The survival for patients with advanced
breast cancer following conventional
combination chemotherapy remains limited. Attempts to circumvent drug resistance have involved high-dose
chemotherapy along with autologous hematopoietic stem cell support. Despite this, relapse remains the primary cause of death.
Breast tumor cells are commonly found in hematopoietic stem cell collections. The role of reinfused occult
tumor cells in malignant relapse following high-dose
chemotherapy has yet to be determined but is likely to have a negative impact. Strategies to decrease stem cell contamination under investigation include: (1) improved regimens for
stem cell mobilization, (2) enhanced techniques for
tumor cell detection, (3) targeted
tumor cell purging and (4) alternative sources of stem cells. These approaches hold promise for improving the outcome of patients undergoing high-dose
chemotherapy and stem cell reinfusion for poor-prognosis
breast cancer.