High-dose chemotherapy: therapeutic potential in the age of growth factor support

The steep dose-response curve for most chemotherapeutic drugs and the need to overcome tumor resistance has resulted in renewed interest in the use of high-dose chemotherapy. Bone marrow rescue has allowed the dose-limiting barrier of hematopoietic suspension to be overcome. However, despite such salvage methods and the use of blood products and effective antibiotics, myelosuppression remains a major obstacle to treatment. The use of recombinant colony-stimulating factors in combination with bone marrow following high-dose chemotherapy may well shorten the period of neutropenia and reduce the frequency of neutropenia-related complications, thus making high-dose treatment more acceptable.