High-dose chemotherapy with peripheral blood progenitor autografting.
Mobilized PBPs are an acceptable alternative to ABMT for hematopoietic rescue following high-dose therapy (table 10-3). Platelet recovery appears to be faster following PBPs than ABMT. In most series, leukocyte recovery is also accelerated, but this may be particularly due to the use of colony-stimulating factor. Morbidity and mortality also appear to be reduced. The optimal mobilization methodology is not defined, but larger numbers of PBPs are mobilized by chemotherapy plus colony-stimulating factors compared to CSFs alone, at the cost of enhanced toxicity. The use of PBPs has also facilitated the study of very-high-intensity regimens in which multiple courses of high-dose chemotherapy are given at very short intervals. Following completion of feasibility studies, prospective random assignment trials will be necessary to determine the benefit, if any, of this approach.
Crown
J P
JP
St. Vincents Hospital, Dublin, Ireland.
Fennelly
D
D
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002469:Cell Separation; D003131:Combined Modality Therapy; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D014182:Transplantation, Autologous
D000970:Antineoplastic Agents; D016178:Granulocyte-Macrophage Colony-Stimulating Factor