Autologous bone marrow transplantation in solid tumors

The design and results of recent studies of high-dose therapy in metastatic breast cancer, early-stage breast cancer, stage IV neuroblastoma, recurrent or bulky disease and testicular cancer, particularly the proportion of long-term disease-free survivors, are described. The outcome in these subgroups with conventional therapy is described for comparison. The results of these studies suggest that high-dose therapy with autologous marrow support increases the proportion of patients with long-term survival without evidence of disease. Newer supportive care approaches with recombinant growth factors and mobilized peripheral blood cells and recurrent high-dose therapy cycles of non-cross resistant regimens may improve outcome further in these diseases and increase the application to more resistant tumors. The controversy about the importance of and the unexpected high frequency of marrow contamination is outlined.