Summary
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.
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Kornick WB, Montano A, Gerdes JC, Feder BH: Preliminary observations on the treatment of postirradiation hematopoietic depression in man by the infusion of stored autogenous bone marrow. Ann Intern Med 49:973–986, 1958
McFarland WF, Granville WB, Dameshek W: Autologous bone marrow infusion as an adjunct in therapy of malignant disease. Blood 260:675–683, 1959
McGovern JJ Jr, Russell PS, Atkins L, Webster E: Treatment of terminal leukemia relapse by total body irradiation and intravenous infusion of stored autologous bone marrow obtained during remission. N Eng J Med 260:675–683, 1959
Newton LA, Humble JB, Wilson CW, Pegg DE, Skinner MEG: Total thoracic supervoltage irradiation followed by the intravenous infusion of stored autogenous marrow. Br Med J 1:531–535, 1959
Clifford P, Clift RA, Duff JK: Nitrogen mustard therapy combined with autologous marrow infusion. Lancet 1:687–690, 1961
Pegg DE, Humble JG, Newton KA: The clinical application of bone marrow grafting. Br J Cancer 16:417–435, 1962
Henderson ES, Samayo RJ: Evidence that drugs in multiple combinations have materially advanced the treatment of human malignancies. Cancer Res 29:2272–2280, 1969
DeVita VT, Serpick A, Carbone PP: Combination chemotherapy in the treatment of advanced Hodgkin's disease. Ann Intern Med 73:881–895, 1970
Cohen MH, Creavan PJ, Fossieck BE Jr, Broder LE, Selawry OS, Johnston AV, Williams Cl, Minna JD: Intensive chemotherapy of small cell bronchogenic carcinoma. Cancer Treat Rep 61:349–354, 1977
Young RC, Chabner BA, Hubbard SP, Canellos GP, DeVita VT: Preliminary results of trials of chemotherapy in advanced ovarian carcinoma. Natl Cancer Inst Monogr 42:145–148, 1975
DeVita VT Jr, Young RC, Canellos GP: Combination versus single agent chemotherapy: a review of the basis for selection of drug treatment of cancer. Cancer 35:98–110, 1975
Thomas ED, Buckner CD, Banaji M, Cliff RA, Fefer A, Flournay W, Goodell B, Hickman RD, Lerner KG, Weiman PE, Sale GE, Sanders JE, Singer J, Stevens M, Sturb R, Weiden PL: One hundred patients with acute leukemia treated by chemotherapy, total body irradiation, and allogeneic marrow transplantation. Blood 49:511–533, 1977
Thomas ED, Sturb R, Cliff RA, Fefer A, Johnson L, Neiman PE, Lerner KG, Glucksburg H, Buckner CD: Bone marrow transplantation. N Eng J Med 292:832–902, 1975
Thomas ED, Sturb R: Technique for human marrow grafting. Blood 36:507–515, 1970
Urso P, Congdon CC: The effect of the amount of isologous bone marrow injected on the recovery of hematopoietic organs, survival, and body weight after lethal irradiation injury in mice. Blood 12:251–258, 1957
Gorin NC, Herzig, Bull MI, Graw RG: Long term preservation of bone marrow and stem cell pool in days. Blood 51:257–265, 1978
Van Patten LM: Quantitative aspects of the storage of bone marrow cells for transplantation. Eur J Cancer 1:15–22, 1965
Anner RM, Dewinklo BD: Frequency and significance of bone marrow involvement by metastatic solid tumors. Cancer 39:1337–1344, 1977
Barnes DWH, Lootit JF: The radiation recovery factor: preservation by the Polge-Smith-Parks technique. J Natl Cancer Inst 15:901–5, 1954
Ashwood-Smith MJ, Farrat J: Low Temperature Preservation in Medicine and Biology. University Park Press Baltimore, 1980
Pegg DE: Long term preservation of cells and tissues. J Clin Path 29:271–285, 1976
Schlater M: Drugs that modify cellular responses to low temperature. Fed Proc 36:2950–2959, 1972
Major P: Cryobiology: The freezing of biological systems. Science 168:939–949, 1970
Frei E III, Canellos GP: Dose: a critical factor in cancer chemotherapy. Am J Med 69:585–593, 1980
Brindley CO, Salvin LG, Potee KG, Lipowska B, Shinder BI, Regelson W, Colsky J: Further comparative trial of thio-phosphoramide and mechlorethamine in patients with melanoma and Hodgkin's disease. J Chronic Dis 17:19, 1964
Frei E III, Spurr CL, Brindley CO, Selawry D, Holland JF, Rall DP, Wasserman LR, Houystralen B, Shnider BI, McIntyre OR, Matthews LB, Miller SP: Clinical studies of dichloromethotrexate (NSC 29630). Clin Pharmacol Ther 6:160–171, 1965
