One study on bone marrow transplants for women with breast cancer casts doubt on the procedure and has experts calling for its rejection as a method of treating the disease.

Friday, March 24, 2000

One study on bone marrow transplants for women with breast cancer casts doubt on the procedure and has experts calling for its rejection as a method of treating the disease.

Sen. Pat Piper (DFL-Austin), who authored legislation that would require insurance companies to pay for bone marrow transplants as an experimental procedure for women with breast cancer, says in light of the new research she doesn’t regret pushing for the law.

Researchers have found that among women whose breast cancer had spread, patients who received bone marrow transplants along with high doses of chemotherapy do not survive longer or have a longer time of progression of the disease than many patients who get regular chemotherapy for two years.

The study was set to be published in the New England Journal of Medicine on April 13. The journal already has released the study on its Web site.

Piper defends her bill, passed years ago, as a way to get women the best possible care.

"I have some friends who have benefited from bone marrow transplant and are doing quite well," she said. "We must remember this is only one study. Maybe we’ll find other studies to show this method to be effective. I don’t know. At any rate, women should be able to benefit from all of the options and we should explore those to find out what works and what doesn’t."

Dr. Marcia Angell, the journal’s editor-in-chief, said the report out of South Africa that showed some benefit in the procedure later turned out to be fraudulent. Angell made the report available early, she says, because the South African study "left a lot of concern and confusion among women and insurers who weren’t sure whether to cover it."

A total of 199 patients took part in the study and after three years, there was no significant difference in the survival of the groups or in how long the treatment kept the cancer from recurring.

"It’s true that it is no better than the standard treatment and that’s a disappointment," said Dr. John K. Erban, chief of hematology and oncology at New England Medical Center and a co-author of the study.

The transplant treatment might be preferable for some women because it can be completed in three weeks, he said. Conventional chemotherapy takes two years and often is undesirable for some women, he said.

There may be a very small number of patients who might still benefit following a marrow transplant, Erban said.

In an accompanying editorial in the journal, Dr. Marc E. Lippman wrote, "This form of treatment for women with metastatic breast cancer has been proved to be ineffective and should be abandoned in favor of well-justified alternative experimental approaches." Lippman is a physician associated with the Lombardi Cancer Center in Washington.