The beneficial effect of high dose chemotherapy with HSCT in patients with advanced ovarian carcinoma, with complete clinical remission

Twenty-two patients with advanced ovarian carcinoma underwent
high-dose chemotherapy supported by hematopoietic stem cell transplantation.
Ten patients received double transplantation following ICE and CME,
respectively. Twelve patients received only one course of high dose chemotherapy
(CME, ICE, Melphalan and Carboplatine or Melphalan). Seven and 15 patients
were in CR and PR prior to autologous HSCT, respectively. Toxicity was in a
majority of cases manageable. One patient died due to infection complication
after the second transplant. All patients were followed and their fate registered.
It was shown that patients in clinical remission prior to HD chemotherapy
enjoyed statistically significant better two years survival as compared to those with
PR (83% vs 37%, p=0.049). The median follow-up of patients was 24.7 months
in the CR group and 12.5 months in PR group. Overall cumulative proportion of survival was significantly better in the group with CR prior to the procedure.
There was no difference in overall survival with respect to one or two HD
chemotherapy courses and to length of the disease. The survival of patients with
PR was unsatisfactory calling for a maintenance involving immunotherapy
according to the recent progress in this field.