Cullen MH, Creaven PS, Fossieck JR, Brodes LE, Dewary OS, Johnston AR, Williams CL, Minna JD: Intensive chemotherapy of small cell bronchogenic carcinoma. Cancer Treat Rep 61:349–353, 1977
Pinkel D, Harnandez K, Bovella L, Holton C, Aur R, Samoy G, Pratt C: Drug dose and remission duration in childhood lymphocytic leukemia. Cancer 27:247–256, 1971
Gehan E., Coltman C: Southwest Oncology Group unpublished observations, 1980
Bonadonna G, Valagossa P: Dose response effect of CMF in breast cancer. Proc Am Soc Clin Onc 21:413, 1980 (Abstract)
DeVita VT, Serpick AA, Carbone PP: Combination chemotherapy in the treatment of advanced Hodgkin's disease. Ann Int Med 73:881–895, 1970
Young RC, Canellos GP, Chabner BA, Schein PS, DeVita VT: Maintenance chemotherapy for advanced Hodgkin's disease in remission. Lancet 1:1339, 1973
Lewis BJ, DeVita VT: Combination chemotherapy of the lymphomas. Semin Hematol 15:431–462, 1978
Bross I, Rimm AA, Slack WH, Ausman RK, Jones R: Is toxicity really necessary? Cancer 19:1780–1804, 1966
Tattersall MHN, Tobias JS: How strong is the case for intensive cancer chemotherapy? Lancet 2:1071–1072, 1976
Skipper HE, Schlabel FM Jr, Wilcox WS: Experimental evaluation of potential anticancer agents XII. On the criteria and kinetics associated with “curability” of experimental leukemia. Cancer Chemother Rep 35:1–111, 1964
Skipper HE: Reasons for success and failure in treatment of murine leukemias with the drugs now employed in treating human leukemias. Cancer Chemotherapy, vol. 1, University Microfilms International, Ann Arbor, MI, 1978, pp 1–166
Skipper HE, Schlabel FM Jr, Mellet LB, Montgomery JA, Willkoff LJ, Lloyd AH, Brockman RW: Implications of biochemical, cytokinetic, pharmacologic and toxicologic relationships in the design of optional therapeutic schedules. Cancer Chemother Rep 54:431–450, 1950
Bruce WR, Meeker BE, Valeriote FA: Comparison of the sensitivity of normal hematopoietic and transplanted lymphoma colony-forming cells to chemotherapeutic agents in vivo. J Natl Cancer Inst 37:233–245, 1966
Bruce WB, Valeriote FA, Merker BE: Survival of mice bearing a transplanted syngeneic lymphoma following treatment with cyclophosphamide, 5-fluorouracil, or 1,3-bis (2 chloroethyl)-1-nitrosourea. J Natl Cancer Inst 39:257–266, 1967
Steel GG: Growth and survival of tumor stem cells. In: Growth Kinetics of Tumors. Clarendon Press, Oxford, 1977, pp 244–267
Herzig GP: Autologous marrow transplantation in cancer chemotherapy. Prog Hemat 12:1–23, 1981
Salmon SE, Hamburger AW, Soehnlen B, Durie BGM, Alberts DS, Moon TE: Quantitation of differential sensitivity of human tumor stem cells to anticancer drugs. N Eng J Med 298:1321–1327, 1978
Von Hoff DD, Casper J, Bradley E, Sandbach J, Jones D, Makuch R: Association between human tumor colony forming assay results and response of an individual patient's tumor to chemotherapy. Am J Med 70:1027–1032, 1981
Selby P, Buick RP, Tannock I: A critical appraisal of the “Human Tumor Stem Cell Assay”. N Eng J Med 308:129–133, 1983
Pinedo HR, Bull JM, Zaharko DS, Chabner BA: The relative contribution of drug concentration and duration of exposure to mouse bone marrow toxicity during continuous methotrexate infusion. Cancer Res 37:445–447, 1977
Chabner BA: Pharmacological considerations in autologous bone marrow transplant regimens. In: Biology of Bone Marrow Transplantation. Academic Press, London/ New York, 1980, pp 37–143
Deisseroth A, Abrams RA: The role of autologous stem cell reconstitution in intensive therapy for resistant neoplasms. Cancer Treat Rep 63:461–471, 1979
Bodey GP, Buckley M, Sathe YS, Freireich EJ: Quantitative relationships between circulating leukocytes and infection in patients with leukemia. Ann Int Med 64:328–340, 1966
Philip T, Herve P, Racadot E, Cahn JY, Biron P, Brunat-Mentigny M, Peters A, Mayer M: Intensive cytoreductive regimen and autologous bone marrow transplantation in leukemia and solid tumors (a review). Immunology of Transplantation (Amsterdam), in press, 1983
Appelbaum FR, Herzig GP, Ziegler JL, Graw RG, Levine AS, Deisseroth AB: Successful engraftment of cryopreserved autologous bone marrow in patients with malignant lymphoma. Blood 52:85–95, 1978
Appelbaum FR, Deisseroth AB, Graw RG, Herzig GP, Levine AS, Magrath IT, Pizzo PA, Poplack DG, Ziegler JL: Prolonged complete remission following high dose chemotherapy of Burkitts lymphoma in relapse. Cancer 41:1059–1063, 1978
