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Marrow transplants don't work for breast cancer

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Few stories in medicine are as sobering as the American experience with autologous bone marrow transplantation (ABMT) for treating breast cancer

Few stories in medicine are as sobering as the American experience with autologous bone marrow transplantation (ABMT) for treating breast cancer. It has been a disaster.


It was suggested that a combination of bone marrow transplants and very high doses of anticancer drugs could pulverise breast cancer into submission. But legal wranglings over who should foot the bill for the high cost of this supposed treatment, as well as the findings of major randomised trials that didn't support the use of the therapy, conspired to scuttle this establishment approach to breast cancer treatment from the start.


So, what lessons has the US medical establishment learned from this sorry episode? For one, you can't say a treatment is cost-effective when its effectiveness hasn't been proven in the first place.


For another, defining what is 'experimental' is an important government job, and should clarify financial support of major trials.


Finally, the media also has a 'watchdog' role to play in making sure new treatments are all they're cracked up to be (BMJ, 2002; 324: 1088-92).


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