Skip to main content
Log in

Intensive chemotherapy with autologous bone marrow transplantation for small-cell lung cancer

  • Original Articles
  • Bone Marrow Transplantation, Chemotherapy, Small-Cell Lung Cancer
  • Published:
Cancer Chemotherapy and Pharmacology Aims and scope Submit manuscript

Summary

Since 1980, 75 patients with small-cell lung cancer (SCLC) have been entered into four consecutive studies of high-dose chemotherapy using autologous bone marrow transplantation (ABMT) to assist haematological recovery. In the first study, 25 patients were treated with cyclophosphamide (160–200 mg/kg) as the sole chemotherapy; in the second (26 patients), the cycle of high-dose cyclophosphamide (with or without 800–1,200 mg/m2 etoposide) was repeated as induction treatment. In the first study, response was high [14 complete responses (CR), 7 partial responses (PR)] but was not increased by repeating the cycle (15 CR, 8 PR), and survival was slightly worse in the second trial. In the third study, 15 patients were treated with doxorubicin, vincristine and etoposide for two cycles and then with 200 mg/kg cyclophosphamide. Although high-dose cyclophosphamide increased the complete response rate, the additional responses were short-lived. In the final study, an attempt was made to increase the initial CR rate by combination chemotherapy using carboplatin (400–600 mg/m2), etoposide (120 mg/ m2x4) and either high-dose cyclophosphamide (40 mg/kg x4) or melphalan (140 mg/m2). Although all nine patients responded, none underwent a CR. The long-term survival (up to 7 years) does not appear to be different from that in comparably selected cases treated with conventional chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cornbleet MA, McElwain TJ, Kumar PJ, Filshie J, Selby P, Carter RL, Hedley DW, Clark ML, Millar JL (1983) Treatment of advanced malignant melanoma with high dose melphalan and autologous bone marrow transplantation. Br J Cancer 48: 329

    Google Scholar 

  2. Gregory MW, Birkhead BG, Souhami RL (1988) A mathematical model of drug resistance applied to treatment for small cell lung cancer. J Clin Oncol 6: 457

    Google Scholar 

  3. Humblet Y, Symann M, Bosly A, Delaunois L, Francis C, Machiels J, Beauduin M, Doyen C, Weynants P, Longueville J, Prignot J (1987) Late intensification chemotherapy with autologous bone marrow transplantation in selected small-cell carcinoma of the lung: a randomized study. J Clin Oncol 5: 1864

    Google Scholar 

  4. Ihde DC, Lichter AS, Deisseroth AB, Bunn PA, Carney DN, Cohen MH, Makuch RW, Johnston-Early A, Minna JD (1983) Late intensive combined modality therapy with autologous bone marrow infusion in extensive small cell lung cancer. Proc Am Soc Clin Oncol C774

  5. Klastersky J, Nicaise C, Longeval E, Stryckmans P, for the EORTC Lung Cancer Working Party (1982) Cisplatin, Adriamycin and etoposide (CAV) for remission induction of small cell bronchogenic carcinoma. Evaluation of efficacy and toxicity and pilot study of a “late intensification” with autologous bone marrow rescue. Cancer 50: 652

    Google Scholar 

  6. Schuler U, Ehninger G, Wagner T (1987) Repeated high-dose cyclophosphamide administration in bone marrow tranplantation: exposure to activated metabolites. Cancer Chemother Pharmacol 20: 248

    Google Scholar 

  7. Smith IE, Evans BD, Harland SJ, Robinson BA, Yarnold JR, Glees JG, Ford HT (1985) High-dose cyclophosphamide with autologous bone marrow rescue after conventional chemotherapy in the treatment of small cell lung carcinoma. Cancer Chemother Pharmacol 14: 120

    Google Scholar 

  8. Smith IE, Harland SJ, Robinson BA, Evans BD, Goodhart LC, Calvert AH, Yarnold J, Glees JP, Baker J, Ford HT (1985) Carboplatin: a very active new cisplatin analog in the treatment of small cell lung cancer. Cancer Treat Rep 69: 43

    Google Scholar 

  9. Souhami RL, Harper PG, Linch DC, Trask C, Gladstone AH, Tobias J, Spiro SG, Geddes DM, Richards JDM (1982) High dose cyclophosphamide with autologous bone marrow transplantation as initial treatment of small cell carcinoma of the bronchus. Cancer Chemother Pharmacol 8: 31

    Google Scholar 

  10. Souhami RL, Harper PG, Linch DC, Trask C, Goldstone AH, Tobias JS, Spiro SG, Geddes DM, Richards JDM (1983) High dose cyclophosphamide for small cell carcinoma of the bronchus. Cancer Chemother Pharmacol 10: 205

    Google Scholar 

  11. Souhami RL, Bradbury I, Geddes DM, Spiro SG, Harper PG, Tobias JS (1985) The prognostic significance of laboratory parameters measured at diagnosis in small cell carcinoma of the lung. Cancer Res 45: 2878

    Google Scholar 

  12. Souhami RL, Finn G, Gregory W, Birkhead BG, Birkhead BG, Buckman R, Edwards D, Goldstone AH, Harper PG, Spiro SG, Tobias JS, Geddes D (1985) Very high dose cyclophosphamide as initial treatment for small cell carcinoma of the lung. J Clin Oncol 3: 958

    Google Scholar 

  13. Spitzer G, Farha P, Valdivieso M, Dicke K, Zander A, Vellekoop L, Murphy WK, Dhingra HM, Umsawasdi T, Chiuten D, Carr DT (1986) High-dose intensification therapy with autologous bone marrow support for limited small cell bronchogenic carcinoma. J Clin Oncol 4: 4

    Google Scholar 

  14. Wolff S (1983) High dose etoposide as single agent chemotherapy for small cell carcinoma of the lung. Cancer Treat Rep 67: 957

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This work was supported by the Cancer Research Campaign

Rights and permissions

Reprints and permissions

About this article

Cite this article

Souhami, R.L., Hajichristou, H.T., Miles, D.W. et al. Intensive chemotherapy with autologous bone marrow transplantation for small-cell lung cancer. Cancer Chemother. Pharmacol. 24, 321–325 (1989). https://doi.org/10.1007/BF00304766

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00304766

Keywords

Navigation