Pritchard J, McElwain TJ, Graham BLeJ. High-dose melphalan with autologous marrow for treatment of advanced neuroblastoma. Br J Cancer 45:86–94, 1982
Buckner CD, Rudolph RH, Fefer A, Cliff RA, Epstein RB, Funk DD, Neiman PE, Skichler JJ, Storb R, Thomas ED: High dose cyclophosphamide therapy for malignant disease. Cancer 29:357–365, 1972
Tobias JS, Weiner RS, Griffiths CT, Richman CM, Parker LM, Yankee RA: Cryopreserved autologous marrow infusion following high dose cancer chemotherapy. Eur J Cancer 13:269–277, 1977
Dover D, Champlin RE, Ho WN, Sarna GP, Wells JH, Graze PR, Cline MJ, Gale RP: High dose combined modality therapy and autologous bone marrow transplantation in resistant cancer. Am J Med 71:973–976, 1981
Gorin WC, David R, Stachowiak J, Salmon C, Petit JC, Parlier Y, Najman A, Duhamel G: High dose chemotherapy and autologous bone marrow transplantation in acute leukemias, malignant lymphomas and solid tumors. Env J Cancer 17:557–568, 1981
Bligham G, Spitzer G, Litan J, Zanter AR, Verma DS, Vellekoop L, Samuels ML, McCredle KB, Dicke KA: The treatment of advanced testicular carcinoma with high dose chemotherapy and autologous marrow support. Env J Cancer 17:443–441, 1981
Sarna GP, Champlin R, Wells J, Gale RP. Phase I study of high dose mitomycin with autologous bone marrow support. Cancer Treat Rep 66:277–282, 1982
Gale RP: Autologous bone marrow transplantation in patients with cancer. J Am Med Assoc 243:540–542, 1980
Spitzer G, Dicke KA, Litam J, Verna S, Zander A, Lanzotti V, Valdirieso M, McCredle KB, Samuels ML: High dose combination chemotherapy with autologous bone marrow transplantation in adult solid tumors. Cancer 43:3075–3085, 1980
Klatersky J, Wicaise C, Longerail E, Stryckman P, and the EOTRC Lung Cancer Working Party: Cisplatinum, adriamycin, and etoposide (CAV) for remission induction in small cell carcinoma of the lung. Cancer 50:652–658, 1982
Glade LM, Robinson WA, Hartmann DW, Klein JJ, Thomas MR, Morton W: Autologous bone marrow transplantation in the therapy of small cell carcinoma of the lung. Cancer Res 42:4270–4275, 1982
Souhami RL, Harper PG, Linch D, Trask C, Golstone AH, Tobias JL, Spiro SG, Gedeles DM, Richards JDM: High dose cyclophosphamide with autologous marrow transplantation as initial treatment of small cell carcinoma of the bronchus. Cancer Chemother Pharmacol 8:31–34, 1982
Dicke KA, Vellekoop L, Spitzer G, Zander AR, Schell F, Verma DS: Autologous bone marrow transplantation in neoplasia. In: Biology of Bone Marrow Transplantation, Academic Press Inc., London/New York, 1980, pp 159–165
Zander AR, Spitzer G, Vellekoop L, Verma D, Minhaar G, Dicke KA: New developments in bone marrow transplantation. Cancer Bull 33:286–295, 1981
McElwain TJ, Hedley DW, Burton G, Clink HM, Gordon MY, Jarman M, Juttner CA, Millar JL, Milstead RAV, Prentice G, Smith IE, Spence D, Woods M: Marrow autotransplantation accelerates haematological recovery in patients with malignant melanoma treated with high dose melphalan. Br J Cancer 40:72–80, 1979
Knight WA III, Page CP, Kuhn JG, Clark GM, Bell BS, Newcomb TF: High dose melphalan with autologous bone marrow infusion in Dukes D colorectal carcinoma. Proc Am Soc Clin Oncol 2:118, 1983 (Abstract)
Phillips GL, Fay JW, Herzig GP, Herzig RH, Weiner RS, Wolff SN, Lazarus HM, Karanes C, Ross WE, Kramer BS. A Phase I–II study: intensive BCNU and cryopreserved autologous marrow transplantation for refractory cancer. Cancer, 1983, in press
Hronin PA, Mahaley MS, Rudnick SA: Prediction of BCNU toxicity in patients with malignant glioma: an assessment of risk factors. N Eng J Med 303:183–188, 1980
Spitzer G, Dicke KA, Verma DS, Zander A, McCredle KB: High dose BCNU therapy with autologous bone marrow infusion. Cancer Treat Rep 63:1257–1264, 1979
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Clinical Fellow of the American Cancer Society
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LeMaistre, C.F., Knight, W.A. High dose chemotherapy with autologous marrow rescue in the treatment of resistant solid tumors. Invest New Drugs 1, 321–329 (1983). https://doi.org/10.1007/BF00177416
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DOI: https://doi.org/10.1007/BF00177416