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Although it is possible to use very high doses of chemotherapy
or radiation to kill cancer cells, such treatments also kill the
blood-making stem cells in the bone marrow. Damage to these cells
lowers a person's blood cell count. Too few white blood cells can lead
to severe infections that could be fatal. Too few platelets make people
bleed easily. This, too, can be fatal.
One way to get around this is to remove some of the patient's
stem cells from either the peripheral (circulating) blood or bone
marrow, give the high-dose treatment, and then return the stem cells
into the body through a blood transfusion. The stem cells are able to
find their way back into the bone marrow, where they soon re-establish
themselves and restore the body's ability to make new blood cells.
At one time it was thought that this would be a good way to
treat women with advanced breast cancer. However, several studies have
found that women who receive high-dose chemotherapy do not live any
longer than women who receive standard chemotherapy without a stem cell
transplant. High-dose chemotherapy with stem cell transplant also
causes more serious side effects than standard dose chemotherapy.
Research is still being done in this area. Although newer
studies may show a benefit, it is likely to be small, and the toxicity
from this treatment is very high. At this time, most experts recommend
that women with breast cancer not receive high-dose chemotherapy,
except as part of a clinical trial.
Last Medical Review: 09/18/2009 Last Revised: 09/18/2009
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