High-dose chemotherapy and autologous transplant with peripheral-blood stem cells

The use of high-dose chemotherapy with autologous bone marrow transplantation has expanded over the last decade; however, patients who have tumor involvement in their bone marrow or who have received previous pelvic irradiation are frequently excluded from consideration for this therapy due to the inability to harvest an adequate rescue product. The ability to collect autologous peripheral-blood progenitors has allowed the expansion of this therapy to these two patient populations. Also, as experience using peripheral-blood progenitors has grown, it has become apparent that in some patient populations, engraftment times may be significantly shortened by their use, either alone or in combination with autologous bone marrow. This type of hematopoietic rescue following high-dose chemotherapy has now been used in a number of studies for the treatment of a variety of malignancies. Various mobilization and cell selection techniques are currently being evaluated for further refinement of this technique.