[High-dose chemotherapy and autologous bone marrow transplantation in solid tumors. A review]

This review deals with high-dose chemotherapy plus haematopoietic stem cell support as treatment to patients with chemosensitive solid tumours, breast-, testicular-, small cell lung-, and ovarian cancer. Dose-intensification of cytotoxic agents without stem cell support has not increased survival in these patients. High-dose chemotherapy plus stem cell support is a promising treatment strategy as adjuvant therapy in patients with high-risk breast cancer, i.e. more than 6-10 metastatic axillary lymph nodes, and there are several on-going randomized studies investigating conventional versus high-dose therapy in this situation both in Europe and in the US. Another international randomized study concerns patients with testicular cancer, where high-dose therapy is given as relapse treatment and as initial therapy in high-risk patients. High-dose therapy is an experimental treatment in all solid tumours, but there are no data supporting randomized studies in other solid tumours.