Hematopoietic cell transplantation for germ cell tumors and other adult solid tumors

High-dose chemotherapy (HDC) followed by autologous hematopoietic stem cell transplantation (ASCT) allows for dose escalation of chemotherapy to maximize the antitumor activity in chemosensitive malignancies, including lymphomas, myeloma, and certain solid tumors. Use of peripheral blood progenitor cells (PBPCs) for bone marrow support and advances in supportive care have led to improvement in the safety of the procedure with current treatment-related mortality (TRM) rates less than 5%. At the present time, HDC with ASCT is widely used for relapsed or refractory germ cell tumors (GCTs). In contrast, its use for other solid tumors, such as breast cancer or ovarian cancer, has largely disappeared in the last decade, given the broad perception of an overall lack of benefit. Allogeneic hematopoietic stem cell transplantation remains an investigational approach for certain solid tumors, where there appears to have a graft-versus-tumor effect, such as renal cell carcinoma. This chapter will review the updated results of stem cell transplantation in solid malignancies, with a particular emphasis on GCT.