherapy with or without stem cell support can be used clinically as a surrogate maker to predict outcome in breast cancer patients.
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