HIGH-DOSE THERAPY WITH AUTOLOGOUS BONE-MARROW TRANSPLANTATION AS A SALVAGE REGIMEN FOR OVARIAN-CANCER

Between 1983 and 1988, eight patients with refractory epithelial ovarian cancer were treated with marrow ablative chemoradiotherapy followed by autologous bone marrow transplantation. By using a high dose regimen it was proposed that improved tumor response would be achieved, leading to increased patient salvage. The regimen consisted of cyclophosphamide 60 mg per kilogram per day intravenously (IV) for two consecutive days in seven patients and one patient received melphalan 180 mg/m(2)IV. In conjunction with the chemotherapy the patients received 12.5 Gray of radiation in 2.5 Gray fractions, to the total body in five patients and to the trunk in three patients. All patients had Stage III or IV disease and had previously been treated with cisplatin. All had surgically documented minimal (less than 5 millimeters) disease prior to high dose therapy (HDT). There were three treatment related deaths. The remaining patients had disease recurrence noted from 7 to 13 months after HDT. This study suggests that a different therapeutic regimen should be considered in future studies utilizing HDT with autologous bone marrow transplantation for refractory ovarian cancer.