A new technique that matures and expands stem cells when manipulated outside the body appear to hasten recovery of low blood cell levels following a stem cell transplantation in women with breast cancer. Results from a recent study published in the journal, Blood showed quicker recovery of white blood cell, red blood cell and platelet levels in patients who received this treatment as part of a stem cell transplantation.

Results from some recent trials suggest that high-dose chemotherapy with an autologous stem cell transplant is superior treatment compared to conventional dose chemotherapy for patients with stage II and stage III breast cancer (cancer that has spread outside the breast to local lymph nodes). High-dose chemotherapy is an aggressive form of treatment which is effective at killing more cancer cells than standard dose chemotherapy. However, this treatment also kills more healthy cells in the body, especially blood-producing stem cells. Stem cells are immature blood producing cells produced in the bone marrow (spongy material inside large bones). Stem cells eventually develop into the 3 types of blood cells: red blood cells to carry Oxygen to tissues, platelets to aid in blood clotting, and white blood cells which fight infection. When these cells reach critically low levels, serious complications such as anemia, bleeding and infection can occur. Thus, it is imperative to restore stem cell levels as quickly as possible. In an autologous stem cell transplant, the patient’s own stem cells are collected before chemotherapy treatment, frozen, and infused back into the patient after treatment to “rescue” the bone marrow.

Although high-dose treatment followed by stem cell transplantation is an effective anti-cancer treatment strategy, patients are at a high risk for developing life-threatening complications due to low levels of blood cells during the time the stem cells develop into mature blood cells. If stem cells are simply re-infused into the patient without being treated, it commonly takes over 7 to 14 days for their development into the 3 distinct blood cell types. During this time, patients are highly susceptible to serious infections, severe anemia which may require red blood cell infusions and low platelet levels which may require platelet infusions. The most common and serious complication during this time is infection due to low white blood cell levels. Researchers have recently developed a way to mature and expand a patient’s collected stem cells before re-infusing them into the patient. This decreases the amount of time during which blood cell levels are diminished in patients and potentially eliminates the associated risks caused by these low levels.

A recent clinical trial was conducted involving this new method of maturing and expanding collected stem cells in a culture prior to re-infusion. Twenty-four women with stage II or stage III breast cancer were evaluated following high-dose chemotherapy and an autologous stem cell transplant. Almost 30% of these patients had low blood cell levels for only 3 days or less following transplantation. Approximately 40% of patients recovered their white blood cell levels 5 to 6 days following transplantation. Forty percent of patients did not experience infection related fevers and did not require antibiotics. Patients also required fewer red blood cell and platelet infusions. This clinical trial demonstrates that this simple stem cell expansion procedure could significantly reduce low blood counts, which could ultimately lead to fewer side effects and shorter hospital stays for patients undergoing this procedure.

Persons with breast cancer may wish to discuss the risks and benefits of receiving stem cell transplants with stem cell expansion or about the participation in a clinical trial utilizing other promising new strategies. Two sources of information on ongoing clinical trials that can be discussed with a doctor include comprehensive, easy-to-use services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. (Blood, Vol 96, No 7, pp2385-2390, 2000)

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