High dose chemotherapy with autologous marrow rescue in the treatment of resistant solid tumors

Abstract

Toxicity in the form of marrow suppression has hampered the investigation of intensive chemotherapy as it applies to the treatment of solid tumors. The use of autologous marrow rescue to ameliorate protracted aplasia permits the application of high dose chemotherapy to the treatment of solid tumors. We review the theoretical limitations of this technique and present results reported in selected solid tumors. Autologous marrow rescue from intensive chemotherapy is an innovative approach in overcoming the resistence to chemotherapy that is typical of solid tumors. The role of this therapy in the treatment of solid tumors remains to be defined.

Dexamethasone increases angiopoietin‐1 and quiescent hematopoietic stem cells: A novel mechanism of dexamethasone‐induced hematoprotection

“…Hematopoietic suppression is the major dose-limiting toxicity of many anticancer chemotherapy agents [1]. Glucocorticoid pretreatment has been shown to protect hematopoietic stem cells (HSCs) from bone marrow-suppressing chemotherapy in mice [2] and humans [3].…”

Rapid and complete hemopoietic reconstitution following combined transplantation of autologous blood and bone marrow cells. A changing role for high dose chemo‐radiotherapy?

“…For these reasons, they require vigorous supportive measures such as blood component transfusions, protected environment and systemic antibacterial, antifungal and antiviral prophylaxis and/or treatment. Even the less demanding autologous bone marrow transplantation remains a complex therapeutic procedure that should be restricted to specialized centers because of substantial morbidity and mortality (LeMaistre and Knight, 1983). This is probably the reason why physicians are reluctant to refer patients ultimately incurable with standard therapy but initially responsive to less toxic regimens.…”