Abstract
Autologous hematopoietic progenitor-cell support (AHPCS), derived from bone marrow or from peripheral blood progenitor cells (PBPCs), allows for the dose escalation of chemotherapy up to 10-fold, exploiting the dose-response effect of alkylators and other drugs. While AHPCS circumvents myelosuppression, extramedullary organ toxicities become dose limiting. These substantial dose increments clearly increase the antitumor activity of high-dose chemotherapy (HDC) compared with standard dose chemotherapy (SDC), with the goal of improving patient outcome. Widespread substitution of PBPCs for bone marrow support and other improvements in patient care have increased the safety of HDC to current treatment-related mortality (TRM) rates below 5%. Since the advent of modern cisplatin-based chemotherapy, cure rates for metastatic germ-cell tumors have reached 70-80%. The standard first-line regimen of bleomycin/etoposide/cisplatin yields long-term event-free survival rates of 90% in advanced-disease good-risk patients.
Original language | English (US) |
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Title of host publication | Thomas' Hematopoietic Cell Transplantation |
Subtitle of host publication | Fifth Edition |
Publisher | Wiley-Blackwell |
Pages | 739-750 |
Number of pages | 12 |
Volume | 2-2 |
ISBN (Electronic) | 9781118416426 |
ISBN (Print) | 9781118416006 |
DOIs | |
State | Published - Jan 1 2016 |
Keywords
- Autologous stem-cell transplantation
- Breast cancer
- Germ-cell tumor
- High-dose chemotherapy
- Testicular cancer
ASJC Scopus subject areas
- General Medicine