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We report on the prognostic significance of tumorbiologic parameters and CD34 +  cell dose in 120 patients with metastatic breast cancer (MBC) who received high‐dose chemotherapy (HDCT) with autologous blood stem cell transplantation as first‐line treatment. Her2/neu, p53, Ki67, and bcl‐2 protein expression were studied using immunohistochemical staining on formalin‐fixed, paraffin‐embedded primary tumor sections. DNA content of tumor cells (DNA‐index) and tumor cell proliferation (S‐phase fraction) were measured by DNA flow cytometry. The relationship between these parameters and the CD34 +  cell dose and progression free (PFS) and overall survival (OS) was analyzed.  With a median follow‐up period of 40 months (range, 7‐89 months), no more than two metastatic sites (relative risk [RR] = 3.84 [95% confidence interval (CI) 1.49‐10];  p  =.005) and hyperploidy (RR = 2.58 [95% CI 1.26‐5.26];  p  =.009) were independent predictors of longer PFS according to multivariate analysis. Independent prognostic factors of longer OS included one or two metastatic sites (RR = 4.16 [95% CI 1.96‐4.16]; p &lt;.001), a positive combined hormone receptor status (RR = 2.45 [95% CI 1.45‐4.14];  p  =.001) and a high number of infused stem cells (&gt;7.8 × 10 6  CD34 +  cells per kg body weight) (RR = 2.0 [95% CI 1.17‐3.42];  p  =.01).  In conclusion, positive hormone receptors, ≤2 metastatic sites, high DNA‐index and high CD34 +  cell dose (&gt;7.8 × 10 6  CD34 +  cells per kg) are predictors for a favorable outcome after autotransplantation for MBC. Our observation might indicate a favorable effect of HDCT in MBC patients with overexpression of Her2/neu who might have a worse prognosis when treated with conventional chemotherapy.

stem cells

Stem Cell Dose and Tumorbiologic Parameters as Prognostic Markers for Patients with Metastatic Breast Cancer Undergoing High‐Dose Chemotherapy with Autologous Blood Stem Cell Support