Several malignancies have shown a dose-response relationship. The hematopoietic toxicity of dose escalations is often rescued by bone marrow transplantation. Prolonged disease-free survival can now be expected for patients with lymphoma, Hodgkin's disease, leukemia and breast cancer when high-dose cytotoxic therapy (high dose CT) is followed by autologous bone marrow transplant (AuBMT). Bone marrow (BM) and/or peripheral blood (PB) can be cryopreserved before high-dose CT and are utilized for stem cells rescue for AuBMT. Clinical trials of patients with lymphoma, leukemia, Hodgkin's disease, and breast cancer have proven the importance of timing the induction and high-dose CT, and properly sequenced therapy has resulted in prolonged disease-free survival in these patients. The rationale for high-dose cytotoxic therapy, methods of stem cells cryopreservation, the complications of high-dose CT, and results of treatment for various malignancies are briefly detailed with emphasis on designing future trials. Carefully designed trials have proven the usefulness of AuBMT and offer a promising approach to the future of cancer chemotherapy.
